Does it fit in your pocket? economic burden of PD-1 inhibitors' toxicity in the supplementary health system: evidence from Brazil
Abstract Background A full understanding of the economic burden associated with treatment-related adverse events (AEs) can aid estimates of the incremental costs associated with incorporating new technologies and support cost-effective economic modeling in Brazil. In this context, the main objective...
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-023-09736-6 |
| _version_ | 1797774324690583552 |
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| author | Hugo Santos Duarte Cassia Rita Pereira da Veiga Claudimar Pereira da Veiga Alberto Julius Alves Wainstein Wesley Vieira da Silva Ana Paula Drummond-Lage |
| author_facet | Hugo Santos Duarte Cassia Rita Pereira da Veiga Claudimar Pereira da Veiga Alberto Julius Alves Wainstein Wesley Vieira da Silva Ana Paula Drummond-Lage |
| author_sort | Hugo Santos Duarte |
| collection | DOAJ |
| description | Abstract Background A full understanding of the economic burden associated with treatment-related adverse events (AEs) can aid estimates of the incremental costs associated with incorporating new technologies and support cost-effective economic modeling in Brazil. In this context, the main objective of this work was to evaluate in a real-life database: (i) the direct medical cost of monitoring the occurrence of AEs (CMO); (ii) the direct medical cost of managing an identified AE (CMN); and (iii) the total direct medical cost of monitoring and managing AEs (TMC), in quarterly periods from 0 to 24 months of the monitoring of cancer patients who used a PD-1 inhibitor from the perspective of the supplementary health system in Brazil. Methods This study was conducted from the supplementary health system (SSS) perspective and followed the methodological guidelines related to cost-of-illness studies. A bottom-up (person-based) approach was used to assess the use of health resources to monitor and manage AEs during the use of PD-1 inhibitors, which made it possible to capture differences in the mean frequency of the use of health services with stratification results for different subgroups. As the Brazilian SSS is complex, asymmetric, and fragmented, this study used information from different sources. The methodology was divided into three parts: (i) Data Source: clinical management of AEs; (ii) Microcosting: management of the economic burden of AEs; (iii) Statistical analysis: stratification of results for different subgroups. Results Analysis of the economic burden of toxicity showed higher CMO costs than CMN in all the periods analyzed. In general, for every BRL 100 on average invested in the TMC of AEs, BRL 95 are used to monitor the occurrence of the AE and only BRL 5 to manage an identified AE. This work also showed that the sociodemographic characteristics of patients, the journey of oncological treatment, and the toxicity profile affect the economic burden related to AE. Conclusion This study provided real-world evidence of the economic burden of AEs associated with the use of PD-1 inhibitors in Brazil. This work also made methodological contributions by evaluating the economic burden of AE of PD-1 inhibitors considering the kinetics of toxicity occurrence and categorizing the costs in terms of CMO, CMN and TMC. |
| first_indexed | 2024-03-12T22:19:23Z |
| format | Article |
| id | doaj.art-ff95f7ca36644029995536981066bf66 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-03-12T22:19:23Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-ff95f7ca36644029995536981066bf662023-07-23T11:10:12ZengBMCBMC Health Services Research1472-69632023-07-0123111110.1186/s12913-023-09736-6Does it fit in your pocket? economic burden of PD-1 inhibitors' toxicity in the supplementary health system: evidence from BrazilHugo Santos Duarte0Cassia Rita Pereira da Veiga1Claudimar Pereira da Veiga2Alberto Julius Alves Wainstein3Wesley Vieira da Silva4Ana Paula Drummond-Lage5Faculdade de Ciências Médicas de Minas GeraisDepartamento de Gestão de Serviços de Saúde, Escola de Enfermagem, Universidade Federal de Minas GeraisFDC Business School, Fundação Dom Cabral, Faculdade de Ciências Médicas de Minas GeraisUniversidade Federal de Alagoas - UFALFaculdade de Ciências Médicas de Minas GeraisAbstract Background A full understanding of the economic burden associated with treatment-related adverse events (AEs) can aid estimates of the incremental costs associated with incorporating new technologies and support cost-effective economic modeling in Brazil. In this context, the main objective of this work was to evaluate in a real-life database: (i) the direct medical cost of monitoring the occurrence of AEs (CMO); (ii) the direct medical cost of managing an identified AE (CMN); and (iii) the total direct medical cost of monitoring and managing AEs (TMC), in quarterly periods from 0 to 24 months of the monitoring of cancer patients who used a PD-1 inhibitor from the perspective of the supplementary health system in Brazil. Methods This study was conducted from the supplementary health system (SSS) perspective and followed the methodological guidelines related to cost-of-illness studies. A bottom-up (person-based) approach was used to assess the use of health resources to monitor and manage AEs during the use of PD-1 inhibitors, which made it possible to capture differences in the mean frequency of the use of health services with stratification results for different subgroups. As the Brazilian SSS is complex, asymmetric, and fragmented, this study used information from different sources. The methodology was divided into three parts: (i) Data Source: clinical management of AEs; (ii) Microcosting: management of the economic burden of AEs; (iii) Statistical analysis: stratification of results for different subgroups. Results Analysis of the economic burden of toxicity showed higher CMO costs than CMN in all the periods analyzed. In general, for every BRL 100 on average invested in the TMC of AEs, BRL 95 are used to monitor the occurrence of the AE and only BRL 5 to manage an identified AE. This work also showed that the sociodemographic characteristics of patients, the journey of oncological treatment, and the toxicity profile affect the economic burden related to AE. Conclusion This study provided real-world evidence of the economic burden of AEs associated with the use of PD-1 inhibitors in Brazil. This work also made methodological contributions by evaluating the economic burden of AE of PD-1 inhibitors considering the kinetics of toxicity occurrence and categorizing the costs in terms of CMO, CMN and TMC.https://doi.org/10.1186/s12913-023-09736-6Health managementBurden of toxicityCostOncologyPD-1/PD-L1 inhibitor |
| spellingShingle | Hugo Santos Duarte Cassia Rita Pereira da Veiga Claudimar Pereira da Veiga Alberto Julius Alves Wainstein Wesley Vieira da Silva Ana Paula Drummond-Lage Does it fit in your pocket? economic burden of PD-1 inhibitors' toxicity in the supplementary health system: evidence from Brazil BMC Health Services Research Health management Burden of toxicity Cost Oncology PD-1/PD-L1 inhibitor |
| title | Does it fit in your pocket? economic burden of PD-1 inhibitors' toxicity in the supplementary health system: evidence from Brazil |
| title_full | Does it fit in your pocket? economic burden of PD-1 inhibitors' toxicity in the supplementary health system: evidence from Brazil |
| title_fullStr | Does it fit in your pocket? economic burden of PD-1 inhibitors' toxicity in the supplementary health system: evidence from Brazil |
| title_full_unstemmed | Does it fit in your pocket? economic burden of PD-1 inhibitors' toxicity in the supplementary health system: evidence from Brazil |
| title_short | Does it fit in your pocket? economic burden of PD-1 inhibitors' toxicity in the supplementary health system: evidence from Brazil |
| title_sort | does it fit in your pocket economic burden of pd 1 inhibitors toxicity in the supplementary health system evidence from brazil |
| topic | Health management Burden of toxicity Cost Oncology PD-1/PD-L1 inhibitor |
| url | https://doi.org/10.1186/s12913-023-09736-6 |
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