O-1 ECONOMIC IMPACT OF LONG-TERM ALBUMIN INFUSIONS IN PATIENTS WITH DECOMPENSATED CIRRHOSIS AND UNCOMPLICATED ASCITES FROM THE BRAZILIAN PUBLIC AND PRIVATE HEALTHCARE SYSTEMS PERSPECTIVES
Introduction and Objectives: Liver cirrhosis is among the most common liver-related causes of death and is associated with severe complications that entail a major burden for patients and healthcare systems. The ANSWER trial showed that long-term human albumin infusions (LTA) (40g twice/week for two...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-03-01
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| Series: | Annals of Hepatology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268123001163 |
| _version_ | 1797862176272154624 |
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| author | Carlos Terra Elisabet Viayna Laura Ayzin Cristina Fuster Susana Aceituno Maria Soler Claudio Tafla |
| author_facet | Carlos Terra Elisabet Viayna Laura Ayzin Cristina Fuster Susana Aceituno Maria Soler Claudio Tafla |
| author_sort | Carlos Terra |
| collection | DOAJ |
| description | Introduction and Objectives: Liver cirrhosis is among the most common liver-related causes of death and is associated with severe complications that entail a major burden for patients and healthcare systems. The ANSWER trial showed that long-term human albumin infusions (LTA) (40g twice/week for two weeks followed by 40g/week for up to 18 months) added to standard medical treatment (SMT) managed to significantly reduce mortality and disease-related complications in patients with cirrhosis and uncomplicated ascites. Assess the economic impact of implementing LTA following the ANSWER protocol in patients with cirrhosis and uncomplicated ascites in Brazil from the public (SUS) and private (ANS) healthcare systems perspectives. Materials and Methods: Cost/patient/year was calculated for patients treated with LTA+SMT and compared to those treated with SMT only. Incidence of clinical complications and healthcare resource utilization (HCRU) were gathered from the ANSWER trial. Pharmacological costs (spironolactone, furosemide, human albumin) were gathered from the “Health Care Price Bank” and CMED. Costs of clinical complications (spontaneous bacterial peritonitis, other bacterial infections, hepatic encephalopathy, renal dysfunction, hepatorenal syndrome, refractory ascites) and other HCRU (LTA administration visit, large volume paracentesis, hospitalizations) were gathered from the literature and ANS. All costs were transformed to 2021 Brazilian Reals (R$). A univariate sensitivity analysis was performed by applying a 20% increase/decrease to all variables. Results: The overall cost for patients treated with LTA+SMT was R$118,759 and R$189,675 lower than that for patients treated with SMT only for SUS and ANS, respectively. The additional cost of LTA (R$30,767 and R$59,897, respectively) was compensated by a reduction in complications and HCRU (R$149,526 and R$249,572, respectively). Conclusions: Our study suggests that should the clinical outcomes of the ANSWER trial translate to real-world effectiveness, LTA administration to patients with cirrhosis and uncomplicated ascites may lead to cost savings for the SUS and ANS in Brazil. |
| first_indexed | 2024-04-09T22:14:58Z |
| format | Article |
| id | doaj.art-54f7c5c898a240cdae8afd1111994154 |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-04-09T22:14:58Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-54f7c5c898a240cdae8afd11119941542023-03-23T04:34:30ZengElsevierAnnals of Hepatology1665-26812023-03-0128101012O-1 ECONOMIC IMPACT OF LONG-TERM ALBUMIN INFUSIONS IN PATIENTS WITH DECOMPENSATED CIRRHOSIS AND UNCOMPLICATED ASCITES FROM THE BRAZILIAN PUBLIC AND PRIVATE HEALTHCARE SYSTEMS PERSPECTIVESCarlos Terra0Elisabet Viayna1Laura Ayzin2Cristina Fuster3Susana Aceituno4Maria Soler5Claudio Tafla6Liver Unit, Gastroenterology Department, Rio de Janeiro State University, Rio de Janeiro, Brazil; Liver Unit of Casa de Saúde São José, Rio de Janeiro, BrazilHealth Economics and Outcomes Research, Scientific and Medical Affairs, Grifols S.A., Sant Cugat Del Vallès, SpainInternational Market Access, Grifols International, Sant Cugat Del