RESUMO
BACKGROUND: Chagas disease (CD) is a neglected disease affecting millions worldwide, yet little is known about its economic burden. This systematic review is part of RAISE project, a broader study that aims to estimate the global prevalence, mortality, and health and economic burden attributable to chronic CD and Chronic Chagas cardiomyopathy. The objective of this study was to assess the main costs associated with the treatment of CD in both endemic and non-endemic countries. METHODS: An electronic search of the Medline, Lilacs, and Embase databases was conducted until 31st, 2022, to identify and select economic studies that evaluated treatment costs of CD. No restrictions on place or language were made. Complete or partial economic analyses were included. RESULTS: Fifteen studies were included, with two-thirds referring to endemic countries. The most commonly investigated cost components were inpatient care, exams, surgeries, consultation, drugs, and pacemakers. However, significant heterogeneity in the estimation methods and presentation of data was observed, highlighting the absence of standardization in the measurement methods and cost components. The most common component analyzed using the same metric was hospitalization. The mean annual hospital cost per patient ranges from $25.47 purchasing power parity US dollars (PPP-USD) to $18,823.74 PPP-USD, and the median value was $324.44 PPP-USD. The lifetime hospital cost per patient varies from $209,44 PPP-USD for general care to $14,351.68 PPP-USD for patients with heart failure. DISCUSSION: Despite the limitations of the included studies, this study is the first systematic review of the costs of CD treatment. The findings underscore the importance of standardizing the measurement methods and cost components for estimating the economic burden of CD and improving the comparability of cost components magnitude and cost composition analysis. Finally, assessing the economic burden is essential for public policies designed to eliminate CD, given the continued neglect of this disease.
Assuntos
Cardiomiopatia Chagásica , Doença de Chagas , Insuficiência Cardíaca , Humanos , Efeitos Psicossociais da Doença , Estresse Financeiro , Doença de Chagas/epidemiologiaRESUMO
Objetivo: Evaluar la costo-efectividad y la costo-utilidad del sunitinib frente al interferón-alfa (IFN-α) como tratamientos de primera línea para pacientes con carcinoma de células renales metastásico en Colombia. Métodos: Se realizó un análisis de costoefectividady de costo-utilidad. La efectividad se midió en años de vida ganados libres de progresión de la enfermedad y en años de vida ganados, y la utilidad, en años de vida ganados ajustados por calidad (AVAC). Las medidas de efectividad fueron extraídas de un estudio clínico, y las del uso de servicios, de una serie de 15 pacientes con carcinoma de células renales metastásico tratadosen Colombia, ajustados por la opinión de expertos locales; los costos de los medicamentos fueron tomados de una institución de referencia. Los costos se expresaron en pesos colombianos de 2006 utilizando una tasa de descuento del 5por ciento anual Resultados: Para el caso base, el análisis demostró una diferencia a favor del sunitinib de $13,47 millones, con una efectividad superior en 0,23 años libres de progresión, un incremento de 0,05 años de vida y a un aumento en AVAC de 0,07. Las razones de costo-efectividad incremental y de costo-utilidad incremental fueron negativas. Conclusiones: El sunitinib fue menos costoso y más efectivo para el tratamiento incial del carcinoma de células renales metastático en la serie de pacientes analizada.
