RESUMO
BACKGROUND: adequate treatment of anxiety disorders reduces the economic impact, improves functionality in daily life activities and quality of life. Pharmacologic treatment depends on patient's characteristics and doctor's experience. The aim of this study was to determine the use of resources in anxiety disorder and to analyze its cost-effectiveness. METHODS: use of resources related to chronic treatment of anxiety disorders and cost-effectiveness of drugs were determined, as well as patients' out-of-pocket expenses and productivity loss. A one-year time horizon and decision tree with benzodiazepines, selective inhibitor of serotonin re-intake (SISR) and tricyclic antidepressant drugs were included. RESULTS: benzodiazepines were the treatment that had the lowest total cost ($147,587 MXP), followed by SISR (incremental cost of $2,182 MXP), and the highest cost was tricyclic antidepressant drugs ($155,903 MXP). CONCLUSIONS: benzodiazepines are good alternative for anxiety disorder because of their high effectiveness to control symptoms and because they reduce hospital costs.
Assuntos
Ansiolíticos/economia , Ansiolíticos/uso terapêutico , Ansiedade/tratamento farmacológico , Ansiedade/economia , Análise Custo-Benefício , HumanosRESUMO
BACKGROUND: In Mexico, six of every twenty Mexicans suffer psychiatric disorders at some time in their lives. This disease ranks fifth in the country. The objective was to determine and compare the cost-effectiveness of two models for hospital care (partial and traditional) at a psychiatric hospital of Instituto Mexicano del Seguro Social (IMSS). METHODS: a multicenter study with a prospective cohort of 374 patients was performed. We made a cost-effectiveness analysis from an institutional viewpoint with a six-month follow-up. Direct medical costs were analyzed, with quality of life gains as outcome measurement. A decision tree and a probabilistic sensitivity analysis were used. RESULTS: patient care in the partial model had a cost 50 % lower than the traditional one, with similar results in quality of life. The cost per successful unit in partial hospitalization was 3359 Mexican pesos while in the traditional it increased to 5470 Mexican pesos. CONCLUSIONS: treating patients in the partial hospitalization model is a cost-effective alternative compared with the traditional model. Therefore, the IMSS should promote the infrastructure that delivers the psychiatric services to the patient attending to who requires it.
Introducción: en México, seis de cada veinte mexicanos presentan trastornos psiquiátricos alguna vez en la vida. Está enfermedad ocupa el quinto lugar en nuestro país. El objetivo de este estudio fue determinar y comparar el costo-efectividad de los dos modelos de atención médica hospitalaria (parcial y tradicional) del IMSS. Métodos: estudio multicéntrico, con cohorte prospectiva de 374 pacientes y análisis de costo-efectividad con perspectiva institucional y seguimiento de seis meses. Se analizaron los costos médicos directos, con la ganancia en calidad de vida como medida de resultados. Se empleó un árbol de decisiones y un análisis probabilístico de sensibilidad. Resultados: la atención de pacientes del modelo de hospitalización parcial implicó un costo 50 % menor al tradicional, con resultados similares en calidad de vida. El costo por unidad de éxito en hospitalización parcial fue de 3359, mientras que en tradicional se incrementó a 5470 (ambas cantidades en pesos mexicanos). Conclusiones: tratar a los pacientes en el modelo de hospitalización parcial es una alternativa costo-efectiva con respecto a la tradicional; el IMSS debe considerar la promoción de la infraestructura que permita ofrecer este servicio a los pacientes que lo requieran.