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Provedor de dados:  BJPS
País:  Brazil
Título:  Cost-effectiveness of insulin analogs from the perspective of the Brazilian public health system
Autores:  Cazarim,Maurílio de Souza
Rodrigues,João Paulo Vilela
Cruz-Cazarim,Estael Luzia Coelho da
Ayres,Lorena Rocha
Pereira,Leonardo Régis Leira
Data:  2017-01-01
Ano:  2017
Palavras-chave:  Diabetes Mellitus/treatment/cost-effectiveness/evaluation
Prolonged Action Insulin
Short Action Insulin
Brazilian Public Health System
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.
Tipo:  Info:eu-repo/semantics/article
Idioma:  Inglês
Identificador:  http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1984-82502017000300616
Editor:  Universidade de São Paulo, Faculdade de Ciências Farmacêuticas
Relação:  10.1590/s2175-97902017000300178
Formato:  text/html
Fonte:  Brazilian Journal of Pharmaceutical Sciences v.53 n.3 2017
Direitos:  info:eu-repo/semantics/openAccess
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