Direct Medical Costs of Treating Chronic Lymphocytic Leukemia Patients in the Private Healthcare System in Brazil: Results From A 24-Month Retrospective Analysis of an Administrative Database

Abstract

A147patient population. Based on a representative population-based patient-cohort, the objective of this study was to develop a decision model that could reflect realworld practice and predict the costs throughout treatment pathway. Methods: All patients newly diagnosed with FL in the UK's population-based Haematological Malignancy Research Network (www.hmrn.org) between 2004 and 2011 were followed until 2014 (n= 741). The mapped treatment pathways, alongside cost information derived from the National Tariff 2013/14, were incorporated into a discrete event simulation in order to reflect the heterogeneity of clinical characteristics, such as stage, and treatment options. Results: The annual cost of treating FL across the UK (population ~ 64 million) was estimated to be around £17 million. The predicted mean cost per patient from diagnosis to death was £10,202. Based on the initial treatment decision average costs were; £17,054 for those treated with chemotherapy (46%), £4,651 for those treated with radiotherapy (12%), and £2,185 for those managed by "watch-and-wait" (42%). The model's predicted costs per patient captured 95% of the actual costs calculated from empirical data, supporting the validity of the model. ConClusions: This is the first modelling study using 'real world' evidence to predict costs of entire FL treatment pathways. As several expensive new technologies/treatments for FL are on the horizon, future application of the model developed here could be used to assess their economic impacts and support healthcare decision makers, especially in the era of personalised medicine.

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“…Foram estimados os custos de manejo de eventos adversos de grau maior ou igual a 3, incluindo custos de procedimentos clínicos (Agência Nacional de Saúde Suplementar, 2016), custos complementares de hospitalização (Paloni et al, 2016) e quantidade média de dias de hospitalização estimada de acordo com expertise médica. O cálculo do custo total dos eventos adversos foi corrigido pelo IPCA (Índice Nacional de Preços ao Consumidor Amplo) acumulado de julho de 2016 a maio de 2021, equivalente a 22,34% (Banco Central do Brasil, 2021).…”

Obinutuzumabe no tratamento de pacientes com leucemia linfoide crônica, não elegíveis à dose completa de fludarabina: análise de impacto orçamentário baseado no tempo para a próxima terapia

“…As curvas de TPPT para GClb e RClb foram obtidas diretamente por meio das curvas publicadas do estudo. Já a curva de Clb foi projetada pela premissa de riscos proporcionais por meio da aplicação do inverso do hazard ratio (HR) (0,24; IC 95% 0,17-0,34; p < 0,0001) à curva de RClb, na ausência de uma curva publicada para o comparador (Paloni, 2016). O mesmo vale para a curva de OClb que foi extrapolada por meio da aplicação do HR (0,49; IC 95% 0,36-0,67; p < 0,0001) à curva de Clb (Hillmen et al, 2015).…”

“…No contexto brasileiro, um estudo utilizando uma base de dados de indivíduos no Sistema Suplementar de Saúde (SSS) mostrou que pacientes com LLC apresentam uma significativa carga econômica (Paloni, 2016). Os custos elevados com o tratamento e o manejo de LLC são muitas vezes resultados de terapias inadequadas, que necessitam de cuidados adicionais, além de gerarem maiores riscos de infecções e resistên-cia a medicamentos (Stephens et al, 2005).…”