Economic impact of expanded use of biologic therapy for the treatment of rheumatoid arthritis and Crohn’s disease in Argentina, Brazil, Colombia, and Mexico

Tundia, Namita; Kotze, Paulo Gustavo; Serrano, Jorge Rojas; Abreu, Mirhelen Mendes de; Skup, Martha; Macaulay, Dendy; Signorovitch, James; Chaves, Leonardo Passos; Chao, Jingdong; Bao, Yanjun

doi:10.1080/13696998.2016.1209508

Cited by 11 publications

(12 citation statements)

References 41 publications

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“…It is true that it represents a considerable economic burden to increase the number of RA patients receiving therapy with biologics in Latin America. However, it has been calculated that the expanded use of biologic agents will result in cumulative cost net savings due to reduced indirect costs of RA [33]. Still, the compliance rate of an anti-TNF therapy is rather low in Brazil, i.e.…”

Section: Discussionmentioning

confidence: 99%

Impact of clinical and psychological factors associated with depression in patients with rheumatoid arthritis: comparative study between Germany and Brazil

et al. 2020

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Objective To investigate the prevalence of depressive symptoms and its association with clinical and psychological factors in patients with rheumatoid arthritis (RA) in Germany and in Brazil. Method A convenience sample of 267 RA patients, 176 from Germany (age 62.4 ± 12.3 years) and 91 from Brazil (age 56.3 ± 12.6 years), was used in this cross-sectional study. The following questionnaires were used: Beck Depression Inventory (BDI), painDETECT test, Perceived Stress Questionnaire, fatigue questionnaire (FACIT), Health Assessment Questionnaire Disability Index (HAQ-DI), and the SF–36 questionnaires (Short-Form 36 Health Survey). Disease activity score (DAS 28-CRP) and visual analogue scale (VAS) for pain were also evaluated. Statistical analysis is based on comparison of means and proportions. Statistical significance for non-normal data was evaluated by non-parametrical tests. Results Depressive symptoms were more prevalent in the Brazilian sample (44% vs 22.9%, p = 0.025). Compared to German patients, the Brazilian ones also experienced more pain (current pain status on VAS: 4.67 ± 3.4 vs 3.67 ± 2.31 respectively, p < 0.01), were physically more limited (1.89 ± 1.85 vs 1.01 ± 0.75, p = 0.012), and had higher C-reactive protein levels (7.78 ± 18.3 vs 5.82 ± 10.45, p = 0.028). Despite receiving a more intensive treatment, German patients presented similar disease activity when compared to Brazilian patients (DAS28-CRP: Brazil 3.4 ± 1.5 vs Germany 3.3 ± 1.3, p = 0.307). Conclusion Depressive symptoms are frequent in RA patients from different countries and interact with psychological disorders and the experience of pain. They contribute negatively to their well-being suggesting the need for psychoeducational strategies. Key Points• New psychoeducational strategies for RA management.• Higher inflammation marker in rheumatoid arthritis patients is associated with depression.• Medical treatment in RA influences depressive symptoms.• Depressive symptoms are dependent on population group.• High disease activity is related to depression.

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Section: Discussionmentioning

confidence: 99%

Impact of clinical and psychological factors associated with depression in patients with rheumatoid arthritis: comparative study between Germany and Brazil

et al. 2020

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“…Additionally, Tundia et al (2016) have demonstrated that in Brazil biological drugs represent more than 90% of CD patient treatment drug costs. Under this perspective, the quest for a treatment, at least, as effective and less costly compared to others currently covered by companies becomes key to guaranteeing the financial sustainability of the system.…”

Section: Discussionmentioning

confidence: 99%

“…The access to care and early intervention to treat inflammatory disorders such as CD can be very difficult to achieve in Latin America, including Brazil, which has been facing challenges related to the allocation of scarce resources for the management of this and other chronic conditions (Burgos-Vargas et al, 2013;Tundia et al, 2016). Additionally, the Brazilian Supplementary Health Agency (ANS), subordinate to the Ministry of Health, is responsible for regulating private health insurance plans in Brazil and establishing the mandatory minimum coverage of health technologies by these plans.…”

Section: Introductionmentioning

confidence: 99%

Cost-minimization and budget impact analysis of certolizumab pegol for patients with Crohn’s disease, moderate or severe, with relapse after conventional treatment from the perspective of the Brazilian private payer

