Ciclosporina versus tacrolimus no transplante renal no Brasil: uma comparação de custos
Autor(a) principal: | |
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Data de Publicação: | 2010 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Cadernos de Saúde Pública |
Texto Completo: | https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/4286 |
Resumo: | In Brazil, the Unified National Health System (SUS) is responsible for the majority of kidney transplants. To maintain these interventions, the guidelines recommend the use of cyclosporine or tacrolimus, associated with corticosteroids and azathioprine or mycophenolate. Taking the perspective of the National Health System, an economic analysis was performed on the outpatient and hospital resources and medicines used by patient and therapeutic group. A cohort was constructed from 2000 to 2004, with 5,174 kidney transplant patients in use of cyclosporine or tacrolimus, identified by probabilistic record linkage from the National Health System. The cohort included 4,015 patients in use of cyclosporine and 1,159 using tacrolimus. The majority were males, age < 38 years, with nephritis, cardiovascular diseases, and indeterminate causes as the most frequent primary diagnoses. After 48 months of follow-up, the expenditures were higher for kidney transplants in hospitals in the Northeast, cadaver donors, patients in dialysis > 24 months before the transplant, and in the tacrolimus group. Total hospital and outpatient costs and expenditure on medication were higher in patients on tacrolimus as compared to the cyclosporine group. |
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Ciclosporina versus tacrolimus no transplante renal no Brasil: uma comparação de custosTransplante RenalGastos em SaúdeEconomia da SaúdeIn Brazil, the Unified National Health System (SUS) is responsible for the majority of kidney transplants. To maintain these interventions, the guidelines recommend the use of cyclosporine or tacrolimus, associated with corticosteroids and azathioprine or mycophenolate. Taking the perspective of the National Health System, an economic analysis was performed on the outpatient and hospital resources and medicines used by patient and therapeutic group. A cohort was constructed from 2000 to 2004, with 5,174 kidney transplant patients in use of cyclosporine or tacrolimus, identified by probabilistic record linkage from the National Health System. The cohort included 4,015 patients in use of cyclosporine and 1,159 using tacrolimus. The majority were males, age < 38 years, with nephritis, cardiovascular diseases, and indeterminate causes as the most frequent primary diagnoses. After 48 months of follow-up, the expenditures were higher for kidney transplants in hospitals in the Northeast, cadaver donors, patients in dialysis > 24 months before the transplant, and in the tacrolimus group. Total hospital and outpatient costs and expenditure on medication were higher in patients on tacrolimus as compared to the cyclosporine group.No Brasil, o Sistema Único de Saúde (SUS) é responsável maioria dos transplantes renais. Para a manutenção dessas intervenções, os protocolos recomendam uso da ciclosporina ou tacrolimus, associado com corticosteróides e azatioprina ou micofenolato. Na perspectiva do SUS, realizou-se análise econômica sobre recursos ambulatoriais, hospitalares e medicamentos utilizados por paciente e grupo terapêutico. Foi construída coorte de 2000 a 2004, com 5.174 pacientes em transplantes renais e em uso de ciclosporina ou tacrolimus, identificados por relacionamento probabilístico em registros do SUS. A coorte continha 4.015 pacientes em uso de ciclosporina e 1.159 com tacrolimus. A maioria era do sexo masculino, idade < 38 anos, cujos diagnósticos primários mais freqüentes eram nefrites, doenças cardiovasculares e causas indeterminadas. Após 48 meses, observou-se gasto superior para transplantes renais em hospitais do Nordeste, doador cadáver, naqueles em diálises > 24 meses antes do transplantes renais e no grupo do tacrolimus. Constatou-se maior gasto total com recursos hospitalares, ambulatoriais e medicamentos para os transplantes renais em pacientes com esquemas com tacrolimus, quando comparados com o grupo da ciclosporina.Reports in Public HealthCadernos de Saúde Pública2010-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/4286Reports in Public Health; Vol. 26 No. 1 (2010): JanuaryCadernos de Saúde Pública; v. 26 n. 1 (2010): Janeiro1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZporhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/4286/8725https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/4286/8726Guerra Junior, Augusto AfonsoAcúrcio, Francisco de AssisAndrade, Eli Iola GurgelCherchiglia, Mariângela LealCesar, Cibele CominiQueiroz, Odilon Vanni deSilva, Grazielle Dias dainfo:eu-repo/semantics/openAccess2024-03-06T15:28:05Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/4286Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:04:57.054395Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true |
