Presentation (CTI)

OBJECTIVES: Antiangiogenic treatment for diabetic macular edema (DME) has been available within the Brazilian universal healthcare system (Sistema Único de Saúde - SUS) since April/2022. The effectiveness of antiangiogenics/technology diffusion within SUS 29 months later was assessed based on real-world data.
METHODS: DataSUS (SUS databank) was mined to estimate the monthly evolution (April/2022 to August/2024) of referenced institutions (RI) treating DME patients with antiangiogenics, treated patients (total and naive) and antiangiogenics injections. Percentage of DME potential population receiving antiangiogenics (populational coverage) was calculated based on epidemiology and total number of treated patients. Firstly, Pearson Correlation (PC) and R-squared (R²) were calculated using Excel tools to measure the influence of infrastructure (number of RI) on populational coverage, naive patients starting treatment and number of antiangiogenics injection administered. Secondly, real-world posology of the treatment was assessed by calculating the average number of injections administered per patient during the timeframe analyzed.
RESULTS: Along the months studied, the number of RI increased 159% (54 to 140 institutions), demonstrating the growth of system’s infrastructure. This increment is positively correlated with augmentation of populational coverage (PC=0,9738 / R²=0,9483), number of naïve patients starting treatment (PC=0,8911 / R²=0,8175) and number of antiangiogenics injections administered (PC=0,9670 / R²=0,9351). During the 29-months period, the average number of antiangiogenics injections per DME-patient was 4.32.
CONCLUSIONS: The availability of RI throughout the healthcare system positively influences antiangiogenics diffusion/usage by patients, since the increased number of RIs impacts populational coverage, enables treatment of more naive patients and administration of more antiangiogenics injections. On the other hand, average injections per patient is below data recently published in scientific literature, suggesting undertreatment of DME patients and impacting treatment efficacy. Thus, although infrastructure plays important role for increasing antiangiogenics diffusion, it is also important to find ways of increasing average number of injections per patient.