Cost-effectiveness of insulin analogs from the perspective of the Brazilian public health system

Autor(es)

Cazarim, Maurilio de Souza ^[1] ; Vilela Rodrigues, Joao Paulo ^[1] ; Coelho da Cruz-Cazarim, Estael Luzia ^[1] ; Ayres, Lorena Rocha ^[2] ; Leira Pereira, Leonardo Regis ^[1]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Sch Pharmaceut Sci Ribeirao Preto, Pharmaceut Serv & Clin Pharm Res Ctr CPAFF, Dept Pharmaceut Sci, Ribeirao Preto, SP - Brazil

^[2] Univ Fed Espirito Santo, Dept Pharmaceut Sci, Vitoria, ES - Brazil

• Tipo de documento: Artigo Científico
• Fonte: Brazilian Journal of Pharmaceutical Sciences; v. 53, n. 3 2017.
• Citações Web of Science: 0

Resumo

ABSTRACT Human insulin is provided by the Brazilian Public Health System (BPHS) for the treatment of diabetes, however, legal proceedings to acquire insulin analogs have burdened the BPHS health system. The aim of this study was to perform a cost-effectiveness analysis to compare insulin analogs and human insulins. This is a pharmacoeconomic study of cost-effectiveness. The direct medical cost related to insulin extracted from the Ministry of Health drug price list was considered. The clinical results, i.e. reduction in glycated hemoglobin (HbA1c), were extracted by meta-analysis. Different scenarios were structured to measure the uncertainties regarding the costs and reduction in HbA1c. Decision tree was developed for sensitivity of Incremental Cost Effectiveness Ratio (ICER). A total of fifteen scenarios were structured. Given the best-case scenario for the insulin analogs, the insulins aspart, lispro, glargine and detemir showed an ICER of R$ 1,768.59; R$ 3,308.54; R$ 11,718.75 and R$ 2,685.22, respectively. In all scenarios in which the minimum effectiveness was proposed, lispro, glargine and detemir were dominant strategies. Sensitivity analysis showed that the aspart had R$ 3,066.98 [95 % CI: 2339.22; 4418.53] and detemir had R$ 6,163.97 [95% CI: 3919.29; 11401.57] for incremental costs. We concluded there was evidence that the insulin aspart is the most cost-effective. (AU)

• Processo FAPESP: 14/02087-9 - Avaliação econômica em longo prazo da atenção farmacêutica para pacientes com hipertensão arterial sistêmica
• Beneficiário: Maurilio de Souza Cazarim
• Modalidade de apoio: Bolsas no Brasil - Mestrado