Costs in the treatment of schizophrenia in adults receiving atypical antipsychotics: an 11-year cohort in Brazil
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFMG |
Texto Completo: | https://doi.org/10.1007/s40258-018-0408-4 http://hdl.handle.net/1843/61051 |
Resumo: | Background: Schizophrenia is associated with significant economic burden. In Brazil, antipsychotics drugs, outpatient and hospital services are provided by the Brazilian National Health System for patients with schizophrenia. However, there are few studies that capture the cost of managing these patients within the Brazilian NHS. This is important to appraise different management approaches within universal healthcare systems. Objective: Describe the costs associated with the treatment of schizophrenia in adults receiving atypical antipsychotics in Brazil from 2000 to 2010 through real world data. Methods: We integrated three national databases for adult patients with schizophrenia receiving one or more atypical antipsychotics. Only direct medical costs were assessed as the perspective is a public payer. A multivariate log-linear regression model was performed to evaluate associations between costs and clinical and demographic variables. Results: 174,310 patients with schizophrenia were identified with mean (± SD) annual costs of USD 1,811.92 ± 284.39 per patient. Atypical antipsychotics accounted for 79.7% of the total cost, with a mean (± SD) annual cost per patient of USD 1,578.74 ± 240.40. Mean (± SD) annual costs per patient of psychiatric hospitalization were USD 2,482.90 ± 302.92 and outpatient psychiatric care was USD 862.96 ± 160.18. Olanzapine was used by 47.7% of patients and represented 62.8% of the total cost of atypical antipsychotics. Patients who used clozapine had the highest mean annual cost per patient regarding outpatient psychiatric care and psychiatric hospitalization. Conclusions: Atypical antipsychotics were responsible for the majority of the schizophrenia treatment cost, and psychiatric hospitalization costs were the highest mean annual cost per patient. As a result, authorities should ensure good quality of use of atypical antipsychotic and encourage outpatient psychiatric care over psychiatric hospitalization where possible. |
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2023-11-17T12:16:15Z2023-11-17T12:16:15Z2018-10165697709https://doi.org/10.1007/s40258-018-0408-41179-1896http://hdl.handle.net/1843/61051Background: Schizophrenia is associated with significant economic burden. In Brazil, antipsychotics drugs, outpatient and hospital services are provided by the Brazilian National Health System for patients with schizophrenia. However, there are few studies that capture the cost of managing these patients within the Brazilian NHS. This is important to appraise different management approaches within universal healthcare systems. Objective: Describe the costs associated with the treatment of schizophrenia in adults receiving atypical antipsychotics in Brazil from 2000 to 2010 through real world data. Methods: We integrated three national databases for adult patients with schizophrenia receiving one or more atypical antipsychotics. Only direct medical costs were assessed as the perspective is a public payer. A multivariate log-linear regression model was performed to evaluate associations between costs and clinical and demographic variables. Results: 174,310 patients with schizophrenia were identified with mean (± SD) annual costs of USD 1,811.92 ± 284.39 per patient. Atypical antipsychotics accounted for 79.7% of the total cost, with a mean (± SD) annual cost per patient of USD 1,578.74 ± 240.40. Mean (± SD) annual costs per patient of psychiatric hospitalization were USD 2,482.90 ± 302.92 and outpatient psychiatric care was USD 862.96 ± 160.18. Olanzapine was used by 47.7% of patients and represented 62.8% of the total cost of atypical antipsychotics. Patients who used clozapine had the highest mean annual cost per patient regarding outpatient psychiatric care and psychiatric hospitalization. Conclusions: Atypical antipsychotics were responsible for the majority of the schizophrenia treatment cost, and psychiatric hospitalization costs were the highest mean annual cost per patient. As a result, authorities should ensure good quality of use of atypical antipsychotic and encourage outpatient psychiatric care over psychiatric hospitalization where possible.Antecedentes: A esquizofrenia está associada a um fardo económico significativo. No Brasil, medicamentos antipsicóticos e serviços ambulatoriais e hospitalares são fornecidos pelo Sistema Único de Saúde para pacientes com