Cost-utility analysis of methylphenidate treatment for children and adolescents with ADHD in Brazil

• Autor(a) principal: Maia, Carlos Renato Moreira
• Data de Publicação: 2016
• Outros Autores: Stella, Steffan Frosi, Wagner, Flávia, Pianca, Thiago Gatti, Krieger, Fernanda Valle, Cruz, Luciane Nascimento, Polanczyk, Guilherme Vanoni, Rohde, Luis Augusto Paim, Polanczyk, Carisi Anne
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UFRGS
• Texto Completo: http://hdl.handle.net/10183/147575
• topic: Transtorno do déficit de atenção com hiperatividade; Análise custo-eficiência; Metilfenidato; Attention deficit hyperactivity disorder; Cost-utility analysis; Methylphenidate

Objective: To perform a cost-utility analysis on the treatment of attention deficit hyperactivity disorder (ADHD) with methylphenidate immediate-release (MPH-IR) in children and adolescents from Brazil. Method: A Markov model was constructed to compare MPH-IR vs. no treatment. A 24-week naturalistic study was conducted to collect transition probabilities and utility data. Effectiveness was expressed as quality-adjusted life-years (QALY), and costs reported in 2014 international dollars (I$). The perspective was the Brazilian Unified Health System as payer, and the time horizon was 6 years. Results: Of 171 patients, 73 provided information at baseline, and 56 at week 24. Considering the MPH-IR monthly cost of I$ 38, the incremental cost-effectiveness ratio (ICER) of treatment was I$ 9,103/QALY for children and I$ 11,883/QALY for adolescents. In two-way sensitivity analysis, considering one Gross National Product per capita (I$ 11,530) as willingness-to-pay, a cost of no-treatment lower than I$ 45/month would render MPH-IR a cost-saving strategy. Discussion: MPH-IR treatment of children and adolescents is cost-effective for ADHD patients from the Brazilian public health system perspective. Both patients and the healthcare system might benefit from such a strategy.