Buget impact analysis of endometriosis clinical treatment in the Brazilian Public Health Care System

Abstract

Objective: The main drugs available for the treatment of endometriosis are equally effective. However, there are differences in adverse events profile and costs. The aim of this study was to estimate the budget impact of incorporating nafarelin for the treatment of endometriosis in the Brazilian Public Health Care System. Methods: A budget impact model was developed comparing nafarelin (400 μg daily) to goserelin (3.6 mg every 28 days), leuprolide (3.75 mg monthly) and danazol (600 mg daily), considering an average treatment period of 6 months. To estimate the number of patients diagnosed with endometriosis, eligible for medical treatment, data about the Brazilian population, prevalence of the disease, proportion of symptomatic patients and percentage of patients that receive medical treatment were used, according to published data. The model assumes that present market share is equivalent among goserelin, leuprolide and danazol. After nafarelin incorporation it was assumed that the market share would be 25% for each drug. Results: The estimated number of eligible patients for endometriosis medical treatment was 1,966,600 women, in 2008, in Brazil. The treatment cost for 6 months with nafarelin, goserelin, leuprolide and danazol were R$ 2,530.20, R$ 3,091.87, R$ 2,307.42 e R$ 1,975.32, respectively. Considering the estimated market share, nafarelin incorporation would lead to an impact of R$ 22,935,118.51 for the Brazilian Public Health Care System budget for endometriosis medical treatment. Conclusion: The budget impact of incorporating nafarelin into the Brazilian Public Health Care System would be of approximately R$ 23 million, with cost reductions if compared only to goserelin.