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The long-term costs for treating multiple sclerosis in a 16-year retrospective cohort study in Brazil

Author

Listed:
  • Isabela Maia Diniz
  • Augusto Afonso Guerra Junior
  • Livia Lovato Pires de Lemos
  • Kathiaja M Souza
  • Brian Godman
  • Marion Bennie
  • Björn Wettermark
  • Francisco de Assis Acurcio
  • Juliana Alvares
  • Eli Iola Gurgel Andrade
  • Mariangela Leal Cherchiglia
  • Vânia Eloisa de Araújo

Abstract

Background: Multiple Sclerosis (MS) is a disease that appreciably impacts on the quality of life of patients and is associated with high expenditure. MS is a chronic multifactorial disease, characterized by inflammation, demyelination and axonal loss. The Brazilian public health system provides pharmacological treatment as well as hospital and outpatient care for patients with relapsing-remitting and secondary progressive multiple sclerosis. However, we are not aware of any previous publications assessing total direct medical costs in patients with a long follow-up within the Brazilian healthcare system. Consequently, the objective is to analyze public spending on patients with MS to guide stakeholders in future investment and disinvestment decisions. Methods and findings: We retrospectively analyzed public Brazilian spending on patients with MS between 2000 and 2015 using the patient-centered registry of all patients in the public health system (SUS) obtained through deterministic-probabilistic record linkage of the Outpatient Information System, Hospital Information System and Mortality Information Systems in Brazil. Descriptive data analysis and a multiple linear regression model was performed to evaluate the associations between the mean annual cost per patient and the clinical and demographic variables. The suitability of the model was verified from a residue analysis and the level of significance adopted was 5%. Results: 28,401 patients were identified and subsequently 23,082 patients were analyzed. The majority of the patients were female (73.3%), lived in the southeast region (58.9%), had a mean age of 36.8 (± 12.2) years and started treatment using one of the interferons beta (78.9%). The total direct medical cost spending in the sixteen years of the follow-up was US $ 2,308,393,465.60, and the mean annual expenditure per patient was US $ 13,544.40 (± 4,607.05). In the best fit model (p

Suggested Citation

  • Isabela Maia Diniz & Augusto Afonso Guerra Junior & Livia Lovato Pires de Lemos & Kathiaja M Souza & Brian Godman & Marion Bennie & Björn Wettermark & Francisco de Assis Acurcio & Juliana Alvares & El, 2018. "The long-term costs for treating multiple sclerosis in a 16-year retrospective cohort study in Brazil," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-14, June.
  • Handle: RePEc:plo:pone00:0199446
    DOI: 10.1371/journal.pone.0199446
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    References listed on IDEAS

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    1. Marcello Moccia & Raffaele Palladino & Roberta Lanzillo & Antonio Carotenuto & Cinzia Valeria Russo & Maria Triassi & Vincenzo Brescia Morra, 2017. "Healthcare Costs for Treating Relapsing Multiple Sclerosis and the Risk of Progression: A Retrospective Italian Cohort Study from 2001 to 2015," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-12, January.
    2. Livio Garattini & Francesca Ghislandi & Milene Costa, 2015. "Cost-Effectiveness Modeling in Multiple Sclerosis: Playing Around with Non-Healthcare Costs?," PharmacoEconomics, Springer, vol. 33(12), pages 1241-1244, December.
    3. A. J. Hawton & C. Green, 2016. "Multiple sclerosis: relapses, resource use, and costs," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(7), pages 875-884, September.
    4. Livia Lovato Pires de Lemos & Augusto Afonso Guerra Júnior & Marisa Santos & Carlos Magliano & Isabela Diniz & Kathiaja Souza & Ramon Gonçalves Pereira & Juliana Alvares & Brian Godman & Marion Bennie, 2018. "The Assessment for Disinvestment of Intramuscular Interferon Beta for Relapsing-Remitting Multiple Sclerosis in Brazil," PharmacoEconomics, Springer, vol. 36(2), pages 161-173, February.
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    Cited by:

    1. Jalal Dahham & Rana Rizk & Ingrid Kremer & Silvia M. A. A. Evers & Mickaël Hiligsmann, 2021. "Economic Burden of Multiple Sclerosis in Low- and Middle‐Income Countries: A Systematic Review," PharmacoEconomics, Springer, vol. 39(7), pages 789-807, July.

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