Economics of Acromegaly Treatment in Brazil: A Budget Impact Analysis of Pituitary Surgery Compared with Long‐Term Octreotide LAR
Economics of Acromegaly Treatment in Brazil: A Budget Impact Analysis of Pituitary Surgery Compared with Long‐Term Octreotide LAR
Data
2019
Autores
Porto, Lara Benigno
Zimmermann, Ivan Ricardo
Naves, Luciana Ansaneli
Journal Title
Journal ISSN
Volume Title
Publisher
PharmacoEconomics - Open
Resumo
Background Acromegaly is a rare, chronic and debilitating disease whose treatment places a high burden on health systems.
In the reality of the Brazilian public health network, many patients are kept on drug treatment because of barriers to access
to surgery.
Objective The aim of this study was to estimate the costs and budget impact of routine transsphenoidal endoscopic surgery
in relation to those of long-term drug treatment with octreotide long-acting release (LAR) from a cohort of patients followed
at the referral medical centre for acromegaly treatment in the Federal District, Brazil.
Methods Based on micro-costing data collected using mixed methods from a local perspective of the public health system,
we performed a budget impact analysis (BIA) on a 3-year time horizon. Uncertainty was handled with deterministic (tornado
and scenario) and probabilistic (Monte Carlo simulations) sensitivity analyses.
Results Compared with the continued use of octreotide LAR at a dose of 30 mg every 28 days, the incremental budget impact
of conducting two surgeries per month, considering a cure rate of 55%, could bring savings of approximately US$879,362.18
(95% CI 860,176.29–898,548.08) over 3 years. Depending on the key variable values, the savings amplitude ranged from
US$431,836.39 to US$1,519,132.04.
Conclusions Improving access to surgery could result in signifcant cost reductions in acromegaly treatment. The present
study stands out for being the frst to estimate the costs of transsphenoidal surgery in the context of the public health system
in Brazil.
Description
Palavras-chave
Citação
Porto LB, Zimmermann IR, Naves LA. Economics of Acromegaly Treatment in Brazil: A Budget Impact Analysis of Pituitary Surgery Compared with Long-Term Octreotide LAR. Pharmacoecon Open. 2019 Jun;3(2):247-254. doi: 10.1007/s41669-018-0103-2.