Resumo

PRADA, Sergio I; TAKEUCHI, Yuri  e  ARIZA, Yoseth. Monetary cost of treatment for Alzheimer's disease in Colombia. Acta Neurol Colomb. [online]. 2014, vol.30, n.4, pp.247-255. ISSN 0120-8748.

Introduction: dementia, particularly Alzheimer's disease, represents an important financial burden upon health systems; however cost-of-illness studies are not frequent in developing countries. Objective: to estimate the potential direct and indirect social cost for Alzheimer's disease, by stages of severity in Colombia for the period 2010-2020. Materials and methods: the prevalence of the disease is taken from previous work that used secondary data and a method of population projection. We assumed average treatment duration of the disease of 8 years, 3 in mild condition, 3 in moderate and 2 in severe. The basket of benefits and services associated with the treatment and care of patients was built for each stage based on medical records, consultation with experts and other sources to estimate unitary prices. Estimates were performed including and excluding the imputed value of informal care, valued by the cost method of salaries not perceived. Finally, the aggregated cost was adjusted by the cost of use of services, utilizing information reported in the provision module of the national information system on social protection (Ministry of Health). Results: the potential direct cost per stage of severity per patient year were: COP 1.5 million (mild), COP 11.3 million (moderate) and COP 30.3 million (severe). The cost per patient for the treatment duration (8 years), at constant 2013 prices, would be COP 33.3 million, excluding the costs of the caregiver, and COP 99 million including them. By 2010, had all patients with the disease received treatment according to prevalence estimates, would have risen to COP 2 billion in the scenario where a higher proportion of patients are mild state or COP 2.6 billion in the scenario where the highest proportion is in moderate condition. We estimated that 16.5% are actually receiving treatment. Using this factor we estimated direct total costs for 2010 to be in the range COP 116 to 140 thousand millions. Conclusions: The cost estimates presented show that Alzheimer's disease will have a high cost to the Colombian society as access to treatment increases. Methods that incorporate the requirements of care by stage of disease were more appropriate, and allowed to identify that the estimates of models that assume a constant relationship between cost-of-illness and GDP per-capita tend to underestimate the financial burden. To estimate the direct costs of chronic diseases is key for the development of financially sustainable health policies.

Palavras-chave : Alzheimer disease; disease costs; disease progression; dementia/economics; developing countries/statistics and numerical data.

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