Conocer costos en atención de salud: Una necesidad imperativa

Jiménez, Jorge Luis López; Cid, Camilo

doi:10.4067/s0718-85602011000300006

Cited by 3 publications

(3 citation statements)

References 2 publications

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“…Una limitación del presente análisis es, particularmente, la subestimación de las canastas. En la estimación del sector público esto se explica porque los aranceles de FONASA subestiman el valor real de distintas prestaciones 36,37 . Se ha reportado que estos valores de prestaciones son hasta 2,285 veces mayores de lo que se informa en el MAI [38][39][40] .…”

Section: Discussionunclassified

El costo esperado de cáncer en Chile

et al. 2022

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The expected cost of cancer in ChileBackground: Cancer is a public health priority in Chile. Aim: To estimate the expected annual cost of cancer in Chile, due to direct costs of health services, working allowances and indirect costs for productivity losses. Material and Methods: We undertook an ascendent costing methodology to calculate direct costs. We built diagnostic, treatment and follow-up cost baskets for each cancer type. Further, we estimated the expenditure due to sick leave subsidies. Both estimates were performed either for the public or private sector. Costs related to productivity loss were estimated using the human capital approach, incorporating disease related absenteeism premature deaths. The time frame for all estimates was one year. Results: The annual expected costs attributed to cancer was $1,557 billion of Chilean pesos. The health services expected annual costs were $1,436 billion, 67% of which are spent on five cancer groups (digestive, hematologic, respiratory, breast and urinary tract). The expected costs of sick leave subsidies and productivity loss were $48 and $71 billion, respectively. Conclusions: Cancer generates costs to the health system, which obliges health planners to allocate a significant proportion of the health budget to this disease. The expected costs estimated in this study are equivalent to 8.9% of all health expenditures and 0.69% of the Gross Domestic Product. This study provides an updated reference for future research, such as those aimed at evaluating the current health policies in cancer.

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Section: Discussionunclassified

El costo esperado de cáncer en Chile

et al. 2022

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“…and Cid [33] and Gutierrez and Medina [34]. Unfortunately, those 'better sources' are not available.…”

Section: Discussionmentioning

confidence: 99%

A Model-Based Economic Evaluation of Cladribine Versus Alemtuzumab, Ocrelizumab and Natalizumab for the Treatment of Relapsing-Remitting Multiple Sclerosis with High Disease Activity in Chile

Espinoza

Rojas²,

Zaupa

et al. 2021

PharmacoEconomics Open

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The aim of this study was to evaluate the cost effectiveness of cladribine compared with alemtuzumab, natalizumab, and ocrelizumab for the treatment of highly active multiple sclerosis (HAD-MS) from the perspective of the Chilean health care public sector. Materials and Methods A Markov model was used to compare costs and quality-adjusted life-years (QALYs) over a 45-year time horizon using a 3% discount rate for costs and outcomes. Natural history of the disease was modeled in terms of progression of disability according to the Expanded Disability Status Scale (EDSS). A network meta-analysis was used as a source of comparative effectiveness for disability progression and annual relapse rates. Differences in costs and outcomes were modeled for only 10 years due to high temporal uncertainty. Ocrelizumab was assumed to have the same efficacy as cladribine due to lack of data. Direct costs were taken from national tariffs and expressed in 2019 US dollars. Utilities for EDSS health states were obtained from the literature. Second-order uncertainty was characterized through deterministic and probabilistic sensitivity analysis. Findings Compared with natalizumab (the current strategy covered in Chile), cladribine is associated with incremental costs and QALYs of US$70,989 and 1.875, respectively (incremental cost-effectiveness ratio [ICER] $37,861). Ocrelizumab was extendedly dominated by cladribine and natalizumab, and alemtuzumab was dominated by cladribine. A scenario analysis of a 10% discount did not modify the results substantially, but showed a decrease in the ICER of cladribine versus natalizumab (ICER $29,833/QALY). Implications Cladribine is a new oral alternative to treat patients with HAD-MS that is expected to produce higher QALYs than all evaluated alternatives. In the context of a conservative analysis, cladribine cannot be considered cost effective for the Chilean health care public sector using a 1 GDP per capita threshold. However, under reasonable discount scenarios, cladribine becomes an attractive alternative for the health system.

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“…On the other hand, the epidemiological situation and the scarcity of resources in low-and middle-income countries imply evaluating different means for implementing these changes at the lowest possible cost. For these reasons, it is increasingly necessary to base decisionmaking on studies with a medical and economic perspective [11][12][13][14][15][16][17][18] .…”

Section: Introductionmentioning

confidence: 99%