Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Programa de Pós-Graduação em Saúde Pública. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Departamento de Política de Medicamentos e Assistência Farmacêutica. Rio de Janeiro, RJ, Brasil.
Rev Saude Publica. 2023 Aug 4;57:41. doi: 10.11606/s1518-8787.2023057004280. eCollection 2023.
This work aims to analyze the quantity and expenses related to biological drugs used for the treatment of rheumatoid arthritis (RA) in outpatient public care within the Brazilian Unified Health System (SUS).
It is a cross-sectional descriptive study based on secondary data from a historical series, referring to the purchase, volume, and the number of patients treated with different biological drugs (infliximabe, etanercept, adalimumab, rituximab, abatacept, tocilizumab, golimumab, and certolizumab pegol) for RA treatment in outpatient care from 2012 to 2017. The data were extracted from the SUS Outpatient Information System database-SIA/SUS and included ten drugs used for RA treatment. The study assessed the quantity and expenditure of these drugs, the number of RA patients treated, and the expenditure by RA subtypes. The National Broad Consumer Price Index was used to adjust the expenditures for December 2017.
The Ministry of Health allocated approximately $500 million to provide about 2 million units of biological drugs for RA patients from 2012 to 2017. The supply of adalimumab 40 mg and etanercept 50 mg accounted for 68.3% of the total expenditure. The subtypes "other rheumatoid arthritis with rheumatoid factor" (ICD-10 M05.8), "rheumatoid arthritis without rheumatoid factor" (ICD-10 M06.0), and "Felty's syndrome" (M05. 0) represented 84.5% of the total expenditures. The proportion of patients treated with biological drugs increased by 33.0%. There was a significant 83.0% increase in the number of patients using biological drugs compared to the overall number of RA patients treated during the study period.
The results obtained allow us to draw a more recent profile of expenditure on RA treatment and indicate trends in the use of biological drugs for this condition, generating data that can support management decisions in public health policies.
本研究旨在分析巴西全民健康覆盖体系（SUS）中，门诊公共医疗中用于治疗类风湿关节炎（RA）的生物药物的数量和费用。
这是一项基于历史序列的二次数据的横断面描述性研究，涉及 2012 年至 2017 年门诊治疗 RA 的不同生物药物（英夫利昔单抗、依那西普、阿达木单抗、利妥昔单抗、阿巴西普、托珠单抗、戈利木单抗和培塞利珠单抗）的购买量、用量和治疗患者数量。数据从 SUS 门诊信息系统数据库-SIA/SUS 中提取，包括用于 RA 治疗的 10 种药物。研究评估了这些药物的数量和支出、RA 患者的数量以及 RA 亚型的支出。采用国家广泛消费者价格指数对 2017 年 12 月的支出进行调整。
2012 年至 2017 年期间，卫生部共拨款约 5 亿美元，为约 200 万 RA 患者提供生物药物。阿达木单抗 40mg 和依那西普 50mg 的供应占总支出的 68.3%。ICD-10 M05.8（其他类风湿关节炎伴类风湿因子）、ICD-10 M06.0（无类风湿因子的类风湿关节炎）和 M05.0（费尔蒂综合征）这三个亚型占总支出的 84.5%。接受生物药物治疗的患者比例增加了 33.0%。与研究期间接受 RA 治疗的所有患者相比，使用生物药物的患者数量增加了 83.0%。
研究结果可以描绘出 RA 治疗支出的最新概况，并显示出生物药物治疗该病的趋势，为公共卫生政策管理决策提供数据支持。
