Cost-utility analysis of methylphenidate treatment for children and adolescents with ADHD in Brazil
Objective: To perform a cost-utility analysis on the treatment of attention deficit hyperactivity disorder (ADHD) with methylphenidate immediate-release (MPH-IR) in children and adolescents from Brazil. Method: A Markov model was constructed to compare MPH-IR vs. no treatment. A 24-week naturalistic study was conducted to collect transition probabilities and utility data. Effectiveness was expressed as quality-adjusted life-years (QALY), and costs reported in 2014 international dollars (I$). The perspective was the Brazilian Unified Health System as payer, and the time horizon was 6 years. Results: Of 171 patients, 73 provided information at baseline, and 56 at week 24. Considering the MPH-IR monthly cost of I$ 38, the incremental cost-effectiveness ratio (ICER) of treatment was I$ 9,103/QALY for children and I$ 11,883/QALY for adolescents. In two-way sensitivity analysis, considering one Gross National Product per capita (I$ 11,530) as willingness-to-pay, a cost of no-treatment lower than I$ 45/month would render MPH-IR a cost-saving strategy. Discussion: MPH-IR treatment of children and adolescents is cost-effective for ADHD patients from the Brazilian public health system perspective. Both patients and the healthcare system might benefit from such a strategy. Trial registration number: NCT01705613.
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Associação Brasileira de Psiquiatria
2016
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oai:scielo:S1516-444620160001000302016-03-09Cost-utility analysis of methylphenidate treatment for children and adolescents with ADHD in BrazilMaia,Carlos R.Stella,Steffan F.Wagner,FlaviaPianca,Thiago G.Krieger,Fernanda V.Cruz,Luciane N.Polanczyk,Guilherme V.Rohde,Luís A.Polanczyk,Carísi A. Attention deficit hyperactivity disorder cost-utility analysis methylphenidate Objective: To perform a cost-utility analysis on the treatment of attention deficit hyperactivity disorder (ADHD) with methylphenidate immediate-release (MPH-IR) in children and adolescents from Brazil. Method: A Markov model was constructed to compare MPH-IR vs. no treatment. A 24-week naturalistic study was conducted to collect transition probabilities and utility data. Effectiveness was expressed as quality-adjusted life-years (QALY), and costs reported in 2014 international dollars (I$). The perspective was the Brazilian Unified Health System as payer, and the time horizon was 6 years. Results: Of 171 patients, 73 provided information at baseline, and 56 at week 24. Considering the MPH-IR monthly cost of I$ 38, the incremental cost-effectiveness ratio (ICER) of treatment was I$ 9,103/QALY for children and I$ 11,883/QALY for adolescents. In two-way sensitivity analysis, considering one Gross National Product per capita (I$ 11,530) as willingness-to-pay, a cost of no-treatment lower than I$ 45/month would render MPH-IR a cost-saving strategy. Discussion: MPH-IR treatment of children and adolescents is cost-effective for ADHD patients from the Brazilian public health system perspective. Both patients and the healthcare system might benefit from such a strategy. Trial registration number: NCT01705613.info:eu-repo/semantics/openAccessAssociação Brasileira de PsiquiatriaBrazilian Journal of Psychiatry v.38 n.1 20162016-03-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462016000100030en10.1590/1516-4446-2014-1516 |
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Maia,Carlos R. Stella,Steffan F. Wagner,Flavia Pianca,Thiago G. Krieger,Fernanda V. Cruz,Luciane N. Polanczyk,Guilherme V. Rohde,Luís A. Polanczyk,Carísi A. |
spellingShingle |
Maia,Carlos R. Stella,Steffan F. Wagner,Flavia Pianca,Thiago G. Krieger,Fernanda V. Cruz,Luciane N. Polanczyk,Guilherme V. Rohde,Luís A. Polanczyk,Carísi A. Cost-utility analysis of methylphenidate treatment for children and adolescents with ADHD in Brazil |
author_facet |
Maia,Carlos R. Stella,Steffan F. Wagner,Flavia Pianca,Thiago G. Krieger,Fernanda V. Cruz,Luciane N. Polanczyk,Guilherme V. Rohde,Luís A. Polanczyk,Carísi A. |
author_sort |
Maia,Carlos R. |
title |
Cost-utility analysis of methylphenidate treatment for children and adolescents with ADHD in Brazil |
title_short |
Cost-utility analysis of methylphenidate treatment for children and adolescents with ADHD in Brazil |
title_full |
Cost-utility analysis of methylphenidate treatment for children and adolescents with ADHD in Brazil |
title_fullStr |
Cost-utility analysis of methylphenidate treatment for children and adolescents with ADHD in Brazil |
title_full_unstemmed |
Cost-utility analysis of methylphenidate treatment for children and adolescents with ADHD in Brazil |
title_sort |
cost-utility analysis of methylphenidate treatment for children and adolescents with adhd in brazil |
description |
Objective: To perform a cost-utility analysis on the treatment of attention deficit hyperactivity disorder (ADHD) with methylphenidate immediate-release (MPH-IR) in children and adolescents from Brazil. Method: A Markov model was constructed to compare MPH-IR vs. no treatment. A 24-week naturalistic study was conducted to collect transition probabilities and utility data. Effectiveness was expressed as quality-adjusted life-years (QALY), and costs reported in 2014 international dollars (I$). The perspective was the Brazilian Unified Health System as payer, and the time horizon was 6 years. Results: Of 171 patients, 73 provided information at baseline, and 56 at week 24. Considering the MPH-IR monthly cost of I$ 38, the incremental cost-effectiveness ratio (ICER) of treatment was I$ 9,103/QALY for children and I$ 11,883/QALY for adolescents. In two-way sensitivity analysis, considering one Gross National Product per capita (I$ 11,530) as willingness-to-pay, a cost of no-treatment lower than I$ 45/month would render MPH-IR a cost-saving strategy. Discussion: MPH-IR treatment of children and adolescents is cost-effective for ADHD patients from the Brazilian public health system perspective. Both patients and the healthcare system might benefit from such a strategy. Trial registration number: NCT01705613. |
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Associação Brasileira de Psiquiatria |
publishDate |
2016 |
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http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462016000100030 |
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