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PCV16. Cost Analysis of Pulmonary Arterial Hypertension in a Tertiary Care Setting in Mexico City

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PCV16. Cost Analysis of Pulmonary Arterial Hypertension in a Tertiary Care Setting in Mexico City

A704 VALUE IN HEALTH 16 (2013) A665–A728
tal budget impact with this new procedure incorporation under the SUS perspec-
tive. METHODS: The BIA was based on a Markov model with quarterly cycles and
5-year time horizon in order to predict clinical and economic outcomes in a scenario
with TAVI incorporation compared to the actual scenario – drug therapy (amiodarone,
furosemide and digoxin) with or without aortic balloon valvoplasty. Epidemiological
data were obtained from DATASUS and survival was extrapolated from PARTNER
cohort B trial by using a Weibull distribution. Resource use, also gathered from this
trial, included early perioperative complications (30 days) and late events (rehospi-
talization, dialysis, stroke, pacemaker implantation and major vascular complica-
tions). Costs were taken from the official Brazilian public official lists (DATASUS and
BPS). Market-share data was obtained from Sociedade Brasileira de Hemodinâmica e
Cardiologia Intervencionista. RESULTS: The estimated number of Brazilian patients
eligible for SSVS treatment was 795, 922, 1,180, 1,335 and 1,402 respectively for years 1-5
of analysis. Compared to the current scenario, the inclusion of TAVI procedure with a
13% market share during the analysis period shows an additional budget through year
1-5 of 3.5M, 5.0M, 6.7M, 8.1M and 9.4M, consecutively. CONCLUSIONS: The incremental
budget impact to include TAVI as a treatment option in the Brazilian Public Healthcare
System for SSVS high-risk patients was estimated to be USD 65 million in 5 years.
PCV14
ANÁLISE DE IMPACTO ORÇAMENTÁRIO DO OCLUSOR SEPTAL PERCUTÂNEO
PARA O FECHAMENTO DE COMUNICAÇÃO INTERATRIAL (CIA) DO TIPO OSTIUM
SECUNDUM
Senna K.M.S., Costa M.G., Tura B.R., Correia M.G., Santos M.S.
INC, Rio de Janeiro, Brazil
OBJETIVOS: Analisar o impacto orçamentário do implante de oclusor septal per-
cutâneo para o fechamento de comunicação interatrial do tipo ostium secundumem
comparação a cirurgia cardíaca convencional. MÉTODOS: Análise sob a perspectiva
do Sistema Único de Saúde (SUS) em um horizonte temporal de cinco anos, para
uma população de pacientes portadores de CIA do tipo Ostium Secundum.O modelo
considerou os custos com as intervenções durante o período de internação e a
análise da incorporação do oclusor seguiu o pressuposto de uma taxa de utilização
de 75% dos pacientes portadores de CIA OS. RESULTADOS: Apresentou uma redução
de mais de sete milhões de reais a favor da incorporação do oclusor percutâneo
em relação a cirurgia como procedimento exclusivo. As análises de sensibilidade
confirmaram uma economia favorecendo o oclusor percutâneo para o fechamento
de CIA ostium secundum. E ao cruzar as variações de custos da cirurgia, do oclusor
e das taxas de utilização para uma melhor aproximação da realidade, o resultado
permaneceu favorável e demonstrou uma concentração do número de casos na
faixa entre zero e R$40.000.000,00 em economia. CONCLUSÕES: A análise demon-
strou a possibilidade de redução dos custos para o fechamento de CIA do tipo ostium
secundumcom a incorporação de uma tecnologia que já vem sendo bem indicada
e utilizada ao longo dos últimos 36 anos, como uma alternativa segura e eficaz ao
fechamento cirúrgico tradicional. O implante de oclusor septal percutâneo é uma
opção repleta de méritos ao evitar que o paciente sofra os traumas físicos e riscos
associados ao procedimento cirúrgico, bem como os riscos psicológicos causados
pela estética gerada pela cicatriz cirúrgica e trauma da internação para as crianças.
PCV15
ECONOMIC EVALUATION OF COLLAGENASE VERSUS HYDROGEL DRESSINGS
FOR CHRONIC-WOUND TREATMENT FROM THE PUBLIC PAYER PERSPECTIVE
Tolentino A.C.
1, Murta L.
2, Pereira N.