dc.title.none.fl_str_mv |
Ciclosporina versus tacrolimus no transplante renal no Brasil: uma comparação de custos |
title |
Ciclosporina versus tacrolimus no transplante renal no Brasil: uma comparação de custos |
spellingShingle |
Ciclosporina versus tacrolimus no transplante renal no Brasil: uma comparação de custos Guerra Junior, Augusto Afonso Transplante Renal Gastos em Saúde Economia da Saúde |
title_short |
Ciclosporina versus tacrolimus no transplante renal no Brasil: uma comparação de custos |
title_full |
Ciclosporina versus tacrolimus no transplante renal no Brasil: uma comparação de custos |
title_fullStr |
Ciclosporina versus tacrolimus no transplante renal no Brasil: uma comparação de custos |
title_full_unstemmed |
Ciclosporina versus tacrolimus no transplante renal no Brasil: uma comparação de custos |
title_sort |
Ciclosporina versus tacrolimus no transplante renal no Brasil: uma comparação de custos |
author |
Guerra Junior, Augusto Afonso |
author_facet |
Guerra Junior, Augusto Afonso Acúrcio, Francisco de Assis Andrade, Eli Iola Gurgel Cherchiglia, Mariângela Leal Cesar, Cibele Comini Queiroz, Odilon Vanni de Silva, Grazielle Dias da |
author_role |
author |
author2 |
Acúrcio, Francisco de Assis Andrade, Eli Iola Gurgel Cherchiglia, Mariângela Leal Cesar, Cibele Comini Queiroz, Odilon Vanni de Silva, Grazielle Dias da |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Guerra Junior, Augusto Afonso Acúrcio, Francisco de Assis Andrade, Eli Iola Gurgel Cherchiglia, Mariângela Leal Cesar, Cibele Comini Queiroz, Odilon Vanni de Silva, Grazielle Dias da |
dc.subject.por.fl_str_mv |
Transplante Renal Gastos em Saúde Economia da Saúde |
topic |
Transplante Renal Gastos em Saúde Economia da Saúde |
description |
In Brazil, the Unified National Health System (SUS) is responsible for the majority of kidney transplants. To maintain these interventions, the guidelines recommend the use of cyclosporine or tacrolimus, associated with corticosteroids and azathioprine or mycophenolate. Taking the perspective of the National Health System, an economic analysis was performed on the outpatient and hospital resources and medicines used by patient and therapeutic group. A cohort was constructed from 2000 to 2004, with 5,174 kidney transplant patients in use of cyclosporine or tacrolimus, identified by probabilistic record linkage from the National Health System. The cohort included 4,015 patients in use of cyclosporine and 1,159 using tacrolimus. The majority were males, age < 38 years, with nephritis, cardiovascular diseases, and indeterminate causes as the most frequent primary diagnoses. After 48 months of follow-up, the expenditures were higher for kidney transplants in hospitals in the Northeast, cadaver donors, patients in dialysis > 24 months before the transplant, and in the tacrolimus group. Total hospital and outpatient costs and expenditure on medication were higher in patients on tacrolimus as compared to the cyclosporine group. |
publishDate |
2010 |
dc.date.none.fl_str_mv |
2010-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/4286 |
url |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/4286 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/4286/8725 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/4286/8726 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html application/pdf |
dc.publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
dc.source.none.fl_str_mv |
Reports in Public Health; Vol. 26 No. 1 (2010): January Cadernos de Saúde Pública; v. 26 n. 1 (2010): Janeiro 1678-4464 0102-311X reponame:Cadernos de Saúde Pública instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
instname_str |
Fundação Oswaldo Cruz (FIOCRUZ) |
instacron_str |
FIOCRUZ |
institution |
FIOCRUZ |
reponame_str |
Cadernos de Saúde Pública |
collection |
Cadernos de Saúde Pública |
repository.name.fl_str_mv |
Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ) |
repository.mail.fl_str_mv |
cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br |
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1798943367068909568 |