Author(s)
Rosim MP1, Medeiros M2, dos Santos WM1, Okumura L3, Barros Pena JL4, Castillo JM5, Oliveira Jr WP6, Nita ME7, Lucchetta RC2, Vieira M8, Almeida ALC9, de Resende MVC10, Riveros BS2
1MAPESolutions, São Paulo, Brazil, 2MAPESolutions, Sao Paulo, Brazil, 3Pequeno Príncipe Children's Hospital, Curitiba, Brazil, 4Pós-Graduação em Ciências Médicas, Belo Horizonte, Brazil, 5Catholic University of Pernambuco, Recife, Brazil, 6Câmara Federal dos Deputados, Brasília, Brazil, 7MAPESolutions and University of São Paulo, São Paulo, Brazil, 8Instituto do Coração, São Paulo, Brazil, 9Santa Casa de Misericórdia da Feira de Santana, Feira de Santana, Brazil, 10Hospital Samaritano, São Paulo, Brazil
OBJECTIVES: To estimate the budget impact of incorporating global longitudinal strain (GLS) for the early detection of cardiotoxicity in patients under cancer treatment, compared to conventional echocardiographic measurements (ECO) in the Brazilian Private Healthcare System (PHS). METHODS: The BI was calculated based on a Markov constructed with the following health states: no changes, cardiotoxicity, heart failure, reversibility and death, with annual cycles. Eligible population was estimated through an epidemiological approach, based on the prevalence of cancer, proportion of cancer patients treated with anthracyclines and proportion of patients covered by health plans. The time horizon was 5 years, with perspective of the PHS. One scenario was built considering only the cost of GLS and ECO, whereas the other scenario included direct medical costs related to the management of cardiotoxicity and heart failure. Probabilistic sensitivity analyses were performed to explore uncertainties. RESULTS: The initial eligible population was estimated in 209,657 patients. The scenario considering only GLS and ECO procedures costs resulted in a positive BI, from BRL3.6 million in the first year to R$ 59 million in the fifth year. Considering total costs, the incorporation of GLS has the potential to result in savings to PHS from the fourth year of incorporation. In the fifth year the economy reaches about R$ 9 million. Deterministic results are corroborated by the probabilistic analyses. CONCLUSIONS: Cardiotoxicity has a major impact in cancer patients treated with anthracyclines, being associated with increased risk of heart failure and mortality. Since GLS has the potential of early detection of cardiotoxicity, allowing the rapid onset of treatment, the use of GLS has the potential to promote savings for the private healthcare system.
Conference/Value in Health Info
2019-09, ISPOR Latin America 2019, Bogota, Colombia
Value in Health Regional, Volume 20S (October 2019)
Code
PCV7
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
Cardiovascular Disorders