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. 2018 Jul 27:6:205.
doi: 10.3389/fpubh.2018.00205. eCollection 2018.

Health Economic Evaluations of Cancer in Brazil: A Systematic Review

Alessandro G Campolina  1   2   3 , Tania Y Yuba  4 , Tassia C Decimoni  4 , Roseli Leandro  4 , Maria Del Pilar Estevez Diz  1 , Hillegonda M D Novaes  3   4 , Patrícia C de Soárez  3   4
Affiliations

Health Economic Evaluations of Cancer in Brazil: A Systematic Review

Alessandro G Campolina et al. Front Public Health. .

Abstract

Background: A large number of health economic evaluation (HEE) studies have been published in developed countries. However, Brazilian HEE literature in oncology has not been studied.

Objective: To investigate whether the scientific literature has provided a set of HEE in oncology capable of supporting decision making in the Brazilian context. Methods: A systematic review was conducted to identify and characterize studies in this field. We searched multiple databases selecting partial and full HEE studies in oncology (1998-2013). Results: Fifty-five articles were reviewed, of these, 33 (60%) were full health economic evaluations. Type of cancers most frequently studied were: breast (38.2%), cervical (14.6%), lung (10.9%) and colorectal (9.1%). Procedures (47.3%) were the technologies most frequently evaluated. In terms of the intended purposes of the technologies, most (63.6%) were treatments. The majority of the incremental cost-effectiveness ratios (ICERs) reported have been below the cost-effectiveness threshold suggested by the World Health Organization (WHO). Conclusions: There has been an increase in the number of HEEs related to cancer in Brazil. These studies may support decision-making processes regarding the coverage of and reimbursement of healthcare technologies for cancer treatment in Brazil.

Keywords: Brazil; cost-benefit analysis; costs and cost analysis; health care costs; neoplasms.

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Figures

Figure 1
Figure 1
Flow diagram of the process for the selection of health economic evaluations related to cancer in Brazil, 1998–2013. Bireme, Biblioteca Regional de Medicina (Regional Library of Medicine); BVS ECOS, Biblioteca Virtual em Saúde Economia da Saúde (Health Economics [database] of the [Brazilian] Virtual Library of Health); EED, Economic Evaluation Database; EMBASE, Excerpta Medica; JBES, Jornal Brasileiro de Economia da Saúde (Brazilian Journal of Health Economics); LILACS, Latin American and Caribbean Health Sciences Literature; SciELO, Scientific Electronic Library Online; SISREBRATS, Sistema de Informação da Rede Brasileira de Avaliação de Tecnologias em Saúde (Brazilian Network for the Evaluation of Health Technologies).
Figure 2
Figure 2
Number and proportional distribution of health economic evaluations related to cancer in Brazil, by publication date and type, 1998–2013.
Figure 3
Figure 3
ICERs per QALY gained, in United States Dollars (at 2013 rates), reported in health economic evaluations related to cancer in Brazil, 1998–2013 (× USD 1,000). *1× per capita GDP = USD 14,588.62; 3× per capita GDP = USD 43,765.86 (2013). CAP, capecitabine; LAP, lapatinib; mFLOX, modified 5-fluorouracil, leucovorin, and oxaliplatin; mFOLFOX6, modified 5-fluorouracil, folinic acid, and oxaliplatin (mFOLFOX6); NMPOA, Núcleo Mama Porto Alegre (Breast Center of Porto Alegre); SFM, screen-film mammography; FFDM, full-field digital mammography; TRAST, trastuzumab.
Figure 4
Figure 4
ICERs per life year gained, in United States Dollars (at 2013 rates), reported in health economic evaluations related to cancer in Brazil, 1998–2013 (× USD 1,000). *1× per capita GDP = USD 14,588.62; 3× per capita GDP = USD 43,765.86 (2013). 5-FU/LV, 5-fluorouracil plus leucovorin; FOLFIRI, folinic acid, 5-fluorouracil, and irinotecan; FOLFOX, 5-fluorouracil, folinic acid, and oxaliplatin; MRI, magnetic resonance imaging.
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