Does it fit in your pocket? economic burden of PD-1 inhibitors' toxicity in the supplementary health system: evidence from Brazil

被引：3

作者：

Duarte, Hugo Santos ^{[1
]}

da Veiga, Cassia Rita Pereira ^{[2
]}

da Veiga, Claudimar Pereira ^{[3
]}

Wainstein, Alberto Julius Alves ^{[1
]}

da Silva, Wesley Vieira ^{[4
]}

Drummond-Lage, Ana Paula ^{[1
]}

机构：

[1] Fac Ciencias Med Minas Gerais, Alameda Ezequiel Dias, 275, BR-30130110 Belo Horizonte, MG, Brazil

[2] Univ Fed Minas Gerais, Dept Gestao Serv Saude, Escola Enfermagem, Ave Alfredo Balena, 190, BR-30130100 Belo Horizonte, MG, Brazil

[3] Fundacao Dom Cabral, FDC Business Sch, Ave Princesa Diana, 760, Alphaville Lagoa Ingleses, BR-34018006 Nova Lima, MG, Brazil

[4] Univ Fed Alagoas UFAL, Ave Lourival Melo Mota, S-N, Tabuleiro Martins, BR-57072900 Maceio, AL, Brazil

来源：

BMC HEALTH SERVICES RESEARCH | 2023年 / 23卷 / 01期

关键词：

Health management; Burden of toxicity; Cost; Oncology; PD-1; PD-L1; inhibitor; RENAL-CELL CARCINOMA; NIVOLUMAB PLUS IPILIMUMAB; CAUSE ADVERSE EVENTS; LUNG-CANCER FINDINGS; TRIAL-BASED COSTS; 1ST-LINE THERAPY; SUNITINIB;

D O I：

10.1186/s12913-023-09736-6

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

BackgroundA full understanding of the economic burden associated with treatment-related adverse events (AEs) can aid estimates of the incremental costs associated with incorporating new technologies and support cost-effective economic modeling in Brazil. In this context, the main objective of this work was to evaluate in a real-life database: (i) the direct medical cost of monitoring the occurrence of AEs (CMO); (ii) the direct medical cost of managing an identified AE (CMN); and (iii) the total direct medical cost of monitoring and managing AEs (TMC), in quarterly periods from 0 to 24 months of the monitoring of cancer patients who used a PD-1 inhibitor from the perspective of the supplementary health system in Brazil.MethodsThis study was conducted from the supplementary health system (SSS) perspective and followed the methodological guidelines related to cost-of-illness studies. A bottom-up (person-based) approach was used to assess the use of health resources to monitor and manage AEs during the use of PD-1 inhibitors, which made it possible to capture differences in the mean frequency of the use of health services with stratification results for different subgroups. As the Brazilian SSS is complex, asymmetric, and fragmented, this study used information from different sources. The methodology was divided into three parts: (i) Data Source: clinical management of AEs; (ii) Microcosting: management of the economic burden of AEs; (iii) Statistical analysis: stratification of results for different subgroups.ResultsAnalysis of the economic burden of toxicity showed higher CMO costs than CMN in all the periods analyzed. In general, for every BRL 100 on average invested in the TMC of AEs, BRL 95 are used to monitor the occurrence of the AE and only BRL 5 to manage an identified AE. This work also showed that the sociodemographic characteristics of patients, the journey of oncological treatment, and the toxicity profile affect the economic burden related to AE.ConclusionThis study provided real-world evidence of the economic burden of AEs associated with the use of PD-1 inhibitors in Brazil. This work also made methodological contributions by evaluating the economic burden of AE of PD-1 inhibitors considering the kinetics of toxicity occurrence and categorizing the costs in terms of CMO, CMN and TMC.

引用

页数：11

共 42 条

[1]

Alves D, 2019, VALUE HEALTH, V22, pS463, DOI 10.1016/j.jval.2019.09.339

[2] Comparison of adverse event costs of nivolumab combined with ipilimumab versus sunitinib for previously untreated metastatic renal cell carcinoma [J].