Rosim¹,

Duva²,

Ferraz³

et al. 2017

JBES

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Objectives: Budget impact and cost-effectiveness analysis are often required by payers when discussing drug reimbursement. We hereby present a cost-minimization (CMA) and budget impact analysis (BIA) regarding the incorporation of certolizumab pegol (CZP) for the treatment of patients with Crohn's disease, a debilitating condition that affects the digestive tract. Methods: Considering that the scientific literature demonstrates CZP as effective as the alternatives (infliximab and adalimumab), a CMA was conducted, including a Markov 10-year time horizon modeling. Focusing on the assumptions for both CMA and BIA, a total of 36 stakeholders from the private sector were surveyed regarding treatment and disease-related costs. For the BIA, drug acquisition costs, administration costs, no population growth and an immunobiologic drug (bDMARD) switching rate of 5% were also considered. We assumed that CZP would gradually gain market share until it reaches 20% of new or switching patients in the fourth year. In addition, probability sensitivity analyses were performed. Results: In the cost-minimization, the calculated costs for 10-year treatment were BRL149k (infliximab); BRL118k (adalimumab) and BRL83k (CZP). Probabilistic sensitivity analysis was conducted with 1,000 random simulations, with CZP being less costly than its comparators in all simulations. Additionally, the BIA result indicates that CZP is a cost-saving intervention, with a predicted five-year impact of BRL317k for every 100-patient cohort. Conclusions: Certolizumab pegol was shown to be not only effective but also a cost-saving drug when compared to other anti-TNF drugs available for the Brazilian private healthcare system. RESUMOObjetivos: Análises de impacto orçamentário e de custo-efetividade são, com frequência, exigidas por pagadores para a decisão sobre incorporação de drogas. Por esse motivo, apresentaremos uma análise de custo-minimização e de impacto orçamentário do certolizumabe pegol (CZP) para o tratamento de pacientes com doença de Crohn, doença crônica e debilitante que afeta o trato digestivo. Métodos: Trinta e seis pagadores privados foram entrevistados para que fosse possível

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“…Vale la pena señalar que estos datos podrían ser diferentes en la actualidad dado que los mismos se refieren a la era prebiológica. Por otro lado, Tundia et al estimaron el impacto económico futuro relacionado con la creciente utilización de agentes biológicos para el tratamiento de la AR desde la perspectiva social en Argentina, Brasil, Colombia y México para el periodo 2012-2022 (46) . El modelo predijo que la creciente utilización de drogas biológicas para el tratamiento de los pacientes con AR en 2012-2022 resultaría en un ahorro neto acumulado de ARS 2,3 billones en 2012, en Argentina.…”

Section: Frecuencia Mensualunclassified

Epidemiología, uso de recursos y costos de la artritis reumatoidea en Argentina

Secco

Alfie

Espínola

et al. 2020

Rev Peru Med Exp Salud Publica

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La presente revisión tiene como objetivo identificar información sobre parámetros epidemiológicos y estimar el costo de la artritis reumatoidea (AR) moderada a severa. Se llevó a cabo una búsqueda de la literatura en las principales bases de datos. Se recurrió a un consenso de expertos locales en reumatología para encontrar los parámetros más realistas, utilizando un método Delphi modificado. Se estimaron los costos médicos directos, utilizando información recopilada en la base de datos de costos unitarios del Instituto de Efectividad Clínica y Sanitaria de Argentina. Los costos indirectos se estimaron a través del enfoque del capital humano. Los costos se expresaron en dólares estadounidenses (USD) a noviembre de 2017. La prevalencia reportada de AR en Argentina fue 0,94% (IC95%: 0,86 a 1,02), con una tasa de incidencia anual de 19 cada 100 000 personas (IC95%: 17 a 20). El costo anual de las drogas modificadoras de la enfermedad fue de USD 33 936,10 por paciente. El costo atribuido a las infecciones serias fue de USD 2474,6. El costo del reemplazo bilateral de rodillas por paciente fue de USD 5276,8, y el del reemplazo total de cadera, de USD 9196,4. El costo por paciente por año de días de hospitalización y los costos indirectos de la AR se acrecentaron al aumentar el puntaje de discapacidad. La revisión reporta información útil acerca de parámetros epidemiológicos y de costos de la AR moderada a severa en la era de los agentes biológicos, con el fin de resultar de utilidad para la conducción de evaluaciones económicas de salud en Argentina.

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Economic impact of expanded use of biologic therapy for the treatment of rheumatoid arthritis and Crohn’s disease in Argentina, Brazil, Colombia, and Mexico

Abstract: Increasing biologics use to treat RA and CD may limit cost growth over time by reducing medical and indirect costs. These findings may inform policy decisions regarding biologics use in Argentina, Brazil, Colombia, and Mexico.

Cited by 11 publications

References 41 publications

Impact of clinical and psychological factors associated with depression in patients with rheumatoid arthritis: comparative study between Germany and Brazil

Impact of clinical and psychological factors associated with depression in patients with rheumatoid arthritis: comparative study between Germany and Brazil

Cost-minimization and budget impact analysis of certolizumab pegol for patients with Crohn’s disease, moderate or severe, with relapse after conventional treatment from the perspective of the Brazilian private payer

Epidemiología, uso de recursos y costos de la artritis reumatoidea en Argentina

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