2
1Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil, 2ANOVA - Knowledge
Translation, Rio de Janeiro, Brazil
OBJECTIVES: To develop cost-effectiveness analysis of collagenase (CO) versus
hydrogel (HG) dressings for chronic-wound treatment in adults, under the per-
spective of Brazilian public payers. METHODS: Data from the Brazilian Hospital
Information System from January 1st to December 31st 2012 was used to define the
annual number of hospital admissions due to chronic wounds (only non-surgical
records with L89 ICD-10 code included). The model assumed that CO is the current
practice in Brazilian public hospitals and patients are discharged at the time their
wound heals. The difference in MHT was applied to the average length of stay
(LOS) reported in the database. Resource use was estimated through expert panel
and unit costs were obtained from Brazilian official price lists. RESULTS: A total
of 280,440 hospitalizations were identified with mean LOS of 4.47 days. The model
estimated costs for the inpatient period assuming one dressing change for CO and
HG. The cost per dressing change was estimated as 13.83BRL for CO and 11.95BRL
for HG and the overall treatment costs were 61.82BRL and 53.42BRL according to the
LOS. HG-related incremental costs were -8,40BRL indicating a cost-saving profile.
Addopting HG as wound management protocol would save 527,227.20BRL for the
2012 cohort. Benefits in terms of reduction in LOS were not accounted in the base
case scenario. CONCLUSIONS: HG dressing has shown higher efficacy when com-
pared to CO dressings, with fewer costs. The clinical and economic incremental
results between different dressings reinforce the need of evidence-based decision
making and rational resource allocation.
PCV16
COST ANALYSIS OF PULMONARY ARTERIAL HYPERTENSION IN A TERTIARY
CARE SETTING IN MEXICO CITY
Rely K.
1, Ramírez-Neria P.
2, Pulido T.
3, Escamilla C.
4, Alexandre P.K.
5, Cañedo A.
6,
Salinas Escudero C.
1
1CEAHealthTech, Mexico City, Mexico, 2Instituto Nacional de Cardiología - Ignacio Chávez, México
D.F., Mexico, 3National Heart Institute, Mexico City, Mexico, 4INSP, Mexico City, Mexico, 5Johns
Hopkins University, Baltimore, MD, USA, 6Instituto Nacional de Neurología y Neurocirugía, México
D.F., Mexico
OBJECTIVES: The present study determined the total direct health-care costs for the
management of PAH patients with differing degrees of disease severity. The study
also aimed to find the key cost drivers in the management of PAH. METHODS: PAH
patients were recruited from a tertiary care hospital between January 1, 2009 and
total consumption of all drugs from the C group. Total consumption of drugs acting
on the renin-angiotensin system (C09) in Serbia in opserved period was over 41
% of the total consumption of all drugs from the C group. The highest percentage
in this group belonged to the ACE inhibitors. Consumption of angiotensin recep-
tor inhibitors is small and it is only a few percent of the total consumption of all
drugs from C09 group. However, consumption of drugs in this subgroup recorded
steady growth in recent years. CONCLUSIONS: In Serbia in the observed period,
ACE inhibitors are the most frequently used drugs within the group of drugs which
is used for treatment of hypertension. This research was supported by Provincial
Secretariat for Science and Technological Development, Autonomous Province of
Vojvodina project No 114-451-2458/2011 and by Ministry of Science, Republic of
Serbia, project no 41012.
PCV11
IMPACTO ECONÓMICO Y EN DISCAPACIDAD DEL INCREMENTRO DE
UTILIZACIÓN DE TROMBOLISIS EN EL CUIDADO AGUDO DE L ICTUS ISQUÉMICO
EN CHILE
Hoffmeister L.
1, Mar J.
2, Lavados P.
3, Comas M.
4, Arrospide A.
2, Biagini L.
1, Castells X.
