Document Detail


Cost-effectiveness analysis of medical treatment of benign prostatic hyperplasia in the Brazilian public health system.
MedLine Citation:
PMID:  23131517     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Objective: To perform a cost-effectiveness analysis of medical treatment of benign prostatic hyperplasia (BPH) under Brazilian public health system perspective (Unified Health System - ″Sistema Unico de Saude (SUS) ″). Material and Methods: A revision of the literature of the medical treatment of BPH using alpha-blockers, 5-alpha-reductase inhibitors and combinations was carried out. A panel of specialists defined the use of public health resources during episodes of acute urinary retention (AUR), the treatment and the evolution of these patients in public hospitals. A model of economic analysis (Markov) predicted the number of episodes of AUR and surgeries (open prostatectomy and transurethral resection of the prostate) related to BPH according to stages of evolution of the disease. Brazilian currency was converted to American dollars according to the theory of Purchasing Power Parity (PPP 2010: US$ 1 = R$ 1.70). Results: The use of finasteride reduced 59.6% of AUR episodes and 57.9% the need of surgery compared to placebo, in a period of six years and taking into account a treatment discontinuity rate of 34%. The mean cost of treatment was R$ 764.11 (US$ 449.78) and R$ 579.57 (US$ 340.92) per patient in the finasteride and placebo groups, respectively. The incremental cost-effectiveness ratio (ICERs) was R$ 4.130 (US$ 2.429) per episode of AUR avoided and R$ 2.735 (US$ 1.609) per episode of surgery avoided. The comparison of finasteride + doxazosine to placebo showed a reduction of 75.7% of AUR episodes and 66.8% of surgeries in a 4 year time horizon, with a ICERs of R$ 21.191 (US$ 12.918) per AUR episodes avoided and R$ 11.980 (US$ 7.047) per surgery avoided. In the sensitivity analysis the adhesion rate to treatment and the cost of finasteride were the main variables that influenced the results. Conclusions: These findings suggest that the treatment of BPH with finasteride is costeffective compared to placebo in the Brazilian public health system perspective.
Authors:
Luciana Ribeiro Bahia; Denizar Vianna Araujo; Camila Pepe; Michelle Trindade; Caroline Mendonça Camargo; Valter Javaroni
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International braz j urol : official journal of the Brazilian Society of Urology     Volume:  38     ISSN:  1677-6119     ISO Abbreviation:  Int Braz J Urol     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-11-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158091     Medline TA:  Int Braz J Urol     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  595-605     Citation Subset:  IM    
Affiliation:
State University of Rio de Janeiro, Rio de Janeiro, Brazil.
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