Cost-Effectiveness of Pediatric Universal Screening for Familial Hypercholesterolemia in Argentina.

OBJECTIVE: Our study aimed to evaluate the expected cost-effectiveness of pediatric universal screening for the early diagnosis of familial hypercholesterolemia in Argentina using a probabilistic model. METHODS: Two different healthcare technologies were compared: (1) Universal screening of hypercholesterolemia at 6 years of age and (2) previous diagnostic situation (comparator). The perspective of the public Argentine healthcare system funded by the National Ministry of Health was used, considering only direct costs. Effectiveness was evaluated in terms of the number of life-years gained (LYG) and quality-adjusted life-years (QALYs) obtained by identifying familial hypercholesterolemia through each of the screening strategies. Only direct costs of screening and treatment of each strategy were evaluated. The time horizon was extended to 60 years. Future avoided costs of prevented coronary events were also included. Cost-effectiveness was measured in terms of the incremental cost-effectiveness ratio (ICER) per LYG and QALYs. Different scenarios were evaluated: (1) only index case, (2) index case and first-degree relatives, and (3) index case and first-degree relatives measuring QALYs. Sensitivity studies were conducted. RESULTS: Each identified child complying with follow-up visits and treatment gains 8.14 life-years. The ICER values obtained were 1465.35 USD/LYG and 1726.50 USD/LYG when applying a discount rate of 5%. The ICER was 10%-17% of the gross domestic product per capita in Argentina (mean 2010-2019: 12 446 USD) and did not exceed the minimum annual retirement income. CONCLUSION: Pediatric universal screening for familial hypercholesterolemia could be considered a cost-effective health technology in Argentina.

Making Universal Health Care Effective in Argentina: A Blueprint for Reform.

The reform of a health care system requires attention to specific components but also to the creation of an environment that supports change. Argentina has achieved nominal universal health coverage (UHC) but it still needs to work on achieving effective universal health coverage, especially with regard to quality and equity. Nominal coverage means that everyone has been enrolled and has the right to access, and effective coverage means that people have actually received prioritized health care services. In this article, we present our proposals to advance UHC in Argentina. The article includes an overview of Argentina's health system, then introduces the driving forces for reform, and finally analyzes four key issues where we provide our action plan to implement health reform for moving Argentina forward. Overall, our ultimate goal is to provide actual UHC and not aspirational UHC in Argentina by strengthening provincial health systems through enforcing public insurance schemes; utilizing an explicit priority-setting approach to make decisions on health coverage; reducing health disparities in coverage and outcomes, at least on prioritized health problems; and building a primary care-oriented health care system.

Análisis del proceso institucional de generación de una política social de impacto multisectorial el plan nacer y la asignación universal por hijo y por embarazo / Analysis of the institutional process of generating a social policy with a multisectoral impact, the plan to be born and the universal allocation by child and pregnancy

El Plan Nacer es un programa federal del Ministerio de Salud de la Nación implemen»tado para invertir recursos en salud destinados a mejorar la cobertura de salud y la calidad de la atención de las mujeres embarazadas, puérperas y de los niños/as menores de 6 años que no tienen obra social. El Programa, en acuerdo con las pro»vincias, desarrolla Seguros Públicos de Salud para la población materno-infantil sin obra social, a través de un modelo de financiamiento por resultados. En función de los resultados alcanzados, el Gobierno Nacional puso en marcha en agosto del 2012 el Programa SUMAR, la ampliación del Plan Nacer. El Programa SUMAR, junto con la cobertura para la población materno-infantil, incorpora a los niños/as y adolescentes de 6 a 19 años y a las mujeres hasta los 64 años