2023年巴西结核病服务估计费用。

IF 3.4 3区 医学 Q1 RESPIRATORY SYSTEM
Elias Jabbour, Marcia Pinto, Ricardo E Steffen, Fernanda Dockhorn, Daniele M Pelissari, Nicole M de Souza, Eduardo de Souza Alves, Anete Trajman, Jonathon R Campbell
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引用次数: 0

摘要

导言:为了在巴西消除结核病,扩大筛查和预防战略至关重要。我们估计了巴西结核病服务的成本,以支持预算编制、成本效益分析并为这些战略的实施提供信息。方法:我们利用巴西5个大城市(马瑙斯、累西腓、阿雷格里港、圣保罗和里约热内卢)的数据库估算2023年结核病服务成本。我们估计了特定组成部分的平均成本和95%不确定范围(95% UR),并根据国家成人和儿童结核病诊断和治疗算法将这些组成部分结合起来,以估计不同服务的成本。我们利用这些产出来估算家庭接触调查的成本。结果:我们估计,通过结核菌素皮肤试验(TST)或干扰素γ释放试验检测儿童结核病感染并提供3个月每周一次异烟肼和利福喷丁(3HP)的平均(95% UR)成本分别为48美元(25- 82美元)和67美元(43- 101美元)。为儿童提供6个月的药物敏感结核病(DS-TB)治疗费用为557美元(163- 1195美元)。成人的费用与TST和3HP的费用相似,为49美元(25- 86美元),DS-TB治疗6个月的费用为583美元(175- 1252美元)。对于儿童和成人,利福平耐药结核病(RR-TB)的6个月新治疗方案的费用低于18个月治疗方案。在儿童中,6个月方案的费用为4807美元(1559- 10066美元),18个月方案的费用为9212美元(2756- 19567美元)。成人的相应费用为3518美元(1169- 7330美元)和7910美元(2533- 16717美元)。在1万个有指数结核病患者的家庭中,我们估计使用TST和3HP进行结核病感染筛查和治疗以及DS-TB和RR-TB疾病6个月方案的费用为1 093 531美元(95% UR $409 349- 2 217 054美元)。结论:不同的诊断和治疗选择在结核病服务方面存在重要的成本差异。这些数据是编制预算和提高成本效益的必要投入。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Estimated costs of tuberculosis services in Brazil, 2023.

Introduction: To eliminate tuberculosis (TB) in Brazil, scaling up screening and prevention strategies will be essential. We estimated costs of TB services in Brazil to support budgeting, cost-effectiveness analysis and inform the implementation of these strategies.

Methods: We leveraged databases from five large cities in Brazil (Manaus, Recife, Porto Alegre, São Paulo and Rio de Janeiro) to estimate costs of TB services in 2023 US dollars. We estimated mean costs and 95% uncertainty ranges (95% UR) for specific components and combined these components according to national algorithms for TB diagnosis and treatment in adults and children to estimate costs for different services. We leveraged these outputs to estimate the costs of household contact investigation.

Results: We estimated the mean (95% UR) cost of testing children for TB infection with a tuberculin skin test (TST) or interferon-gamma release assay and providing 3 months of once-weekly isoniazid and rifapentine (3HP) was US$48 ($25-$82) and US$67 ($43-$101), respectively. Providing 6 months of treatment for drug-susceptible tuberculosis (DS-TB) to children was US$557 ($163-$1195). In adults, costs were similar to the cost of TST and 3HP costing US$49 ($25-$86) and 6 months of DS-TB treatment being $583 ($175-$1252). For both children and adults, costs of newer, 6-month treatment regimens for rifampin-resistant tuberculosis (RR-TB) were less expensive than 18-month regimens. In children, the cost was US$4807 ($1559-$10 066) for the 6-month regimen and US$9212 ($2756-$19 567) for the 18-month regimen. Corresponding costs in adults were US$3518 ($1169-$7330) and US$7910 ($2533-$16 717). Across 10 000 households with an index TB patient, we estimated use of a TST and 3HP for TB infection screening and treatment and 6-month regimens for DS-TB and RR-TB disease to cost $1 093 531 (95% UR $409 349-$2 217 054).

Conclusion: There are important cost differences in TB services depending on diagnostic and treatment choices. These data are essential inputs for budgeting and cost-effectiveness.

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来源期刊
BMJ Open Respiratory Research
BMJ Open Respiratory Research RESPIRATORY SYSTEM-
CiteScore
6.60
自引率
2.40%
发文量
95
审稿时长
12 weeks
期刊介绍: BMJ Open Respiratory Research is a peer-reviewed, open access journal publishing respiratory and critical care medicine. It is the sister journal to Thorax and co-owned by the British Thoracic Society and BMJ. The journal focuses on robustness of methodology and scientific rigour with less emphasis on novelty or perceived impact. BMJ Open Respiratory Research operates a rapid review process, with continuous publication online, ensuring timely, up-to-date research is available worldwide. The journal publishes review articles and all research study types: Basic science including laboratory based experiments and animal models, Pilot studies or proof of concept, Observational studies, Study protocols, Registries, Clinical trials from phase I to multicentre randomised clinical trials, Systematic reviews and meta-analyses.
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