Tratamento da infecção pelo vírus da hepatite C em candidatos a transplante renal submetidos a diálise: impacto orçamentário no SUS / Hepatitis C treatment in patients on dialysis awaiting renal transplantation: a budget impact analysis

Trata-se de uma análise de impacto orçamentário derivada dos resultados do estudo "Custo-efetividade do tratamento da infecção pelo vírus da hepatite C em candidatos a transplante renal submetidos a diálise". Teve como objetivo estimar o impacto orçamentário da ampliação da oferta do tratamento da infecção pelo vírus da hepatite C (VHC) para candidatos a transplante renal. Para tal, foi construído um modelo de Markov, a fim de estimar o custo médio do tratamento de diferentes proporções da população-alvo. Foram estimados os casos prevalentes e incidentes da infecção na população em diálise, candidata a transplante renal, em um horizonte de tempo de dez anos. Com base nestas estimativas, foi calculado o valor a ser despendido pelo SUS para tratar a população-alvo em três cenários diferenciados, caracterizados pela proporção da população submetida ao tratamento. Os valores encontrados foram comparados com o gasto do sistema para garantia de terapias de substituição renal no período de um ano, identificando-se que o custo do tratamento de toda a população candidata a transplante, infectada pelo VHC, corresponde a 0,3 por cento do valor despendido com TRS pelo SUS.

This is an analyses of the budget impact derived from the cost-effectiveness study on the hepatitis C treatment in candidates for renal transplantation under dialysis. It aims to estimate the budget impact of an offer of hepatitis C treatment for all candidates for renal transplantation. A Markov model was developed to estimate the mean cost for treatment of distinct proportions of the target population. The prevalence and incidence of hepatitis C in the candidates for renal transplantation in the dialysis population was also estimated in a horizon of ten years. Based on these estimative, we calculate the amount needed for treatment of this population in three distinct scenarios characterized by a proportion of the population under treatment. The values were compared with the expense of the system to guarantee renal replacement therapies in one year, identifying the cost of treatment of all candidates for transplant, infected with HCV, corresponding to 0.3 percent of the amount spent with renal transplantation within the SUS.

[Economic expenditures of multiple sclerosis medications and feasibility of providing health insurance policies for medications]

Treatment of multiple sclerosis [MS], a brain disorder, is very costly and requires supportive care and management of symptoms. MS is, in fact, a highly debilitating chronic disease with social and economic consequences. It has been shown that insurance policies can influence the economic burden of MS by reducing the cost of drug coverage. This study, therefore, aimed to probe the feasibility of providing health insurance policies for MS medications. The population of this retrospective and applied study constituted all Iranian MS patients taking Interferon drugs from 2000 to 2009. Data gathering tool was a checklist through which the related data were collected from National Statistics Center of Iran and the Ministry of Health [Deputy of Food and Drug Affairs and Deputy of Health]. Data were analyzed by means of Excel and Eviews 6 [econometric software]. The predictions showed that the total cost of Interferon drugs in the country would be 20,206,788,808 Rls in the next 30 years [provided that the government's subsidy continues].The results also showed that the cost of insurance covering Interferon for the whole country [scenario I], for the urban population [scenario II], and for only 50% of urban population [scenario III] were, respectively, 354/209, 693/261, and 385 /523 Rls. The present feasibility study, showing possibilities for different affordable insurance scenarios, presents practical recommendations for health sector policy makers to cover Interferon drug costs