Estimativas de custo da hepatite crônica B no sistema único de saúde Brasileiro em 2005

Castelo, Adauto; Barreto, Tânia C.B.B.; Alves, Marcia Regina Dias; Araújo, Denizar Vianna

doi:10.1590/s0104-42302007000600013

Cited by 23 publications

(14 citation statements)

References 9 publications

(9 reference statements)

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“…The annual costs per patient with CC, DC and CHC, used in the analysis, were extracted from a local study [13] concerning the cost of CHB in 2005, in Brazil, based on SUS information. The objective of that study was to describe the standard treatment, the use of resources and the direct costs for each stage of CHB in the SUS system, in 2005.…”

Section: Annual Costs Due To the Chb Complicationsmentioning

confidence: 99%

Cost-effectiveness of entecavir versus lamivudine for the suppression of viral replication in chronic hepatitis B Patients in Brazil

Costa¹,

L.'Italien²,

Nita³

et al. 2008

Braz J Infect Dis

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Section: Annual Costs Due To the Chb Complicationsmentioning

confidence: 99%

Cost-effectiveness of entecavir versus lamivudine for the suppression of viral replication in chronic hepatitis B Patients in Brazil

Costa¹,

L.'Italien²,

Nita³

et al. 2008

Braz J Infect Dis

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“…e Annual spending per patient, according to the stages of the disease, were obtained from a 2005 study evaluating the direct costs of CHB in Brazil. 3 The values were corrected sing the National Consumer Price Index (IPCA) for 2011. The costs included medical fees, laboratory tests, diagnostic and therapeutic procedures, hospitalizations and spending on non-anti-viral medicines.…”

Section: Methodsmentioning

confidence: 99%

Antivirais incorporados no Brasil para hepatite B cronica: analise de custo-efetividade

et al. 2013

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OBJECTIVE:To evaluate the cost-effectiveness of different drug therapies for chronic hepatitis B in adult patients. METHODS:Using a Markov model, a hypothetical cohort of 40 years for HBeAg-positive or HBeAg-negative patients was constructed. Adefovir, entecavir, tenofovir and lamivudine (with rescue therapy in cases of viral resistance) were compared for treating adult patients with chronic hepatitis B undergoing treatment for the first time, with high levels of alanine aminotransferase, no evidence of cirrhosis and without HIV co-infection. Values for cost and effect were obtained from the literature, and expressed in effect on life years (LY). A discount rate of 5% was applied. Univariate sensitivity analysis was conducted to assess model uncertainties. RESULTS:Initial treatment with entecavir or tenofovir showed better clinical outcomes. The lowest cost-effectiveness ratio was for entecavir in HBeAgpositive patients (R$ 4,010.84/LY) and lamivudine for HBeAg-negative patients (R$ 6,205.08/LY). For HBeAg-negative patients, the incremental cost-effectiveness ratio of entecavir (R$ 14,101.05/LY) is below the threshold recommended by the World Health Organization. Sensitivity analysis showed that variation in the cost of drugs may make tenofovir a cost-effective alternative for both HBeAg-positive and HBeAg-negative patients. CONCLUSIONS:Entecavir is the recommended alternative to start treating patients with chronic hepatitis B in Brazil. However, if there is a reduction in the cost of tenofovir, it can become a cost-effective alternative.

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“…17 In this study, direct costs were analysed and calculated in real (R$). The annual cost per patient with compensated cirrhosis, decompensated cirrhosis and hepatocellular carcinoma were taken from the 2005 study by Castelo et al, 4 which evaluated direct costs of CHB in Brazil. These costs included: fees, doctors, laboratory tests, diagnostic and therapeutic procedures, hospital admissions and spending on non-antiviral medicine.…”

Section: Parametresmentioning

confidence: 99%

Custo-efetividade dos análogos de nucleosídeos/nucleotídeos para hepatite crônica B

Almeida¹,

Silva²,

Ruas³

et al. 2012

Rev. Saúde Pública

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OBJECTIVE:To conduct a cost-effectiveness analysis of drug alternatives with rescue therapy in case of relapse due to viral resistance for the treatment of patients with chronic hepatitis B (CHB). METHODS:Hypothetical cohort of patients with CHB, HBeAg-negative, without clinical or histological evidence of cirrhosis, detectable HBV DNA, histological diagnosis of the disease, positive serum HBsAg for longer than six months, high levels of alanine aminotransferase (ALT) (twice as high as the upper limit of normality) and mean age of 40 years. A Markov model was developed for chronic hepatitis B (HBeAg-negative) with a 40-year time horizon. Costs and benefi ts were discounted at 5%. Annual rates of disease progression, costs due to complications and the effi cacy of medicines were obtained from the literature. One-way and probabilistic sensitivity analysis evaluated uncertainties. RESULTS:Initiation of treatments with entecavir resulted in an increase of 0.35 discounted life-years gained compared to lamivudine. The incremental cost-effectiveness ratio was R$ 16,416.08 per life-years gained. In the sensitivity analysis, the incremental cost-effectiveness ratio was more sensitive to variation in the probability of transition from chronic hepatitis B to compensated cirrhosis, discount rate and medicine prices (± 10%). In the probabilistic sensitivity analysis, the acceptability curve showed that beginning treatment with entecavir was the most cost-effective alternative in comparison with the use of lamivudine. CONCLUSIONS:The availability of entecavir is economically attractive as part of early treatment for patients with chronic hepatitis B without HIV co-infection. Cost-effectiveness: chronic hepatitis B Almeida AM et al Chronic hepatitis B (CHB) is a serious public health problem which affects between 350 and 400 million people worldwide. DESCRIPTORS:2 A population based prevalence study of hepatitis B infection in Brazil revealed endemic levels > 1% across all the capital cities of each region and of the Federal District. The overall prevalence of HbsAg in the Brazilian state capitals was 0.37% (95%CI 0.25;0.50). The prevalence of this marker was 0.055% (95%CI 0.012;0.10) in the ten to 19 year old age group and of 0.6% (95%CI 0.41;0.78) for the 20 to 69 year old age group. The North showed the highest results for both age groups.a Treatment, when prescribed, is critical in avoiding progression and complications of the disease such as compensated cirrhosis, decompensated cirrhosis and hepatocellular carcinoma. a Treatment costs become signifi cantly higher with the high morbidity and mortality of patients in advanced stages of the disease, as serious hepatic complications increase the complexity of treatment and the risk of death. 23In Brazil, until 2009, the guidelines from advocated interferon and lamivudine for the treatment of CHB. Currently, drugs such as adefovir, entecavir and tenofovir are also included. b A systematic review 1 showed adefovir, entecavir and telbivudina effectiveness to be similar ...

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Estimativas de custo da hepatite crônica B no sistema único de saúde Brasileiro em 2005

Cited by 23 publications

References 9 publications

Cost-effectiveness of entecavir versus lamivudine for the suppression of viral replication in chronic hepatitis B Patients in Brazil

Cost-effectiveness of entecavir versus lamivudine for the suppression of viral replication in chronic hepatitis B Patients in Brazil

Antivirais incorporados no Brasil para hepatite B cronica: analise de custo-efetividade

Custo-efetividade dos análogos de nucleosídeos/nucleotídeos para hepatite crônica B

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