National Guidelines for High-Cost Drugs in Brazil: Achievements and Constraints of an Innovative National Evidence-Based Public Health Policy

Picon, Paulo Dornelles; Beltrame, Alberto; Banta, David

doi:10.1017/s0266462313000056

Cited by 8 publications

(6 citation statements)

References 28 publications

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“…Theseresults contributed to more efficient care and evidence based allocation of resources [9]. However, the impactof distinct medical typologies that contain clinical practice guidelines on medical costs have not been researched thoroughly [10]–[13]. There are several typologies of alcohol dependence [14]–[16] which are widely adopted in the published literature.…”

Section: Introductionmentioning

confidence: 99%

LAT Software Induced Savings on Medical Costs of Alcohol Addicts' Care - Results from a Matched-Pairs Case-Control Study

et al. 2014

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Lesch Alcoholism Typology (LAT) is one of the most widely used clinical typologies of alcohol addiction. Study tested whether introduction of LAT software in clinical practice leaded to improved outcomes and reduced costs. Retrospective matched-pairs case-control cost comparison study was conducted at the Regional Addiction Center of the University Clinic in Serbia involving 250 patients during the four-year period. Mean relapse frequency followed by outpatient detoxification was 0.42±0.90 vs. 0.70±1.66 (LAT/non-LAT; p = 0.267). Adding relapses after inpatient treatment total mean-number of relapses per patient was 0.70±1.74 vs. 0.97±1.89 (LAT/non-LAT; p = 0.201). However, these relapse frequency differentials were not statistically significant. Total hospital costs of Psychiatry clinic based non-LAT addicts' care (€54,660) were significantly reduced to €36,569 after initiation of LAT. Mean total cost per patient was reduced almost by half after initiation of LAT based treatment: €331±381 vs. €626±795 (LAT/non-LAT; p = 0.001). Mean cost of single psychiatry clinic admission among non-LAT treatment group was €320±330 (CI 95% 262–378) and among LAT €197±165 (CI 95% 168–226) (p = 0.019). Mean LAT software induced net savings on psychiatric care costs were €144 per patient. Total net savings on hospital care including F10 associated somatic co-morbidities amounted to €295 per patient. More sensitive diagnostic assessment and sub-type specific pharmacotherapy and psychotherapy following implementation of LAT software lead to significant savings on costs of hospital care.

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Section: Introductionmentioning

confidence: 99%

LAT Software Induced Savings on Medical Costs of Alcohol Addicts' Care - Results from a Matched-Pairs Case-Control Study

et al. 2014

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“…The distribution of medication for treating AD is based on the evidence-based Brazilian public guidelines 7 , used by Brazil's Ministry of Health since 2002. In addition to the pharmaceuticals already cited, there are other therapeutic possibilities that include transdermal rivastigmine and orallyadministered memantine 8 .…”

mentioning

confidence: 99%

Trends and disparities in the use of cholinesterase inhibitors to treat Alzheimer’s disease dispensed by the Brazilian public health system – 2008 to 2014: a nation-wide analysis

Moraes

Souza

Lucchetti

et al. 2018

Arq. Neuro-Psiquiatr.

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In light of the high cost of dementia treatment, there is legislation authorizing free distribution of cholinesterase inhibitors to those suffering from Alzheimer’s disease in Brazil. However, the existence of this free distribution does not guarantee adequate distribution. Objectives The present study aimed to investigate the trends of prescriptions and the coverage of Alzheimer’s disease treatment using cholinesterase inhibitors from public pharmacies dispensing high-cost drugs in Brazil. Methods This was a retrospective study that collected data from the Brazilian public Unified Health System. All cholinesterase inhibitors distributed at no cost to Brazilians during the year 2014, as well as the estimated number and percentages of patients who used these medications, were evaluated and compared to data from the year 2008. Results Our estimates indicated that 9.7% of the population having dementia syndromes used cholinesterase inhibitors, as well as 16.1% of those with Alzheimer’s disease in Brazil. A clear disparity was noted between the use and distribution of cholinesterase inhibitors, depending on the region in which they were found. Over time, an increase in the distribution of cholinesterase inhibitors has been noted. In 2008, that use was 12.0% whereas, in 2014, it was 16.1%, an increase of 34% in six years. Conclusion It was estimated that 16.1% of patients with Alzheimer’s disease in Brazil use cholinesterase inhibitors. These values have increased and, in spite of not being satisfactory, they indicate a potential for improvement. However, there is still a significant disparity among the regions.

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“…Important measures to optimize the use of new health system-funded drugs include therapeutic clinical guidelines, restriction criteria for prescriptions, effectiveness, and security monitoring 1,3 . Some of these measures are already incorporated by the SUS for the medicinal products of the specialized component, the HIV/ AIDS program and others from the strategic component 46 . The classification of Motola et al 31 , adopted in the present study to determine the therapeutic value of drugs, considers the interrelationship between treatment availability and the therapeutic effect, addressing three areas of pharmaceutical innovation 4,47 : use context (including alternative therapies), drug novelty (chemical, pharmacological and pharmaceutical) and impact (efficacy, safety).…”

Section: Discussionmentioning

confidence: 99%

Análise de medicamentos novos registrados no Brasil na perspectiva do Sistema Único de Saúde e da carga de doença

Botelho

Martins

Reis

2018

Ciênc. saúde coletiva

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National Guidelines for High-Cost Drugs in Brazil: Achievements and Constraints of an Innovative National Evidence-Based Public Health Policy

Cited by 8 publications

References 28 publications

LAT Software Induced Savings on Medical Costs of Alcohol Addicts' Care - Results from a Matched-Pairs Case-Control Study

LAT Software Induced Savings on Medical Costs of Alcohol Addicts' Care - Results from a Matched-Pairs Case-Control Study

Trends and disparities in the use of cholinesterase inhibitors to treat Alzheimer’s disease dispensed by the Brazilian public health system – 2008 to 2014: a nation-wide analysis

Análise de medicamentos novos registrados no Brasil na perspectiva do Sistema Único de Saúde e da carga de doença

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