Faculdade de Medicina de Botucatu Universidade Estadual Paulista BotucatuSP Brasil Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brasil.
Institute of Health Economics and Clinical Epidemiology Faculty of Medicine University Hospital of Cologne Cologne Germany Institute of Health Economics and Clinical Epidemiology, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany.
Arch Endocrinol Metab. 2024 Jul 30;68:e230311. doi: 10.20945/2359-4292-2023-0311. eCollection 2024.
The aim of this study was to estimate the budget impact of adding cabergoline to the Brazilian Unified Health System (SUS) formulary for the treatment of patients with Cushing's disease (CD) who do not achieve disease control after transsphenoidal surgery.
We conducted a budget impact analysis (BIA) from the perspective of the Brazilian SUS over a 5-year time horizon. We compared two scenarios: ketoconazole (Scenario 1) versus including cabergoline as a treatment option (Scenario 2). All analyses were conducted using Microsoft Excel. Uncertainty was explored in univariate sensitivity analyses.
The total costs were BRL $25,596,729 for Scenario 1 and BRL $32,469,169 for Scenario 2. The budget impact of adding cabergoline to the formulary for CD treatment within the SUS would be BRL $6,091,036 over 5 years. On univariate analyses, variations in the rates of surgical failure and CD recurrence had the greatest potential to affect the final costs associated with cabergoline.
The estimated budget impact of adding cabergoline to the formulary for CD treatment within the Brazilian SUS would be about BRL $6 million. While cost savings cannot be expected, the budget impact of adding cabergoline would be lower than that of adding other treatment options for CD.
本研究旨在评估将卡麦角林纳入巴西全民健康系统（SUS）治疗库，用于治疗经蝶窦手术后仍未控制疾病的库欣病（CD）患者的预算影响。
我们进行了一项为期 5 年的预算影响分析（BIA），从巴西 SUS 的角度进行比较。我们比较了两种方案：酮康唑（方案 1）与将卡麦角林作为治疗选择纳入（方案 2）。所有分析均使用 Microsoft Excel 进行。在单变量敏感性分析中探讨了不确定性。
方案 1 的总成本为 25596729 雷亚尔，方案 2 的总成本为 32469169 雷亚尔。将卡麦角林纳入 SUS 中 CD 治疗的药物目录，预计在 5 年内将增加 SUS 预算 6091036 雷亚尔。在单变量分析中，手术失败率和 CD 复发率的变化对卡麦角林相关最终成本的影响最大。
将卡麦角林纳入巴西 SUS 中 CD 治疗药物目录的预算影响预计约为 600 万雷亚尔。虽然不能期望节省成本，但添加卡麦角林的预算影响将低于添加其他 CD 治疗选择的影响。
