Academic Journal
Cost-effectiveness analysis of medical treatment of benign prostatic hyperplasia in the Brazilian public health system
| العنوان: | Cost-effectiveness analysis of medical treatment of benign prostatic hyperplasia in the Brazilian public health system |
|---|---|
| المؤلفون: | Luciana Ribeiro Bahia, Denizar Vianna Araujo, Camila Pepe, Michelle Trindade, Caroline Mendonça Camargo, Valter Javaroni |
| المصدر: | International Brazilian Journal of Urology, Vol 38, Iss 5, Pp 595-605 (2012) |
| بيانات النشر: | Sociedade Brasileira de Urologia, 2012. |
| سنة النشر: | 2012 |
| المجموعة: | LCC:Diseases of the genitourinary system. Urology |
| مصطلحات موضوعية: | Cost-effectiveness Analysis, Benign Prostatic Hyperplasia, Finasteride, Doxazosin, Diseases of the genitourinary system. Urology, RC870-923 |
| الوصف: | OBJECTIVE: To perform a cost-effectiveness analysis of medical treatment of benign prostatic hyperplasia (BPH) under Brazilian public health system perspective (Unified Health System - "Sistema Único de Saúde (SUS)"). MATERIAL AND METHODS: A revision of the literature of the medical treatment of BPH using alpha-blockers, 5-alpha-reductase inhibitors and combinations was carried out. A panel of specialists defined the use of public health resources during episodes of acute urinary retention (AUR), the treatment and the evolution of these patients in public hospitals. A model of economic analysis(Markov) predicted the number of episodes of AUR and surgeries (open prostatectomy and transurethral resection of the prostate) related to BPH according to stages of evolution of the disease. Brazilian currency was converted to American dollars according to the theory of Purchasing Power Parity (PPP 2010: US$ 1 = R$ 1.70). RESULTS: The use of finasteride reduced 59.6% of AUR episodes and 57.9% the need of surgery compared to placebo, in a period of six years and taking into account a treatment discontinuity rate of 34%. The mean cost of treatment was R$ 764.11 (US$449.78) and R$ 579.57 (US$ 340.92) per patient in the finasteride and placebo groups, respectively. The incremental cost-effectiveness ratio (ICERs) was R$ 4.130 (US$ 2.429) per episode of AUR avoided and R$ 2.735 (US$ 1.609) per episode of surgery avoided. The comparison of finasteride + doxazosine to placebo showed a reduction of 75.7% of AUR episodes and 66.8% of surgeries in a 4 year time horizon, with a ICERs of R$ 21.191 (US$ 12.918) per AUR episodes avoided and R$ 11.980 (US$ 7.047) per surgery avoided. In the sensitivity analysis the adhesion rate to treatment and the cost of finasteride were the main variables that influenced the results. CONCLUSIONS: These findings suggest that the treatment of BPH with finasteride is cost-effective compared to placebo in the Brazilian public health system perspective. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 1677-5538 1677-6119 |
| Relation: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382012000500003; https://doaj.org/toc/1677-5538; https://doaj.org/toc/1677-6119 |
| DOI: | 10.1590/S1677-55382012000500003 |
| URL الوصول: | https://doaj.org/article/37829221366c4e87bd9abff4eef14d96 |
| رقم الانضمام: | edsdoj.37829221366c4e87bd9abff4eef14d96 |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 16775538 16776119 |
|---|---|
| DOI: | 10.1590/S1677-55382012000500003 |