Carine Raquel Blatt1, Noemia Liege Maria da Cunha Bernardo2, Junior Andre Rosa2, Fabiola Bagatini2, Rodrigo Fernandes Alexandre3, Giacomo Balbinotto Neto4, Uwe Siebert5, Mareni Rocha Farias6. 1. Pharmacy Post Graduation Program, University of Santa Catarina State, UFSC, Florianópolis, SC, Brazil; Department of Public Health and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria; University of Santa Catarina South, UNISUL, Tubarão, SC, Brazil. 2. Pharmacy Post Graduation Program, University of Santa Catarina State, UFSC, Florianópolis, SC, Brazil. 3. Ministry of Health, Brasília, DF, Brazil. 4. University of Rio Grande do Sul State, Porto Alegre, RS, Brazil. 5. Department of Public Health and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria; ONCOTYROL - Center for Personalized Cancer Medicine, Innsbruck, Austria; Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USA; Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. 6. Pharmacy Post Graduation Program, University of Santa Catarina State, UFSC, Florianópolis, SC, Brazil; Department of Public Health and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria. Electronic address: marenif@yahoo.com.br.
Abstract
OBJECTIVES: Hepatitis C therapy in Brazil is expensive due to the cost of antiviral drugs and demands on medical resources. The objective of this study was to estimate the direct costs per patient of chronic hepatitis C therapy in a Brazilian setting. METHOD: A microcosting study from a public health system perspective. The costs included were those of antiviral drugs, secondary medicines, diagnostic tests, visits to physicians and other professionals, hospitalization, nurse, and pharmaceutical care. All costs were priced in 2010. The values were converted to US $ (2010). RESULTS: The total direct cost of hepatitis C treatment per patient with interferon alpha (IFN) plus ribavirin (RBV) was US $982.25, with peginterferon alpha (PEG) 2a 180 μg plus RBV was US $10,658.08, and with PEG 2b 120 μg plus RBV was US $12,597.63, taking into account entire treatment according to Brazilian guidelines and assuming that all patients completed full treatment. The antiviral drugs are the most expensive element of the cost of treatment, totaling more than 40% of the medical costs of IFN plus RBV therapy and more than 88% of PEG plus RBV therapy. Calculating an average of 10,000 treatments per year, the total direct cost is US $90,346,772.39. According to the Ministry of Health, 90% of the annual total cost of hepatitis C treatment is accounted for by antiviral drugs. CONCLUSIONS: In Brazil, antiviral drugs are the most expensive component of hepatitis C treatment. The cost of follow-up and support to patients is minimal compared with the cost of antiviral drugs.
OBJECTIVES: Hepatitis C therapy in Brazil is expensive due to the cost of antiviral drugs and demands on medical resources. The objective of this study was to estimate the direct costs per patient of chronic hepatitis C therapy in a Brazilian setting. METHOD: A microcosting study from a public health system perspective. The costs included were those of antiviral drugs, secondary medicines, diagnostic tests, visits to physicians and other professionals, hospitalization, nurse, and pharmaceutical care. All costs were priced in 2010. The values were converted to US $ (2010). RESULTS: The total direct cost of hepatitis C treatment per patient with interferon alpha (IFN) plus ribavirin (RBV) was US $982.25, with peginterferon alpha (PEG) 2a 180 μg plus RBV was US $10,658.08, and with PEG 2b 120 μg plus RBV was US $12,597.63, taking into account entire treatment according to Brazilian guidelines and assuming that all patients completed full treatment. The antiviral drugs are the most expensive element of the cost of treatment, totaling more than 40% of the medical costs of IFN plus RBV therapy and more than 88% of PEG plus RBV therapy. Calculating an average of 10,000 treatments per year, the total direct cost is US $90,346,772.39. According to the Ministry of Health, 90% of the annual total cost of hepatitis C treatment is accounted for by antiviral drugs. CONCLUSIONS: In Brazil, antiviral drugs are the most expensive component of hepatitis C treatment. The cost of follow-up and support to patients is minimal compared with the cost of antiviral drugs.