Dados do Trabalho

Título

IS THERE A DIFFERENCE IN “OUT-OF-POCKET” COSTS OF CANCER TREATMENT WHEN COMPARING PATIENTS FROM BRAZILIAN NATIONAL HEALTH SYSTEM VS. RESEARCH PROTOCOLS? – COMPARATIVE STUDY

Introdução

The economic burden of cancer treatment affects not only the Brazilian National Health System (SUS), but also patients. Indirect not-reimbursed costs include medication, food, transportation, and other so-called “out-of-pocket” costs.

Objetivo

Our study aims to compare the indirect costs of cancer treatment between patients from SUS vs. research protocols.

Método

Observational, cross-sectional and analytical study carried out in 2021. Patients undergoing chemotherapy were divided into groups from: a tertiary hospital linked to SUS; and research protocols from a study and research center. The primary outcome was the assessment of indirect costs, using a socioeconomic questionnaire to identify costs and time spent by patients during treatment. Univariate analysis was performed using Fischer's exact test for categorical variables, and the T or Mann-Whitney test for continuous variables, depending on the normality assessed by the Shapiro-Wilk test. The final multivariate analysis was performed using the Cox logistic regression method, with P < 0.05 as statistical significance. Study approved by the Research Ethics Committee (CAAE 30524420.3.0000.0082).

Resultado

195 patients were included, 165 (84.6%) from the SUS group and 30 (15.4%) from research protocols. Of the total, 61% were female and the mean age of patients was 57 years. The median of global indirect costs in SUS patients was 453.80 Brazilian reais, and in research protocols was 448.00 Brazilian reais (P = 0.317). Comparing the groups in the multivariate analysis, only the time spent by patients on chemotherapy and radiotherapy showed a statistical difference, being greater in the SUS group (OR 2.58, 95% CI 1.03-6.50).

Conclusão

The overall indirect costs of SUS patients is close to those of patients in research protocols, with no statistically significant difference. The decreasing ranking of indirect costs in the SUS group is time-value in chemotherapy/radiotherapy, transport, and time-value in consultations. In the research protocols it is transport, time-value in chemotherapy/radiotherapy and time-value in consultations.

Palavras-chave

Neoplasms, Costs, Chemotherapy

Área

Oncologia - Políticas Públicas, Acesso, Farmacoeconomia e Gestão em Saúde