Eficácia E Custo-Utilidade De Intervenções Para O Tratamento Da Enurese Em Crianças E Adolescentes Sob A Perspectiva Do Sistema Único De Saúde Brasileiro: Effectiveness and Cost-Utility of Interventions for Enuresis Treatment in Children and Adolescents From the Brazilian Single Health System Perspective.

Autor: Moretti E; Setor de Anatomia Humana, Instituto de Ciências Biológicas e da Saúde, Universidade Federal de Alagoas, Maceió, Alagoas, Brasil. Electronic address: eduarda.moretti@icbs.ufal.br., Marcolino MAZ; Programa de Pós-Graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul, Instituto para Avaliação de Tecnologia em Saúde - INCT/IATS (CNPQ 465518/2014-1), Porto Alegre, Rio Grande do Sul, Brasil., Jaguaribe de Lima AM; Departamento de Morfologia e Fisiologia Animal, Universidade Federal Rural de Pernambuco, Recife, Pernambuco, Brasil., Lemos A; Departamento de Fisioterapia, Universidade Federal de Pernambuco, Recife, Pernambuco, Brasil.
Jazyk: angličtina
Zdroj: Value in health regional issues [Value Health Reg Issues] 2023 Sep; Vol. 37, pp. 1-8. Date of Electronic Publication: 2023 Apr 24.
DOI: 10.1016/j.vhri.2023.03.004
Abstrakt: Objectives: This study aimed to estimate the cost-utility of effective interventions for enuresis treatment in children and adolescents and to calculate the incremental cost-utility ratio from the perspective of the Brazilian Unified Health System in a 1-year time horizon.
Methods: The economic analysis is in 7 stages: (1) survey of evidence of treatments for enuresis, (2) performing the network meta-analysis, (3) estimation of the probability of cure, (4) cost-utility analysis, (5) model sensitivity analysis, (6) analysis of acceptability of interventions by acceptability curve, and (7) monitoring the technological horizon.
Results: The association between desmopressin and oxybutynin is the therapeutic strategy with the highest probability of success in the treatment of enuresis in children and adolescents compared with placebo (relative risk [RR] 2.88; 95% confidence interval [CI] 1.65-5.04), followed by the combination therapy between desmopressin and tolterodine (RR 2.13; 95% CI 1.13-4.02), alarm (RR 1.59; 95% CI 1.14-2.23), and neurostimulation (RR 1.43; 95% CI 1.04-1.96). Combination therapy between desmopressin and tolterodine was the only 1 considered not to be cost-effective. Neurostimulation, alarm therapy, and therapy had the respective incremental cost-utility ratio values: R$5931.68, R$7982.92, and R$29 050.56/quality-adjusted life-years.
Conclusion: Among the therapies that are on the borderline of efficiency, the combined therapy between desmopressin and oxybutynin presents the greatest incremental benefit at an incremental cost that is still feasible, given that it does not exceed the reference value of the cost-effectiveness threshold established in Brazil.
(Copyright © 2023 International Society for Health Economics and Outcomes Research. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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