Análise de custos do tratamento sistêmico do câncer colorretal sob a perspectiva de um hospital público

Abstract

ABSTRACT

Introduction: Colorectal cancer is the second most common cancer in the Brazilian population and the third with the highest mortality rate. In the SUS, cancer care is funded through the Autorização de Procedimento de Alto Custo – APAC/Oncology. Objective: To assess whether the reimbursement made available by the SUS to oncology treatment centers is sufficient for the cost of colorectal cancer therapy. Method: Direct costs related to antineoplastics, supportive drugs, solutions/materials in general and laminar flow hood were evaluated. Four scenarios were evaluated, considering the incorporation of innovations in antiemetic therapy and/or safety in handling and administration. Results: Sixty-eight treatment protocols were analyzed in neoadjuvant, adjuvant and metastatic settings. In the neoadjuvant and adjuvant setting of rectal cancer, most had deficient APACs in all settings. In the adjuvant setting of colon cancer, APAC was deficient only for mFOLFOX6, in scenario 4. In the context of palliative therapy for colorectal cancer, 44 protocols were evaluated, with 75% having deficient APACs in scenario 1 and 81.8% in scenario 4. Considering the protocols containing only conventional cytotoxic chemotherapy, when compared in scenarios 1 to 3, 91.6% of the protocols showed surplus APACs. Conclusion: Reassessment of reimbursement values ​​for adjuvant and neoadjuvant treatment of rectal cancers is suggested, while in adjuvant treatment of colon cancer and palliative treatment based on conventional cytotoxic therapy, innovations in supportive therapy and manipulation/administration are that can be implemented in the SUS.

Keywords: Antineoplastics, Colorectal Cancer, Costs and cost analysis, Pharmacoeconomics.