Budget Impact of Including Cannabis-Based Products in Brazil’s Public Health System: A Scenario Analysis
Author(s)
Mariana Dias Lula, MSc1, Ludmila Peres Gargano, PhD1, Maria Laura Silva, PharmD, PhD2, Augusto Afonso Guerra Júnior, PhD1, Cristina Mariano Ruas, PhD1.
1Universidade Federal de Minas Gerais, Belo Horizonte, Brazil, 2University of Bordeaux INSERM U1219, Bordeaux, France.
1Universidade Federal de Minas Gerais, Belo Horizonte, Brazil, 2University of Bordeaux INSERM U1219, Bordeaux, France.
OBJECTIVES: To estimate the budget impact of listing cannabis-based products into Brazil’s Health National System (SUS) for selected clinical indications and to assess the financial feasibility of different coverage scenarios. This study aims to support public policy decision-making by projecting potential costs associated with national access to these therapies.
METHODS: A Budget Impact Analysis (BIA) was conducted from the perspective of the public payer, considering a 5-year time horizon (2026-2030) with no discount rate applied. The analysis included two indications: treatment-resistant epilepsy and spasticity associated with multiple sclerosis. Eligible populations were estimated using national epidemiological data, and unit drug costs were based on current market prices in Brazil. It was assumed that standard-of-care treatment costs would remain unchanged. A market share ranging from 10% to 50% was assumed progressively over the five-year period. Three coverage scenarios were simulated: (i) the first considered restricted access to patients with treatment-resistant epilepsy; (ii) the second modeled access for patients with multiple sclerosis experiencing spasticity; and (iii) the third represented coverage for both conditions.
RESULTS: The projected cumulative budget impact over five years was BRL 7.0 billion for the epilepsy-only scenario, BRL 210 million for the multiple sclerosis-only scenario, and BRL 7.2 billion for the scenario covering both conditions. Costs increased with broader clinical coverage and higher market uptake. Indirect cost savings related to improved health outcomes were not considered.
CONCLUSIONS: Listing cannabis-based products into Brazil’s SUS would result in a substantial budget impact, especially under broader adoption scenarios. Financial sustainability could be enhanced through negotiated pricing, clear clinical guidelines, and phased implementation. This analysis did not consider potential clinical benefits that could reduce other healthcare costs associated with diseases burden, such as hospitalizations or emergency visits.
METHODS: A Budget Impact Analysis (BIA) was conducted from the perspective of the public payer, considering a 5-year time horizon (2026-2030) with no discount rate applied. The analysis included two indications: treatment-resistant epilepsy and spasticity associated with multiple sclerosis. Eligible populations were estimated using national epidemiological data, and unit drug costs were based on current market prices in Brazil. It was assumed that standard-of-care treatment costs would remain unchanged. A market share ranging from 10% to 50% was assumed progressively over the five-year period. Three coverage scenarios were simulated: (i) the first considered restricted access to patients with treatment-resistant epilepsy; (ii) the second modeled access for patients with multiple sclerosis experiencing spasticity; and (iii) the third represented coverage for both conditions.
RESULTS: The projected cumulative budget impact over five years was BRL 7.0 billion for the epilepsy-only scenario, BRL 210 million for the multiple sclerosis-only scenario, and BRL 7.2 billion for the scenario covering both conditions. Costs increased with broader clinical coverage and higher market uptake. Indirect cost savings related to improved health outcomes were not considered.
CONCLUSIONS: Listing cannabis-based products into Brazil’s SUS would result in a substantial budget impact, especially under broader adoption scenarios. Financial sustainability could be enhanced through negotiated pricing, clear clinical guidelines, and phased implementation. This analysis did not consider potential clinical benefits that could reduce other healthcare costs associated with diseases burden, such as hospitalizations or emergency visits.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE107
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
Neurological Disorders