Cost Analysis of Surgical Treatment for Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) Refractory to Clinical Therapy in Brazil
Author(s)
Greice Miotto Buttelli, Bachelors1, Aline Barbosa, Bachelor2, Frederico Magro, MBA, MSc, PharmD1, Bruna Stella Zanotto, PharmB, MSc3, Vanessa Oliveira, M.Sc4, Andre L F Azeredo da Silva, MSc, PhD, MD3.
1Sanofi, Sao Paulo, Brazil, 2Health Economics Manager, Sanofi, Sao Paulo, Brazil, 3HTANALYZE, Santa Catarina, Brazil, 4HTANALYZE, Catarina, Brazil.
1Sanofi, Sao Paulo, Brazil, 2Health Economics Manager, Sanofi, Sao Paulo, Brazil, 3HTANALYZE, Santa Catarina, Brazil, 4HTANALYZE, Catarina, Brazil.
Presentation Documents
OBJECTIVES: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a persistent inflammation of the paranasal sinuses, often resistant to therapy. Surgical intervention is frequently required and often has to be repeated, contributing to significant healthcare costs due to recurrence rates. Limited data exist on the economic impact of such surgeries within Brazil’s private healthcare system. This study aimed to estimate the costs associated with surgical management of refractory CRSwNP, utilizing the Delphi methodology to capture expert insights on real-world practices within the private healthcare perspective.
METHODS: A three-round Delphi process involving eight Brazilian experts in nasal polyp surgery collected data on clinical criteria, surgical practices, and complication rates. Anonymity of panelists was strictly maintained, and consensus was defined as ≥60% agreement. Costs were calculated using the Brazilian Hierarchical Classification of Medical Procedures (CBHPM, Range III, 2024), the SIMPRO consumables list (May/June 2024), and data from the Brazilian National Union of Self-Management in Healthcare Institutions (UNIDAS). All costs are presented in US dollars ($) at a conversion rate of 1 USD = 5.81 BRL.
RESULTS: Total surgery cost was estimated at $9,045.97 in patients without complications, $9,194.07 in patients with minor complications (5% of cases) and $10,522.97 in patients with major complications (<1%). Costs are mostly concentrated in the perioperative period (which includes medical fees, hospital care fees, and hospital charges), material and Orthoses, Prostheses, and Special Materials (OPSM) and postoperative period, corresponding to 60% ($5,392.44), 18% ($1,613.50) and 12% ($1,090.71) of the total cost, respectively, for patients without complications.
CONCLUSIONS: The surgical management of refractory CRSwNP imposes a substantial economic burden on Brazil’s private healthcare system. The results highlight that the costs are substantial, especially in the perioperative period, and increase significantly in cases of complications. This study is important as it provides real-world data on the costs of surgery, supporting the decision-making.
METHODS: A three-round Delphi process involving eight Brazilian experts in nasal polyp surgery collected data on clinical criteria, surgical practices, and complication rates. Anonymity of panelists was strictly maintained, and consensus was defined as ≥60% agreement. Costs were calculated using the Brazilian Hierarchical Classification of Medical Procedures (CBHPM, Range III, 2024), the SIMPRO consumables list (May/June 2024), and data from the Brazilian National Union of Self-Management in Healthcare Institutions (UNIDAS). All costs are presented in US dollars ($) at a conversion rate of 1 USD = 5.81 BRL.
RESULTS: Total surgery cost was estimated at $9,045.97 in patients without complications, $9,194.07 in patients with minor complications (5% of cases) and $10,522.97 in patients with major complications (<1%). Costs are mostly concentrated in the perioperative period (which includes medical fees, hospital care fees, and hospital charges), material and Orthoses, Prostheses, and Special Materials (OPSM) and postoperative period, corresponding to 60% ($5,392.44), 18% ($1,613.50) and 12% ($1,090.71) of the total cost, respectively, for patients without complications.
CONCLUSIONS: The surgical management of refractory CRSwNP imposes a substantial economic burden on Brazil’s private healthcare system. The results highlight that the costs are substantial, especially in the perioperative period, and increase significantly in cases of complications. This study is important as it provides real-world data on the costs of surgery, supporting the decision-making.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE324
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)