esquizofrenia. Entretanto, há poucos estudos que capturem o custo do manejo desses pacientes no SUS brasileiro. Isto é importante para avaliar diferentes abordagens de gestão dentro dos sistemas universais de saúde. Objetivo: Descrever os custos associados ao tratamento da esquizofrenia em adultos que receberam antipsicóticos atípicos no Brasil de 2000 a 2010 por meio de dados do mundo real. Métodos: Integramos três bancos de dados nacionais para pacientes adultos com esquizofrenia recebendo um ou mais antipsicóticos atípicos. Apenas foram avaliados os custos médicos diretos, uma vez que a perspectiva é um pagador público. Um modelo de regressão log-linear multivariado foi realizado para avaliar associações entre custos e variáveis clínicas e demográficas. Resultados: Foram identificados 174.310 pacientes com esquizofrenia com custos anuais médios (± DP) de US$ 1.811,92 ± 284,39 por paciente. Os antipsicóticos atípicos representaram 79,7% do custo total, com um custo médio (± DP) anual por paciente de US$ 1.578,74 ± 240,40. Os custos anuais médios (± DP) por paciente de internação psiquiátrica foram de US$ 2.482,90 ± 302,92 e os cuidados psiquiátricos ambulatoriais foram de US$ 862,96 ± 160,18. A olanzapina foi utilizada por 47,7% dos pacientes e representou 62,8% do custo total dos antipsicóticos atípicos. Os pacientes que usaram clozapina tiveram o maior custo médio anual por paciente em atendimento psiquiátrico ambulatorial e internação psiquiátrica. Conclusões: Os antipsicóticos atípicos foram responsáveis pela maior parte dos custos do tratamento da esquizofrenia, e os custos de internação psiquiátrica foram os maiores custos médios anuais por paciente. Como resultado, as autoridades devem garantir a boa qualidade do uso de antipsicóticos atípicos e encorajar cuidados psiquiátricos ambulatoriais em vez de hospitalização psiquiátrica, sempre que possível.engUniversidade Federal de Minas GeraisUFMGBrasilFAR - DEPARTAMENTO DE FARMÁCIA SOCIALMED - DEPARTAMENTO DE MEDICINA PREVENTIVA SOCIALApplied Health Economics and Health PolicyEsquizofreniaCustos de cuidados de saúdeCustos de medicamentosAntipsicóticosBrasilSchizophreniaHealth care costsAtypical antipsychoticsDrug costsBrazilCosts in the treatment of schizophrenia in adults receiving atypical antipsychotics: an 11-year cohort in Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleWallace Breno BarbosaJuliana de Oliveira CostaLívia Lovato Pires de LemosRosângela Maria GomesHelian Nunes de OliveiraCristina Mariano RuasFrancisco de Assis AcurcioCorrado BarbuiMarion BennieBrian GodmanAugusto Afonso Guerra Júniorapplication/pdfinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSELicense.txtLicense.txttext/plain; charset=utf-82042https://repositorio.ufmg.br/bitstream/1843/61051/1/License.txtfa505098d172de0bc8864fc1287ffe22MD51ORIGINALCosts in the treatment of schizophrenia in adults receiving atypical antipsychotics an 11-year cohort in Brazil.pdfCosts in the treatment of schizophrenia in adults receiving atypical antipsychotics an 11-year cohort in Brazil.pdfapplication/pdf1003051https://repositorio.ufmg.br/bitstream/1843/61051/2/Costs%20in%20the%20treatment%20of%20schizophrenia%20in%20adults%20receiving%20atypical%20antipsychotics%20an%2011-year%20cohort%20in%20Brazil.pdf3c50c553127df889372667c4a9a3a0b0MD521843/610512023-11-17 17:36:52.546oai:repositorio.ufmg.br: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Repositório de PublicaçõesPUBhttps://repositorio.ufmg.br/oaiopendoar:2023-11-17T20:36:52Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false |
dc.title.pt_BR.fl_str_mv |
Costs in the treatment of schizophrenia in adults receiving atypical antipsychotics: an 11-year cohort in Brazil |
title |
Costs in the treatment of schizophrenia in adults receiving atypical antipsychotics: an 11-year cohort in Brazil |
spellingShingle |
Costs in the treatment of schizophrenia in adults receiving atypical antipsychotics: an 11-year cohort in Brazil Wallace Breno Barbosa Schizophrenia Health care costs Atypical antipsychotics Drug costs Brazil Esquizofrenia Custos de cuidados de saúde Custos de medicamentos Antipsicóticos Brasil |
title_short |
Costs in the treatment of schizophrenia in adults receiving atypical antipsychotics: an 11-year cohort in Brazil |
title_full |
Costs in the treatment of schizophrenia in adults receiving atypical antipsychotics: an 11-year cohort in Brazil |
title_fullStr |
Costs in the treatment of schizophrenia in adults receiving atypical antipsychotics: an 11-year cohort in Brazil |
title_full_unstemmed |
Costs in the treatment of schizophrenia in adults receiving atypical antipsychotics: an 11-year cohort in Brazil |
