Dados do Trabalho

Title

TEMPORAL TENDENCY OF PRESCRIPTION OF BIOLOGICAL THERAPY IN RHEUMATOID ARTHRITIS FROM BRAZILIAN PUBLIC HEALTH SYSTEM- SISTEMA UNICO DE SAUDE (SUS).

Background

Analyzing a temporal trend of the epidemiological of the patients with Rheumatoid Arthritis (AR) in treatment with biological therapy assisted in Sistema Único de Saúde (SUS) in Brazil.

Materials and methods

A time-series study, carried in Espírito Santo (ES), through secondary data on patients with RA using biological therapy in the 10 public Pharmacies of the state, between January 2009 to Abril 2017. To compare the annual incidences, a linear trend analysis of these time series was performed for each pharmacy.

Results

There were 9,804 requests for treatment with biological therapies, with dispensation concentrated in the main pharmacies of the metropolitan region of the state (69%); with predominance of women (84%), and mean age of 56 years (+-13,3); the most prevalent drug was adalimumabe (40%), followed by infliximabe (21%), with a total cost of R $ 6,335,100.71. For all biological therapies there was a notable increase in the tendency of the dispensation, being adalimumabe, infliximabe, etanercepte, golimumabe more frequently, followed by certolizumabe, rituximabe, abatacepte and tocilizumabe. Drugs with a growing trend curve in the study period are the drugs that are part of the SUS treatment protocol for RA 2017. The total cost of biological therapies for the treatment of RA throughout the state, based on the amounts paid by SUS, was R $ 6,335,100.71 for the study period to treat 902 patients. The highest expense was with adalimumabe R$ 1,977,984.29, followed by etanercepte R $ 1,410,256.87 and the lowest expense was with rituximabe R$ 47,471.16.

Conclusions

There was expressive increase in the dispensing of these drugs in relation to the growth of the incidence of the new patients by the SUS. Considering that, there is a growing demand for biologicals and that the prevalence of RA in the general population is 1%, an estimated 40,163 cases of RA in the state of the ES. If 30% of the cases received indication of biological therapies, based on the estimate of this study, maintaining the same distribution of biological therapies, the cost would be R $ 84,625,340, assuming the premise that these values should not reduce in the coming years, generating a worry about the cost of therapy in the future.

Área

Public Health