Presentation (CTI)

OBJECTIVES: To conduct a cost-effectiveness and budget impact analysis of polyhexamethylene biguanide combined with betaine (PHMB) gel versus silver sulfadiazine in the treatment of superficial and partial-thickness second-degree burns, from the perspective of the Brazilian Unified Health System(SUS).
METHODS: A Markov model was developed with four health states (healing, infection, complications, and death), weekly cycles, and a 12-week time horizon. The analysis adhered to CHEERS guidelines, incorporating direct costs and clinical outcomes from the literature. The perspective of SUS was adopted, including direct treatment-related costs. The incremental cost-effectiveness ratio (ICER) was calculated and compared with the estimated threshold for Brazil. The robustness of the model was explored through probabilistic and deterministic sensitivity analyses, as well as alternative scenarios. The budget impact was estimated over a five-year period, considering a market share between 15% and 50% in the first year, with annual increases ranging from 10% to 20%.
RESULTS: The use of PHMB gel compared to silver sulfadiazine resulted in cost savings of -R$ 111,491.23 and an incremental effectiveness of 0.50 complications avoided, yielding an incremental cost-effectiveness ratio (ICER) of R$ 222,300.83. The budget impact analysis indicated that adopting this technology for the target population could generate savings ranging from R$ 23 million to R$ 40 million over the five-year horizon, depending on the adoption scenario.
CONCLUSIONS: PHMB gel proved to be a dominant alternative for the treatment of second-degree burns, offering greater effectiveness and lower costs compared to silver sulfadiazine. Its adoption in SUS has the potential to improve clinical outcomes and significantly reduce costs associated with burn management, promoting a more efficient allocation of public health resources.