4
1Universidad Mayor, Santiago, Chile, 2Hospital Alto Deba, Mondragon, Spain, 3Universidad del
Desarrollo, Santiago, Chile, 4Department of Epidemiology and Evaluation, Institut Municipal
d’Investigació Mèdica-Parc de Salut Mar, Mar Teaching Hospital, Barcelona, Spain; Red de
Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Barcelona, Spain
OBJECTIVOS: Estimar el impacto en discapacidad y económico del incremento de
utilización de trombolisis para el manejo agudo de ictus isquémico (IS) en Chile,
aplicando un modelo de simulación de eventos discretos. METODOLOGÍAS: Se mod-
eló la historia natural y el manejo agudo de los IS para población adulta chilena,
incorporando tiempos desde el inicio de síntomas al tratamiento y cuatro escenarios
de utilización de trombolisis: a) utilización actual (1,7%), b) utilización de 11,6%
tratando todos los pacientes que son atendidos dentro de la ventana terapéutica,
c) 25% de utilización, y d) 100% de utilización. Se usaron distribuciones empíricas
y teóricas para incluir la probabilidad y tiempos de los eventos. Se realizó una
simulación entre 2002-2017, usando el software ARENA. Los resultados fueron la
prevalencia de discapacidad por escenario. Se realizó un análisis de impacto pre-
supuestario desde la perspectiva del asegurador público de salud, considerando los
costos directos del tratamiento y de rehabilitación. RESULTADOS: En 2017 man-
teniendo la actual utilización de trombolisis (1,7%), la tasa de prevalencia por IS es
360,8 por 100.000 habitantes, presentando una disminución entre los escenarios,
siendo 299,8 cuando todos los pacientes son tratados. Con respecto a la utilización
actual, aumentar el tratamiento al 11,6% evita 779 discapacitados, al 25% evita
1.783 y tratar a todos los pacientes evita 8.534. A lo largo de la simulación, los costos
ahorrados por casos de rehabilitación evitados son más bajos que los costos de la
trombolisis. CONCLUSIONES: La tasa de prevalencia de discapacidad disminuye
moderadamente al incrementar la utilización de trombolisis. El impacto poblacional
en discapacidad manteniendo la utilización actual es marginal, siendo recomenda-
ble incrementar su utilización. Los costos directos aumentarían por sobre el costo de
rehabilitación evitados, sin embargo, es necesario considerar la limitada cobertura
de atención de la discapacidad en Chile y los costos sociales.
PCV12
PREVALENCE OF RISK FACTORS OF ST ELEVATED MYOCARDIAL INFARCTION
Rasool F.
1, Khan M.S.
2, Ali A.
2, Masood J.
2
1The University of Punjab, Lahore,, Pakistan, 2The Islamia University of Bahawalpur, Punjab-
Pakistan, Bahawalpur, Pakistan
OBJECTIVES: There is no enough data available in our country about the preva-
lence of risk factors for ST elevation myocardial infarction (STEMI) and which has
the highest mortality rate in hospitals of Pakistan. The purpose of study was to
access the age distribution, location of infarct, risk factors, sign & symptoms and
in-hospital management of STEMI patients in Bahawalpur region, southern Punjab,
on of the regions with high risk of coronary heart disease. METHODS: A retrospec-
tive study of 400 patients diagnosed as STEMI admitted to Bahawal Victoria Hospital
(BVH), Bahawalpur, Southern Punjab, Pakistan was done by following their hospital
record. RESULTS: The mean age of STEMI patients were 40 ±10. Smoking, Diabetes
and Hypertension were the risk factors (51.5%), (28%), (20.5%) respectively. Anterior
wall Myocardial infarctions were seen (51.5%). Sweating, vomiting, shortness of
breath (SOB) & nausea accounted for more than 60% of the symptoms with chest
pain mostly in left arm. Among the patients who reached early to hospital & received
Streptokinase (SK) were 150 (75%), those late for SK were 44(22%), thrombolytic
therapy was contraindicated only in 6 (3%) patients. Most prescribed medication
are aspirin (100%), clopidogrel (98%), statin (96%), ACE-I (77.5%), nitrates (69.5%),
beta blocker (60%), anticoagulant (50%), LMW-heparin (33 %). CONCLUSIONS: The
result of our study, in which the risk factors especially smoking were found to have
a prevalence in patients with STEM1 living in southern Punjab, suggested that STEM
1 can be prevented by the modification of these risk factors.
CARDIOVASCULAR DISORDERS – Cost Studies
PCV13
A BUDGET IMPACT ANALYSIS (BIA) OF TRANSCATHETER AORTIC VALVE
IMPLANTATION (TAVI) IN HIGH-RISK PATIENTS WITH SYNTOMATIC SEVERE
VALVE STENOSIS (SSVS) UNDER THE BRAZILIAN PUBLIC HEALTH CARE SYSTEM
(SUS) PERSPECTIVE
Paladini L.
1, Nishikawa A.M.
1, Bueno C.C.
1, Queiroga M.
2, Lemos P.
2, Clark O.A.C.
