Cost-effectiveness of therapeutic approaches to acute lymphocytic leukemia in pediatric patients

Authors

DOI:

https://doi.org/10.33448/rsd-v10i14.22056

Keywords:

Child Health; Leukemia, Lymphoid; Cost-benefit analysis.

Abstract

Objective: To carry out a cost-effectiveness analysis of the most used antineoplastic treatment protocols of acute leukemia in pediatric patients. Methods: Conducted a cost-effectiveness analysis, using the decision tree model, based on the consultation of secondary data from health information systems in Brazil, SIGTAP - SUS. The population consisted of pediatric patients registered in RHC database of INCA, aged 0 to 19 years, showing lymphocytic / lymphoid / lymphoblastic leukemia as a neoplasm basis, in a period from 1997 to 2017. Results: For male patients, bone marrow transplantation (BMT) exhibited a high increase in the ratio as alternatives and demonstrated the least effectiveness. Despite high incremental costs, the treatment performed with Ct associated with BMT (CtMT), showed effectivess much higher than other alternatives, becoming a cost-effective treatment. The association of Ct with radiotherapy (CtRxt) revealed the most effective treatment. For females patients, the treatment performed with CtBMT has shown to be the least cost-effectiveness, along with BMT. In turn, CtRxt provides to be the best cost-effectiveness treatment. Conclusion: The results of this economic analysis revealed better cost-effectiveness for CtRxt and worse cost-effectiveness for BMT, in both sexes. This analysis showed different scenarios according to the patient's gender, in particular, treatment with CtBMT can be an effective therapeutic option for male patients, but not for female patients.

References

Angevine, P. D., & Berven, S. (2014). Health economic studies: an introduction to cost-benefit, cost-effectiveness, and cost-utility analyses. Spine, 39(22 Suppl 1), S9–S15.

Arnaldi, A. P. (2019). Dissertação Análise do custo efetividade dos protocolos LLA 97 e GBTLI 99 para crianças em tratamento de leucemia linfocítica aguda. Universidade de São Paulo.

Ashfaq, K., Yahaya, I. & Hyde, C. (2010). Clinical effectiveness and cost-effectiveness of stem cell transplantation in the management of acute leukaemia: a systematic review. NIHR Health Technology Assessment programme: Executive Summaries (NIHR Journals Library), 14(54), 1-141.

Barban, J. B., Simões, B. P. & Moraes, B. D. G. D. C. (2020). Consenso Brasileiro de Nutrição em Transplante de Células-Tronco Hematopoiéticas: Adultos. Einstein (São Paulo), 18, 1-50.

Cavalcante, M. S., Rosa, I. S. S., & Torres, F. (2017). Leucemia linfóide aguda e seus principais conceitos. Revista Científica da Faculdade de Educação e Meio Ambiente, 8(2), 151-164.

Ferraz, C. R. G., Lorena Sobrinho, J. E. D., Santos, J. P. A. & Xavier, L. S. D. A. (2018). Monografia Manifestações orais em pacientes submetidos a quimioterapia e radioterapia: estratégias de controle e tratamento. Centro Universitário Tabosa de Almeida.

Fung, A., Horton, S., Zabih, V., Denburg, A., & Gupta, S. (2019). Cost and cost-effectiveness of childhood cancer treatment in low-income and middle-income countries: a systematic review. BMJ global health, 4(5), 1-13.

INCA (2016). Incidência, mortalidade e morbidade hospitalar por câncer em crianças, adolescentes e adultos jovens no Brasil: informações dos registros de câncer e do sistema demortalidade. Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA).

INCA (2019). Estimativa 2020: incidência de câncer no Brasil. Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA).

INCA (2020). Câncer infantojuvenil. https://www.inca.gov.br/tipos-de-cancer/cancer-infantojuvenil.

Metayer, C., Milne, E., Clavel, J. et al. (2013). The childhood leukemia international consortium. Cancerepidemiology, 37(3), 336-347.

Ministério da Saúde. (2017). Protocolo de diagnóstico precoce para oncologia pediátrica. http://bvsms.saude.gov.br/b vs/publicacoes/protocolo_diagnostico_precoce_cancer_pediatrico.pdf.

Morando, J., Mauad, M. A. & Fortier, S. C. (2010). Transplante de células-tronco hematopoéticas em crianças e adolescentes com leucemia aguda: experiência de duas instituições Brasileiras. Revista Brasileira de Hematologia e Hemoterapia, 32(5), 350-357.

Moraz, G., Garcez, A. D. S., & Assis, E.M. D. (2015). Estudos de custo-efetividade em saúde no Brasil: uma revisão sistemática. Ciência & Saúde Coletiva, 20(10), 3211-3229.

Oliveira, F. A. S. D. (2018). Monografia Análise alteração de índices de hemograma de pacientes com leucemia linfóide crônica: uma revisão. Universidade Federal de Campina Grande.

Pinheiro, D. M., Silva, M. R., Silva, J. R. & de Melo Diniz, R. T. (2019). Leucemia Linfóide Aguda Tipo B: Relato de um Caso sem Transplante de Medula Óssea. Anais do Seminário Científico do UNIFACIG 2019, (5), 1-5.

Santos, M. H. S. (2017). Monografia Mortalidade e fatores associados ao óbito em crianças e adolescentes com leucemia linfóide aguda tratadas em um serviço de referência no nordeste do Brasil. Universidade Federal de Sergipe.

Silva, C. D. S., Sousa, R. R., & Cardoso, R. O. (2018). Leucemia linfocítica aguda na infância e suas complicações. Revista de Iniciação Científica e Extensão, 1(2), 109-113.

Silva, E. N. D., Silva, M. T., & Pereira, M. G. (2016). Modelos analíticos em estudos de avaliação econômica. Epidemiologia e Serviços de Saúde, 25(4), 855-858.

Silva, J. (2019). Avaliação de Custo-efetividade nas terapias oncológicas, emprego de modelos de Markov: Uma revisão integrativa da literatura. REAS/EJCH, 11(15), 1-16.

Van Litsenburg, R. R., Uyl‐de Groot, C. A., Raat, H., Kaspers, G. J., & Gemke, R. J. (2011). Cost‐effectiveness of treatment of childhood acute lymphoblastic leukemia with chemotherapy only: the influence of new medication and diagnostic technology. Pediatricblood&câncer, 57(6), 1005-1010.

Viana, S. S., Lima, L. M. M. R., Nascimento, J. B. et al. (2015) Secular trends and predictors of mortality in acute lymphoblastic leukemia for children of low socioeconomic level in Northeast Brazil. Leukemiaresearch, 39(10), 1060-1065.

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Published

06/11/2021

How to Cite

CAVALCANTE, F. T. de S.; LIMA, T. M. N. R. de .; BEZERRA , P. M. M.; VIEIRA, T. I.; CAVALCANTI, Y. W. .; SOUSA, S. A. de. Cost-effectiveness of therapeutic approaches to acute lymphocytic leukemia in pediatric patients . Research, Society and Development, [S. l.], v. 10, n. 14, p. e383101422056, 2021. DOI: 10.33448/rsd-v10i14.22056. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/22056. Acesso em: 18 apr. 2024.

Issue

Vol. 10 No. 14

Section

Health Sciences

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Copyright (c) 2021 Francisca Thaís de Sousa Cavalcante; Thayana Maria Navarro Ribeiro de Lima; Paula Maria Maracajá Bezerra ; Thiago Isidro Vieira; Yuri Wanderley Cavalcanti; Simone Alves de Sousa

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