Vallès, SpainScientific and Medical Affairs, Grifols S.A., Sant Cugat Del Vallès, SpainHealth Economics and Outcomes Research, Outcomes’10, Castellón de La Plana, SpainHealth Economics and Outcomes Research, Outcomes’10, Castellón de La Plana, SpainMedical Director, Nilo Saúde, Sao Paulo, BrazilIntroduction and Objectives: Liver cirrhosis is among the most common liver-related causes of death and is associated with severe complications that entail a major burden for patients and healthcare systems. The ANSWER trial showed that long-term human albumin infusions (LTA) (40g twice/week for two weeks followed by 40g/week for up to 18 months) added to standard medical treatment (SMT) managed to significantly reduce mortality and disease-related complications in patients with cirrhosis and uncomplicated ascites. Assess the economic impact of implementing LTA following the ANSWER protocol in patients with cirrhosis and uncomplicated ascites in Brazil from the public (SUS) and private (ANS) healthcare systems perspectives. Materials and Methods: Cost/patient/year was calculated for patients treated with LTA+SMT and compared to those treated with SMT only. Incidence of clinical complications and healthcare resource utilization (HCRU) were gathered from the ANSWER trial. Pharmacological costs (spironolactone, furosemide, human albumin) were gathered from the “Health Care Price Bank” and CMED. Costs of clinical complications (spontaneous bacterial peritonitis, other bacterial infections, hepatic encephalopathy, renal dysfunction, hepatorenal syndrome, refractory ascites) and other HCRU (LTA administration visit, large volume paracentesis, hospitalizations) were gathered from the literature and ANS. All costs were transformed to 2021 Brazilian Reals (R$). A univariate sensitivity analysis was performed by applying a 20% increase/decrease to all variables. Results: The overall cost for patients treated with LTA+SMT was R$118,759 and R$189,675 lower than that for patients treated with SMT only for SUS and ANS, respectively. The additional cost of LTA (R$30,767 and R$59,897, respectively) was compensated by a reduction in complications and HCRU (R$149,526 and R$249,572, respectively). Conclusions: Our study suggests that should the clinical outcomes of the ANSWER trial translate to real-world effectiveness, LTA administration to patients with cirrhosis and uncomplicated ascites may lead to cost savings for the SUS and ANS in Brazil.http://www.sciencedirect.com/science/article/pii/S1665268123001163 |
| spellingShingle | Carlos Terra Elisabet Viayna Laura Ayzin Cristina Fuster Susana Aceituno Maria Soler Claudio Tafla O-1 ECONOMIC IMPACT OF LONG-TERM ALBUMIN INFUSIONS IN PATIENTS WITH DECOMPENSATED CIRRHOSIS AND UNCOMPLICATED ASCITES FROM THE BRAZILIAN PUBLIC AND PRIVATE HEALTHCARE SYSTEMS PERSPECTIVES Annals of Hepatology |
| title | O-1 ECONOMIC IMPACT OF LONG-TERM ALBUMIN INFUSIONS IN PATIENTS WITH DECOMPENSATED CIRRHOSIS AND UNCOMPLICATED ASCITES FROM THE BRAZILIAN PUBLIC AND PRIVATE HEALTHCARE SYSTEMS PERSPECTIVES |
| title_full | O-1 ECONOMIC IMPACT OF LONG-TERM ALBUMIN INFUSIONS IN PATIENTS WITH DECOMPENSATED CIRRHOSIS AND UNCOMPLICATED ASCITES FROM THE BRAZILIAN PUBLIC AND PRIVATE HEALTHCARE SYSTEMS PERSPECTIVES |
| title_fullStr | O-1 ECONOMIC IMPACT OF LONG-TERM ALBUMIN INFUSIONS IN PATIENTS WITH DECOMPENSATED CIRRHOSIS AND UNCOMPLICATED ASCITES FROM THE BRAZILIAN PUBLIC AND PRIVATE HEALTHCARE SYSTEMS PERSPECTIVES |
| title_full_unstemmed | O-1 ECONOMIC IMPACT OF LONG-TERM ALBUMIN INFUSIONS IN PATIENTS WITH DECOMPENSATED CIRRHOSIS AND UNCOMPLICATED ASCITES FROM THE BRAZILIAN PUBLIC AND PRIVATE HEALTHCARE SYSTEMS PERSPECTIVES |
| title_short | O-1 ECONOMIC IMPACT OF LONG-TERM ALBUMIN INFUSIONS IN PATIENTS WITH DECOMPENSATED CIRRHOSIS AND UNCOMPLICATED ASCITES FROM THE BRAZILIAN PUBLIC AND PRIVATE HEALTHCARE SYSTEMS PERSPECTIVES |
| title_sort | o 1 economic impact of long term albumin infusions in patients with decompensated cirrhosis and uncomplicated ascites from the brazilian public and private healthcare systems perspectives |
| url | http://www.sciencedirect.com/science/article/pii/S1665268123001163 |
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