FINANCIAL IMPACT OF NOT PRESCRIBING “BY THE BOOK”- ART AND SUSTAINABILITY OF SEGURO POPULAR
Author(s)
Rivera-Peña G, Gutiérrez-Delgado C
Economic Analysis Unit, Mexico City, Mexico
OBJECTIVES: Estimate the financial impact of current prescription practices for first time enrollees (FTE) financed by SP and calculate potential savings if physicians were adhered to the official guidelines. METHODS: Data for FTE about prescriptions, CD4, Viral Load and public purchase ART prices were obtained from CENSIDA for period January 2012 to Jun 2014. Information was analyzed to identify ART prescriptions according to official guidelines. Average annual cost (AAC) of ART per enrollee was estimated under two scenarios of prescription: a) observed in practice; b) according to official guidelines. With the AAC of ART we estimated the potential savings that would be generated for SP. RESULTS: Around 60% of ART observed prescriptions for FTE adhered to official guidelines. AAC of current prescription for 9,500 FTE amounts to US$34.1 million equivalent to 23% of financial resources available for high cost treatments in SP. If physicians would had adhered to the official guidelines savings for US$5.4 million that represents 16% of the total annual spending in FTE would had been generated in the period analyzed. On average FTE who initiate ART are maintained for 3.5 years with the initial scheme, thus savings that could be generated would reach US$18.8 million. CONCLUSIONS: Financing ART given its chronic nature creates an increasing pressure in the public funds available for high cost treatments in SP. This situation would generate insolvency in the midterm if public policies focused on strengthening prescription monitoring and sanction, cost containment of ART and health outcomes are not enforced in the short term.
Conference/Value in Health Info
2015-09, ISPOR Latin America 2015, Santiago, Chile
Value in Health, Vol. 18, No. 7 (November 2015)
Code
PIN34
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Infectious Disease (non-vaccine)