Custo-efetividade do tratamento da infecção pelo vírus da hepatite C em candidatos a transplante renal submetidos à diálise

Abstract

The objective of the study was to analyze the cost-utility of the treatment of hepatitis C in patients on dialysis awaiting renal transplantation. The aim was to compare among distinct treatments: monotherapy with interferon-_, monotherapy with pegylated interferon, interferon-_ associated with ribavirin, and pegylated interferon with ribavirin, and with those without treatment. The perspective used was the Brazilian Public health system (SUS), which was also the base for calculating the costs of the treatment more cost effective. To analyze the data the Markov model was used for simulation of the costs and results obtained for each treatment used. Data from literature were used to define the health states of the transplanted patients infected by hepatitis C, and the probability of transition among the states. Utility measures derived from specialists evaluation. The costs derived from the procedures list of the SUS. The results show that treatment of hepatitis C before renal transplantation is more cost-effective compared with no treatment, and interferon-a is the best option. The budget impact of this strategy corresponds to 0.3% of the total amount used by the SUS with renal replacement therapy in the year of 2007.