Broadstreet Health Economics and Outcomes Research, Vancouver, BC, Canada.
Astellas Pharma Global Development, Inc., Northbrook, IL, USA.
Adv Ther. 2020 May;37(5):2344-2355. doi: 10.1007/s12325-020-01318-w. Epub 2020 Apr 15.
In Brazil, current data on the use of healthcare resources to manage individuals with overactive bladder (OAB) are lacking. This study aimed to characterize contemporary treatment and the economic burden among patients with OAB managed under the Brazilian public health system (Sistema Único de Saúde [SUS]).
Population-based data from January to December of 2015 were acquired from Brazil's public health database. Adults at least 18 years of age with an ICD-10 diagnostic code for OAB within the period were included. Records of outpatient visits, hospitalizations, and onabotulinumtoxinA injections were used to calculate estimates of resource use and costs (in Brazilian reals [R$]) among those with OAB (frequency [%] and mean (standard deviation [SD]) as appropriate). Patient identifiers were not available, so a record linkage methodology was used to match medical encounters to individuals. Pharmacologic management of OAB was informed by government medication purchases available from the official Brazilian government databases.
During 2015, 26,640 patients with OAB were identified. All cohort members had at least one outpatient visit and 15,349 (57.6%) were hospitalized. Of the study cohort, 10.0% visited a general practitioner (GP), 41.3% visited a specialist, and 52.0% visited other non-medical healthcare practitioners within the year. Mean (SD) healthcare costs among the study cohort totaled R$355 (R$866) per patient per year; and were R$291 (R$654), R$27 (R$130), R$27 (R$30), and R$11 (R$17) for hospitalizations, GP, specialist, and non-medical healthcare practitioner visits per patient per year, respectively. Regional analysis of reported government medication purchases suggested that access to OAB treatments is highly limited.
High resource use and costs were estimated among patients with OAB managed within the SUS. These data provide a snapshot of the management of patients with OAB in Brazil, with the patients seeking treatment under SUS likely representing a more burdened subpopulation.
在巴西，目前缺乏关于医疗资源用于管理膀胱过度活动症（OAB）患者的相关数据。本研究旨在描述巴西公共卫生系统（Sistema Único de Saúde [SUS]）管理下 OAB 患者的当代治疗方法和经济负担。
本研究从巴西公共卫生数据库中获取了 2015 年 1 月至 12 月的基于人群的数据。研究纳入了在此期间至少有一个 OAB ICD-10 诊断代码的 18 岁以上成年人。使用门诊就诊、住院和注射肉毒杆菌毒素 A 的记录来计算 OAB 患者的资源使用和成本估计值（频率[％]和平均值（标准偏差[SD]））。由于无法获取患者标识，因此使用记录链接方法将医疗就诊与个人匹配。OAB 的药物治疗方法信息来源于政府可从官方巴西政府数据库中购买的药物。
2015 年，共确定了 26640 例 OAB 患者。所有队列成员至少有一次门诊就诊，15349 例（57.6％）住院。在研究队列中，有 10.0％的患者就诊于全科医生（GP），41.3％就诊于专科医生，52.0％就诊于其他非医疗保健从业者。研究队列的平均（SD）每位患者每年的医疗保健费用为 355 雷亚尔（R$）（866 雷亚尔）；住院、GP、专科医生和非医疗保健从业者就诊的每位患者每年费用分别为 291 雷亚尔（R$）（654 雷亚尔）、27 雷亚尔（R$）（130 雷亚尔）、27 雷亚尔（R$）（30 雷亚尔）和 11 雷亚尔（R$）（17 雷亚尔）。对报告的政府药物购买的区域分析表明，获得 OAB 治疗的机会受到高度限制。
在 SUS 管理下的 OAB 患者中，估计资源使用量和费用都很高。这些数据提供了巴西 OAB 患者管理情况的快照，在 SUS 下接受治疗的患者可能代表了更有负担的亚人群。
