Economic evaluation of human albumin use in patients with nephrotic syndrome in four Brazilian public hospitals: pharmacoeconomic study.

Autor:	Toledo LAK; MSc. Pharmacist, Hospital Universitário Professor Edgard Santos (HUPES), Universidade Federal da Bahia (UFBA), Salvador (BA), Brazil., Noblat ACB; MD, PhD. Nephrologist, Head of Complex Care Management Division, Hospital Universitário Professor Edgard Santos (HUPES), Universidade Federal da Bahia (UFBA), Salvador (BA), Brazil., Nascimento HFD; MSc. Economist, Hospital Universitário Professor Edgard Santos (HUPES), Salvador (BA), Brazil., Noblat LACB; Pharmacyst, PhD. Professor, School of Pharmacy, Universidade Federal da Bahia (UFBA), and Education and Research Manager, Hospital Universitário Professor Edgard Santos (HUPES), Salvador (BA), Brazil.
Jazyk:	angličtina
Zdroj:	Sao Paulo medical journal = Revista paulista de medicina [Sao Paulo Med J] 2017 Mar-Apr; Vol. 135 (2), pp. 92-99. Date of Electronic Publication: 2017 Apr 20.
DOI:	10.1590/1516-3180.2016.0048030516
Abstrakt:	Context and Objective:: In 2004, the Brazilian National Health Surveillance Agency (Agência Nacional de Vigilância Sanitária, ANVISA) published a resolution establishing guidelines for albumin use. Although the published data do not indicate any definitive conclusions about the benefits of albumin use in patients with nephrotic syndrome (NS), the guidelines recommend this procedure only in cases of edema that is refractory to use of diuretics. The aim here was to analyze albumin use among patients with nephrotic syndrome. Design and Setting:: Pharmacoeconomic study conducted in four large public referral hospitals for nephrology services in northeastern Brazil. Method:: Cost-effectiveness and cost-utility economic evaluations were performed on a concurrent cohort of patients with nephrotic syndrome, who were divided into two groups according to compliance or noncompliance with the guidelines. Quality-of-life data were obtained from the SF36 and CHQ-PF50 questionnaires. Results:: This study enrolled 109 patients (60% adults and 56% women); 41.3% were using albumin in accordance with the guidelines. The weight, diuresis and fluid balance parameters were more cost-effective for patients who adhered to the guidelines. Regarding days of hospitalization avoided, the incremental ratio showed a daily cost of R$ 55.33, and guideline-compliant patients were hospitalized for five days or fewer. The quality of life improved by 8%, and savings of R$ 3,458.13/QALY (quality-adjusted life year) for the healthcare system were generated through guideline compliance. Conclusion:: The economic analyses of this study demonstrated that there were greater cost benefits for patients whose treatment followed the guidelines.
Databáze:	MEDLINE
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