Resource use patterns and costs associated with the treatment of myelofibrosis, polycythemia vera and essential trombocythemia in the brazilian public health care system

Abstract

OBJECTIVES: To evaluate the resource use and associated costs of patients treated for polycythemia vera (PV), myelofibrosis (MF) and essential thrombocythemia (ET) in the Brazilian public health care system. METHODS: DATASUS is a Brazilian comprehensive database that reports all outpatient and inpatient services provided by the Brazilian public health care system. Patients identified with the diagnosis of PV (ICD 10 D45), MF (D47.1) and ET (D47.3) in the Datasus database between January 2010 and December 2010 were included in the analysis, irrespective of the date of diagnosis. Patients' profile was defined based on age, sex and geographical region. Costs and resource use patterns were analyzed for the year 2010 and characterized by the percentage of patients using each health resource, the average quantity per patient and the total associated cost. Analyses were segmented by outpatient (drugs and transport) and inpatient (hospitalization) costs. RESULTS: The number of patients identified with the diagnosis of PV, MF and ET were 1533, 2130 and 2413, respectively. Their average age was 65, 63 and 63 years, and the percentage of females equaled 55%, 55% and 66%, respectively. The majority of patients live in the southeast region of Brazil. The three diseases present a similar treatment pattern. The majority of outpatient costs are associated to first line and second line chemotherapy treatment (21.9% and 77.5% for PV; 12.6% and 86.9% for MF; 12.6% and 87.2% for ET, respectively). The average annual outpatient and inpatient costs per patient were: R$2,581.27 and R$15.27 for PV; R$3,341.02 and R$45.22 for MF; R$ 4,070.28 and R$15.92 for ET) (1 USD = R$2.04). CONCLUSIONS: The current treatment for PV, MFand ET in the Brazilian public health care system relies basically on the use of first and second line chemotherapy. These items are responsible for more than 90% of the annual treatment cost.