Cost-Utility of Reduction Mammaplasty Assessed for the Brazilian Public Health System

Araújo, Carlos Delano Mundim; Veiga, Daniela Francescato; Hochman, Bernardo; Abla, Luiz Eduardo Felipe; Oliveira, Ana Carolina Salles; Novo, Neil Ferreira; Veiga-Filho, Joel; Ferreira, Lydia Masako

doi:10.1177/1090820x14539972

Cited by 19 publications

(17 citation statements)

References 34 publications

(52 reference statements)

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“…Reduction mammoplasty (RM) is commonly performed to both reduce breast weight and volume and reposition the breasts, which improves the HRQoL of the patient. Several randomized studies have demonstrated the effectiveness and cost-effectiveness of RM (1, 4, 5). The procedure is also reported to increase HRQoL regardless of the patient’s body mass index (BMI) (6).…”

Section: Introductionmentioning

confidence: 99%

Overweight is Associated With Increased Incidence of Minor Complications After Reduction Mammoplasty: A Retrospective Analysis of 453 Consecutive Cases

2018

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Section: Introductionmentioning

confidence: 99%

Overweight is Associated With Increased Incidence of Minor Complications After Reduction Mammoplasty: A Retrospective Analysis of 453 Consecutive Cases

2018

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“…A significant portion of the Brazilian population depends on the Brazilian public health system (Sistema Único de Saúde - SUS), which is often the only option for women with breast hypertrophy. Araújo et al studied the cost-utility relationship of reduction mammoplasty performed by the SUS and found that there was a positive relationship, justifying the need to mobilize resources for this type of procedure ( 34 ).…”

Section: Discussionmentioning

confidence: 99%

Outcomes analysis of breast reduction in Brazilian women using the BREAST-Q® questionnaire: a cross-sectional controlled study

Andrade¹,

Veiga²,

Aguiar³

et al. 2018

Clinics

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OBJECTIVE:The aim of this study was to analyse patient-reported outcomes of reduction mammoplasty among Brazilian women.METHODS:A total of 100 women were enrolled in this cross-sectional controlled study, 50 with breast hypertrophy (Hypertrophy Group) and 50 who had undergone breast reduction at least six and up to 12 months before (Mammoplasty Group). The Brazilian version of the BREAST-Q® was applied to assess patient-reported outcomes. The module reduction/mastopexy was used, and the preoperative and postoperative versions were applied to the hypertrophy and mammoplasty groups, respectively.RESULTS:The mammoplasty group presented higher scores for the subscales satisfaction with breasts, psychosocial well-being, sexual well-being and physical well-being (p=0.0001 for all of these subscales).CONCLUSION:These results suggest that patients submitted to reduction mammoplasty are satisfied with the outcomes and present better quality of life scores compared with women with breast hypertrophy.

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“…In fact, few Brazilian studies have been published on health economics, 5,7,28,36,40 and none of them related to spine care in neurosurgery or orthopedics. Some countries have established that thresholds of what should be cost-effective: $50,000.00-$100,000.00 per QALY in the US, 41 Can$20,000.00-$40,000.00 in Canada, 23 and £20,000.00-£30,000.00 in the United Kingdom.…”

Section: Discussionmentioning

confidence: 99%

“…Also, it must be noted that the utility gain for patients from public and private health care systems would not be similar. 5 To date, there have been no published data on utility gain after LDH surgery in the Brazilian public health care system. Future studies are needed to address this issue and provide data on economic evaluation of LDH treatment in the Brazilian public health care system.…”

Section: Discussionmentioning

confidence: 99%

Economic value of treating lumbar disc herniation in Brazil

Falavigna

Scheverin²,

Righesso

et al. 2016

SPI

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OBJECT Lumbar discectomy is one of the most common surgical spine procedures. In order to understand the value of this surgical care, it is important to understand the costs to the health care system and patient for good results. The objective of this study was to evaluate for the first time the cost-effectiveness of spine surgery in Latin America for lumbar discectomy in terms of cost per quality-adjusted life year (QALY) gained for patients in Brazil. METHODS The authors performed a prospective cohort study involving 143 consecutive patients who underwent open discectomy for lumbar disc herniation (LDH). Patient-reported outcomes were assessed utilizing the SF-6D, which is derived from a 12-month variation of the SF-36. Direct medical costs included medical reimbursement, costs of hospital care, and overall resource consumption. Disability losses were considered indirect costs. A 4-year horizon with 3% discounting was applied to health-utilities estimates. Sensitivity analysis was performed by varying utility gain by 20%. The costs were expressed in Reais (R$) and US dollars ($), applying an exchange rate of 2.4:1 (the rate at the time of manuscript preparation). RESULTS The direct and indirect costs of open lumbar discectomy were estimated at an average of R$3426.72 ($1427.80) and R$2027.67 ($844.86), respectively. The mean total cost of treatment was estimated at R$5454.40 ($2272.66) (SD R$2709.17 [$1128.82]). The SF-6D utility gain was 0.044 (95% CI 0.03197–0.05923, p = 0.017) at 12 months. The 4-year discounted QALY gain was 0.176928. The estimated cost-utility ratio was R$30,828.35 ($12,845.14) per QALY gained. The sensitivity analysis showed a range of R$25,690.29 ($10,714.28) to R$38,535.44 ($16,056.43) per QALY gained. CONCLUSIONS The use of open lumbar discectomy to treat LDH is associated with a significant improvement in patient outcomes as measured by the SF-6D. Open lumbar discectomy performed in the Brazilian supplementary health care system provides a cost-utility ratio of R$30,828.35 ($12,845.14) per QALY. The value of acceptable cost-effectiveness will vary by country and region.

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Cost-Utility of Reduction Mammaplasty Assessed for the Brazilian Public Health System

Abstract: Reduction mammaplasty performed in the Brazilian national health care system provides a cost-utility ratio equivalent to approximately £142 per 1 quality-adjusted life year.

Cited by 19 publications

References 34 publications

Overweight is Associated With Increased Incidence of Minor Complications After Reduction Mammoplasty: A Retrospective Analysis of 453 Consecutive Cases

Overweight is Associated With Increased Incidence of Minor Complications After Reduction Mammoplasty: A Retrospective Analysis of 453 Consecutive Cases

Outcomes analysis of breast reduction in Brazilian women using the BREAST-Q® questionnaire: a cross-sectional controlled study

Economic value of treating lumbar disc herniation in Brazil

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