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Retinopathy of prematurity screening and treatment cost in Brazil
Andrea A Zin1, Cynthia Magluta1, Márcia F T Pinto1
1Department of Clinical Research, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, RJ, Brazil, zin.andrea@gmail.com.
Insights
Integrating retinopathy of prematurity (ROP) screening and treatment into Brazil's Unified Health System (SUS) is affordable. The study estimates costs for ROP care, showing feasibility for national implementation.
Area of Science:
- Public Health
- Neonatal Medicine
- Health Economics
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Early detection and treatment of ROP are crucial to prevent blindness.
- The cost-effectiveness of ROP programs within public healthcare systems requires evaluation.
Purpose of the Study:
- To determine the additional financial costs associated with implementing ROP detection and treatment services within Brazil's Unified Health System (SUS).
- To model the budget impact of a national ROP screening and treatment program.
Main Methods:
- A deterministic decision-tree simulation model was employed to estimate direct costs.
- Data from 869 preterm infants (birth weight < 1500 g) in six governmental neonatal intensive-care units (NICUs) in Rio de Janeiro were used.
- Costs were extrapolated to national estimates for 2010, considering staff, equipment, maintenance, and training.
Main Results:
- Unit costs: US$18 per examination, US$398 per treatment, US$29 for training.
- Estimated cost for ROP diagnosis and treatment: US$80 per at-risk infant.
- Additional annual costs for SUS ranged from US$556,640 (52% coverage) to US$1.07 million (100% coverage).
Conclusions:
- Providing ROP care is financially viable within Brazil's SUS.
- The findings suggest feasibility for similar ROP programs in other Latin American countries.
- Effective ROP treatment yields significant social benefits, justifying the investment.
Objective:
To assess the additional cost of incorporating the detection and treatment of retinopathy of prematurity (ROP) into neonatal care services of Brazil's Unified Health System (SUS).
Methods:
A deterministic decision-tree simulation model was built to estimate the direct costs of screening for and treating ROP in neonatal intensive-care units (NICUs), based on data for 869 preterm infants with birth weight less than 1 500 g examined in six governmental NICUs in the capital city of Rio de Janeiro, where coverage was 52% and 8% of infants were treated. All of the parameters from this study were extrapolated to Brazilian newborn estimates in 2010. Costs of screening and treatment were estimated considering staff, equipment and maintenance, and training based on published data and expert opinion. A budget impact analysis was performed considering the population of preterm newborns, screening coverage, and the incidence of treatable ROP. One- and two-way sensitivity analyses were performed.
Results:
In Rio de Janeiro, unit costs per newborn were US$ 18 for each examination, US$ 398 per treatment, and US$ 29 for training. The estimated cost of ROP diagnosis and treatment for all at-risk infants NICUs was US$ 80 per infant. The additional cost to the SUS for one year would be US$ 556 640 for a ROP program with 52% coverage, increasing to US$ 856 320 for 80% coverage, and US$ 1.07 million or 100% coverage.
Conclusions:
The results of this study indicate that providing ROP care is affordable within the framework of the SUS in Brazil, and might be feasible elsewhere in Latin America, considering the evidence of the effectiveness of ROP treatment and the social benefits achieved.
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