OBJECTIVES: To understand the standard of care (SoC) and estimate resource utilization and costs related to chronic rhinosinusitis with nasal polyps (CRSwNP), from the private payer’s perspective in Brazil.

METHODS: Resource use and cost in a 5-year time horizon were estimated based on microcosting approach. To validate disease management and SoC therapies in the country, an expert panel was held, composed of five otorhinolaryngologists from different Brazilian states. Microcosting was segmented in disease evaluation and diagnosis, conservative drug treatment step, first surgical approach, subsequent surgeries, minor and major surgical complications. Since healthcare plans (HMO) are not obligated to reimburse oral outpatient drugs, an alternative scenario was built which excluded out-of-pocket costs. Only direct medical costs were considered from Private Healthcare System perspective. Biological drugs were not considered in the analysis as they do not yet represent a national reality. Unit costs were obtained from Brazilian official price lists, in 2021 Brazilian Real (BRL) values (1BRL=US$5,64).

RESULTS: All patients were assumed to stay on drug treatment throughout the 5-year period. Eighty percent of all CRSwNP patients needs at least one surgery and 30% needs two or more surgeries. The average time between first and second surgeries is 3 years, and, from second to third, 2 years. All patients use intranasal steroids. For acute manifestations, oral steroids and antibiotics are prescribed for all patients. Estimated total cost per patient was 94,285.20BRL for the 5-year horizon and the main cost component was drug treatment (48,860BRL [51.8% of the total]), followed by first surgical approach (22,891BRL [24.3%]), and subsequent surgeries (17,228BRL [18.3%]). Out-of-pocket costs represented 15.1% of total medical cost. In the alternative scenario excluding out-of-pocket costs, 80,045BRL were spent in 5 years.

CONCLUSIONS: The economic burden of CRSwNP is substantial, mainly driven by drugs and surgical procedures. Funding: GSK (218071).