Economic Impact of Implementing a Clinical Protocol and Therapeutic Guidelines for Cow's Milk Protein Allergy in Two States of Brazil
Author(s)
Lindemberg Assunção-Costa, MSc, PharmD, PhD1, Bruno dos Santos de Oliveira, Nutricionista2, João Marcos Bezerra Pires, Nutricionista3, Thiago Augusto Viera Da Silva, Pharmacist4;
1National Institute of Pharmaceutical Assistance and Pharmacoeconomics, Professor, Salvador, Brazil, 2Danone, Market Access, São Paulo, Brazil, 3State Health Secretary of Maranhão - Brazil, Salvador, Brazil, 4State Health Secretary of Rio Grande do Norte, Salvador, Brazil
1National Institute of Pharmaceutical Assistance and Pharmacoeconomics, Professor, Salvador, Brazil, 2Danone, Market Access, São Paulo, Brazil, 3State Health Secretary of Maranhão - Brazil, Salvador, Brazil, 4State Health Secretary of Rio Grande do Norte, Salvador, Brazil
OBJECTIVES: Cow's Milk Protein Allergy (CMPA) is a common childhood allergy, particularly in children under three years old, characterized by immune reactions to milk proteins. In Brazil, CMPA prevalence ranges from 0.5% to 5.4%. Managing CMPA often requires hypoallergenic formulas, which pose a financial challenge for the Brazilian Unified Health System (SUS) This study evaluates the economic impact of implementing a Clinical Protocol and Therapeutic Guidelines (CPTG) for CMPA in Maranhão and Rio Grande do Norte, focusing on cost benefits, challenges, and treatment access improvements.
METHODS: This descriptive study uses clinical and financial data from government reports and databases (2019-2023). The analysis includes the number of patients, annual dietary formula costs, and economic effects of administrative versus judicial management. The study considered children up to 24 months with confirmed CMPA diagnoses in state reference centers. Data analysis involved averages, percentage variations, and the impact of the COVID-19 pandemic on care and costs.
RESULTS: Annually, 468 to 595 children were treated, with an average of 488. The number of visits increased from 1,891 to 2,391. The cost per patient in administrative management was 50% lower than judicial management due to resource control. In 2022, the highest investment reached R$ 2,012,647.58, while in 2023, savings of R$ 399,219.98 (-19.84%) were achieved through optimized management. Maranhao's decentralized distribution expanded access, while Rio Grande do Norte's centralized management by UNICAT ensured consistent supply. Both states faced logistical and budgetary hurdles but showed improvements in care delivery.
CONCLUSIONS: Implementing the CPTG for CMPA in Maranhao and Rio Grande do Norte proved cost-effective, reducing expenses and expanding treatment access. Administrative management led to significant savings compared to judicialization, and decentralization and regularity improved coverage. These results emphasize the need for intergovernmental coordination, early diagnosis, and structured public policies to meet the needs of children with CMPA and optimize SUS resources.
METHODS: This descriptive study uses clinical and financial data from government reports and databases (2019-2023). The analysis includes the number of patients, annual dietary formula costs, and economic effects of administrative versus judicial management. The study considered children up to 24 months with confirmed CMPA diagnoses in state reference centers. Data analysis involved averages, percentage variations, and the impact of the COVID-19 pandemic on care and costs.
RESULTS: Annually, 468 to 595 children were treated, with an average of 488. The number of visits increased from 1,891 to 2,391. The cost per patient in administrative management was 50% lower than judicial management due to resource control. In 2022, the highest investment reached R$ 2,012,647.58, while in 2023, savings of R$ 399,219.98 (-19.84%) were achieved through optimized management. Maranhao's decentralized distribution expanded access, while Rio Grande do Norte's centralized management by UNICAT ensured consistent supply. Both states faced logistical and budgetary hurdles but showed improvements in care delivery.
CONCLUSIONS: Implementing the CPTG for CMPA in Maranhao and Rio Grande do Norte proved cost-effective, reducing expenses and expanding treatment access. Administrative management led to significant savings compared to judicialization, and decentralization and regularity improved coverage. These results emphasize the need for intergovernmental coordination, early diagnosis, and structured public policies to meet the needs of children with CMPA and optimize SUS resources.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
HTA90
Topic
Health Technology Assessment
Topic Subcategory
Systems & Structure
Disease
SDC: Pediatrics, STA: Nutrition