Cost-utility analysis of outpatient parenteral antimicrobial therapy (OPAT) in the Brazilian national health system

Autor(es):Mostrar menos -

Psaltikidis, Eliane Molina ^{[1, 2, 3]} ; da Silva, Everton Nunes ^[4] ; Moretti, Maria Luiza ^{[2, 5]} ; Trabasso, Plinio ^{[2, 5]} ; Bello Stucchi, Raquel Silveira ^{[6, 5]} ; Aoki, Francisco Hideo ^[5] ; de Oliveira Cardoso, Luis Gustavo ^[2] ; Hofling, Christian Cruz ^[2] ; Bachur, Luis Felipe ^[2] ; Ponchet, Danilo da Fontoura ^[6] ; Ceccato Colombrini, Maria Rosa ^[6] ; Tozzi, Cintia Soarez ^[6] ; Ramos, Rosana Fins ^[6] ; Queiroz Costa, Sandra Mara ^[6] ; Resende, Mariangela Ribeiro ^{[2, 3, 5]}

Afiliação do(s) autor(es)

^[1] Univ Estadual Campinas, Sch Med Sci, Campinas, SP - Brazil

^[2] Univ Estadual Campinas, Clin Hosp, Hosp Epidemiol Dept, Campinas, SP - Brazil

^[3] Univ Estadual Campinas, Clin Hosp, Hlth Technol Assessment Dept, Campinas, SP - Brazil

^[4] Univ Brasilia, Fac Ceilandia, Brasilia, DF - Brazil

^[5] Univ Estadual Campinas, Sch Med Sci, Dept Internal Med, Div Infect Dis, Campinas, SP - Brazil

^[6] Univ Estadual Campinas, Day Hosp, Clin Hosp, Campinas, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: EXPERT REVIEW OF PHARMACOECONOMICS & OUTCOMES RESEARCH; v. 19, n. 3, p. 341-352, MAY 4 2019.
• Citações Web of Science: 0

Resumo

Background: Outpatient parenteral antimicrobial therapy (OPAT) has been used for decades in different countries to reduce hospitalization rates, with favorable clinical and economic outcomes. This study assesses the cost-utility of OPAT compared to inpatient parenteral antimicrobial therapy (IPAT) from the perspective of a public university hospital and the Brazilian National Health System (Unified Health System -SUS). Methods: Prospective study with adult patients undergoing OPAT at an infusion center, compared to IPAT. Clinical outcomes and quality-adjusted life year (QALY) were assessed, as well as a micro-costing. Cost-utility analysis from the hospital and SUS perspectives were conducted by means of a decision tree, within a 30-day horizon time. Results: Forty cases of OPAT (1112 days) were included and monitored, with a favorable outcome in 97.50%. OPAT compared to IPAT generated overall savings of 31.86% from the hospital perspective and 26.53% from the SUS perspective. The intervention reduced costs, with an incremental cost-utility ratio of -44,395.68/QALY for the hospital and -48,466.70/QALY for the SUS, with better cost-utility for treatment times greater than 14 days. Sensitivity analysis confirmed the stability of the model. Conclusion: Our economic assessment demonstrated that, in the Brazilian context, OPAT is a cost-saving strategy both for hospitals and for the SUS. (AU)

• Processo FAPESP: 14/50045-3 - Terapia antimicrobiana parenteral ambulatorial baseada em hospital-dia, como ferramenta custo-efetiva de desospitalização no Sistema Único de Saúde
• Beneficiário: Mariângela Ribeiro Resende
• Modalidade de apoio: Auxílio à Pesquisa - Pesquisa em Políticas Públicas para o SUS