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Cadernos de Saúde Pública

Print version ISSN 0102-311XOn-line version ISSN 1678-4464


SILVA, Grasiela Martins da; SENNA, Katia Marie Simões e; SOUSA, Eduardo Branco de  and  TURA, Bernardo Rangel. Budget impact analysis of viscosupplementation for non-surgical treatment of knee osteoarthritis. Cad. Saúde Pública [online]. 2019, vol.35, n.10, e00098618.  Epub Oct 07, 2019. ISSN 0102-311X.

Knee osteoarthritis affects 3.8% of the world population and manifests as pain, edema, stiffness, and reduced joint function, impacting the patient’s quality of life. Treatment consists of the pharmacological, non-pharmacological, and surgical modalities. Viscosupplementation (intraarticular hyaluronate) has been proposed to relieve symptoms and potentially postpone surgery. This study estimated the budget impact of the association of this drug and non-surgical treatment (standard treatment) from the perspective of the Brazilian Unified National Health System. Based on the assumption that 5% of patients proceed to treatment and on the direct costs of the pharmacological and non-pharmacological modalities, the authors calculated the reference and alternative scenarios that compared the different treatment options in a three-year timeline. The principal analysis estimated an incremental budget impact of approximately BRL 126 million (U$ 32 million) for one vial of hyaluronate a year and BRL 252 million (USD 64 million) for two vials a year. Diacerein, an oral chondroprotector, assessed as an alternative, showed a budget impact of BRL 334 million (USD 86 million) in relation to standard treatment, representing a 24% cost increase compared to two vials a year of hyaluronate, making it less economically advantageous. Viscosupplementation can provide better quality of life for patients, reduce costs for the health system, and optimize the flow of care in health services. The estimates presented in this study can assist administrators in the best use of resources and thus in decision-making on the technology’s incorporation.

Keywords : Viscosupplementation; Osteoarthritis; Knee; Budgets.

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