FIBROSE CÍSTICA: ESTIMATIVA DOS CUSTOS DO DIAGNÓSTICO E DO TRATAMENTO EM UM CENTRO DE REFERÊNCIA NA BAHIA

Abstract

Introduction: Cystic Fibrosis is a chronic and progressive condition, in which advances in diagnosis and treatment have contributed to longer patient survival, which leads to increased use of health resources and care costs. Objective: To estimate the costs of diagnosing and treating cystic fibrosis in individuals monitored at the Complexo Hospitalar Professor Edgar Santos. Methods: Open ambispective cohort study, conducted between January 2005 and April 2022, which included 66 individuals diagnosed with cystic fibrosis and regularly followed up at the institution. Data were obtained by detailing each participant's care path, considering only the average direct costs, what were identified, quantified and assigned monetary values. Care costs were also compared between individuals diagnosed through neonatal screening and those with late diagnosis. A bottom-up collection approach was used for specific component costs. Costs were estimated from the perspective of the Unified Health System and the provider institution. In the analyses performed for categorical variables, absolute and percentage frequencies were obtained. For continuous variables with normal distribution, mean and standard deviation (SD) were described, and non-normal ones, by median and interquartile range. The non-parametric Mann-Whitney test was used to compare costs between the two groups (screening and late diagnoses), and a Spearman correlation analysis was performed between costs and follow-up time for each group. Results: During the evaluated period, costs with the consumption of medicines predominated (R$ 6,497,011,60), while the total cost with hospitalizations was R$ 126,781,41. In outpatient care, the measurement of sweat chloride had a cost of R$ 9,150,00 for the health system. The average cost of consultations per individual in the cohort was R$597,00 per year. Costs among participants with late diagnosis were higher than costs among those diagnosed through neonatal screening, being statistically significant (p<0.001). There was a weak correlation between care costs and follow-up time both for those diagnosed through neonatal screening and for those with late diagnosis. Conclusion: During the evaluated period, the costs of Cystic Fibrosis care at the researched institution were high, mainly those related to the medication consumption for the disease control. Individuals with a late diagnosis had higher costs for the diagnosis and treatment of the disease, use more of health resources.