title_sort |
Costs in the treatment of schizophrenia in adults receiving atypical antipsychotics: an 11-year cohort in Brazil |
author |
Wallace Breno Barbosa |
author_facet |
Wallace Breno Barbosa Juliana de Oliveira Costa Lívia Lovato Pires de Lemos Rosângela Maria Gomes Helian Nunes de Oliveira Cristina Mariano Ruas Francisco de Assis Acurcio Corrado Barbui Marion Bennie Brian Godman Augusto Afonso Guerra Júnior |
author_role |
author |
author2 |
Juliana de Oliveira Costa Lívia Lovato Pires de Lemos Rosângela Maria Gomes Helian Nunes de Oliveira Cristina Mariano Ruas Francisco de Assis Acurcio Corrado Barbui Marion Bennie Brian Godman Augusto Afonso Guerra Júnior |
author2_role |
author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Wallace Breno Barbosa Juliana de Oliveira Costa Lívia Lovato Pires de Lemos Rosângela Maria Gomes Helian Nunes de Oliveira Cristina Mariano Ruas Francisco de Assis Acurcio Corrado Barbui Marion Bennie Brian Godman Augusto Afonso Guerra Júnior |
dc.subject.por.fl_str_mv |
Schizophrenia Health care costs Atypical antipsychotics Drug costs Brazil |
topic |
Schizophrenia Health care costs Atypical antipsychotics Drug costs Brazil Esquizofrenia Custos de cuidados de saúde Custos de medicamentos Antipsicóticos Brasil |
dc.subject.other.pt_BR.fl_str_mv |
Esquizofrenia Custos de cuidados de saúde Custos de medicamentos Antipsicóticos Brasil |
description |
Background: Schizophrenia is associated with significant economic burden. In Brazil, antipsychotics drugs, outpatient and hospital services are provided by the Brazilian National Health System for patients with schizophrenia. However, there are few studies that capture the cost of managing these patients within the Brazilian NHS. This is important to appraise different management approaches within universal healthcare systems. Objective: Describe the costs associated with the treatment of schizophrenia in adults receiving atypical antipsychotics in Brazil from 2000 to 2010 through real world data. Methods: We integrated three national databases for adult patients with schizophrenia receiving one or more atypical antipsychotics. Only direct medical costs were assessed as the perspective is a public payer. A multivariate log-linear regression model was performed to evaluate associations between costs and clinical and demographic variables. Results: 174,310 patients with schizophrenia were identified with mean (± SD) annual costs of USD 1,811.92 ± 284.39 per patient. Atypical antipsychotics accounted for 79.7% of the total cost, with a mean (± SD) annual cost per patient of USD 1,578.74 ± 240.40. Mean (± SD) annual costs per patient of psychiatric hospitalization were USD 2,482.90 ± 302.92 and outpatient psychiatric care was USD 862.96 ± 160.18. Olanzapine was used by 47.7% of patients and represented 62.8% of the total cost of atypical antipsychotics. Patients who used clozapine had the highest mean annual cost per patient regarding outpatient psychiatric care and psychiatric hospitalization. Conclusions: Atypical antipsychotics were responsible for the majority of the schizophrenia treatment cost, and psychiatric hospitalization costs were the highest mean annual cost per patient. As a result, authorities should ensure good quality of use of atypical antipsychotic and encourage outpatient psychiatric care over psychiatric hospitalization where possible. |
publishDate |
2018 |
dc.date.issued.fl_str_mv |
2018-10 |
dc.date.accessioned.fl_str_mv |
2023-11-17T12:16:15Z |
dc.date.available.fl_str_mv |
2023-11-17T12:16:15Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/1843/61051 |
dc.identifier.doi.pt_BR.fl_str_mv |
https://doi.org/10.1007/s40258-018-0408-4 |
dc.identifier.issn.pt_BR.fl_str_mv |
1179-1896 |
url |
https://doi.org/10.1007/s40258-018-0408-4 http://hdl.handle.net/1843/61051 |
identifier_str_mv |
1179-1896 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
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Applied Health Economics and Health Policy |
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openAccess |
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Universidade Federal de Minas Gerais |
dc.publisher.initials.fl_str_mv |
UFMG |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
FAR - DEPARTAMENTO DE FARMÁCIA SOCIAL MED - DEPARTAMENTO DE MEDICINA PREVENTIVA SOCIAL |
publisher.none.fl_str_mv |
Universidade Federal de Minas Gerais |
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reponame:Repositório Institucional da UFMG instname:Universidade Federal de Minas Gerais (UFMG) instacron:UFMG |
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