1
1Evidencias, Campinas, Brazil, 2Sociedade Brasileira de Hemodinâmica e Cardiologia
Intervencionista (SBHCI), São Paulo, Brazil
OBJECTIVES: Aortic valve stenosis is a progressive valvular heart disease with a stand-
ard care that involves a major open surgery. However, part of the patients is ineligible
for surgery, therefore drug therapy is the only option available. Once TAVI is a less
invasive surgical option, clinical trials demonstrated significant benefits, although
procedure and device are costly. The aim of this study was to estimate the incremen-
VALUE IN HEALTH 16 (2013) A665–A728 A705
each generic was used to estimate one month’s cost of hypertension treatment;
considering the maximum and minimum dosage for each generic. The affordability
of treatments was calculated by comparing the total cost of medicines to the daily
official minimum wage ($63.12MXN, 2013 prices) RESULTS: The number of days’
wages required to pay one month of antihypertensive therapy ranged from: 0.08-
4.18 for diuretics, 0.67-1.90 for beta blockers, 1.7-3.99 for calcium channel blockers,
0.71-3.31 for ACE inhibitors and 2.38-8.11 for ARBs. CONCLUSIONS: Cost could be
a substantial barrier for permanence in antihypertensive treatment, so that should
be discussed measures to prevent this from happening.
PCV20
TREATMENT COSTS OF ISCHEMIC STROKE PREVENTION AND MANAGEMENT
IN PATIENTS WITH ATRIAL FIBRILLATION (AF) IN LATIN AMERICA: ARGENTINA,
BRAZIL, CHILE, AND VENEZUELA
Soriano M.A.
1, Leyva-Bravo V.
1, González-Rojas G.L.
1, Medina-Farina M.
2, Duarte M.A.
3
1IMS Health, Mexico City, Mexico, 2Hospital Barros Luco, Santiago, Chile, 3Hospital Militar Carlos
Arvelo, Caracas, Venezuela
OBJECTIVES: AF is the most common chronic cardiac arrhythmia worldwide. Most
patients with AF need life-long treatment to be protected from ischemic stroke. The
aim was to conduct a high level cost assessment for stroke prevention and manage-
ment in patients with AF [SPAF & SMAF] in 4 Latin American countries. METHODS:
Overall the costs of SPAF & SMAF were determined through 59 face-to-face interviews
with cardiologists in Argentina, Brazil, Chile and Venezuela. Treatment costs were
estimated using benchmarks from major private and public hospitals in each coun-
tr y. RESULTS: On average, the largest component of real-life medical expenditures
for SPAF, under appropriate treatment given CHADS2 scores, was prescription drugs,
which ranged from 68% in private to 75% in public. Annual SPAF treatment ranged in
price from US$425 in Argentina to US$1,935 in Chile in private institutions and US$85
in Brazil to US$1,199 in Venezuela in public institutions. Moreover, overall treatment
costs in Chile were 5X higher than the least expensive country in each sector. For
SMAF, using rivaroxaban vs the common Vitamin K antagonists resulted in a 24%-46%
cost reduction for disease treatment at a national level due to better patient adher-
ence. This would decrease the stroke incidence/year, which would translate to US$143
M /yr in savings. CONCLUSIONS: AF is an important source of health care resource
utilization because of repeated medical examinations, extensive use of laboratory
tests and pharmacological treatments. Private and public institution cost differences
are common in all 4 countries. Improving access to novel drugs, such as rivaroxaban,
could help improve cost allocation, inducing a savings opportunity in each country.
PCV21
HEALTH-ECONOMIC ASSESSMENT OF THE USE OF CATHETER-BASED RENAL
DENERVATION IN PATIENTS WITH RESISTANT HYPERTENSION IN MEXICO
Ceballos R.M.
1, Sanchez-Kiobashi R.
2, Gay J.G.
3, Pietzsch J.B.
4, Geisler B.P.
4
1Medtronic, Mexico DF, Mexico, 2TI Salud, Mexico DF, Mexico, 3T.I. Salud, Mexico, México D.F.,
Mexico, 4Wing Tech Inc., Menlo Park, CA, USA
OBJECTIVES: Catheter-based renal denervation (RDN) is a new therapy for resistant
hypertension, a condition that affects approx. 10-15% of hypertensive patients, in
which blood pressure is uncontrolled despite the simultaneous use of three or more
antihypertensive drugs. Our objective was to assess clinical and cost-effectiveness
of RDN compared to standard of care (SoC) from the Mexican public payer per-
spective. METHODS: A previously published lifetime Markov model was adapted
to the Mexican setting to predict clinical endpoints (death, myocardial infarction,
stroke, heart failure, coronary heart disease, end-stage renal disease) and costs -
based on Mexican epidemiological and cost data. We evaluated the impact of a
32 mmHg reduction in systolic blood pressure, from a baseline of 178 mmHg, in
a 58-year old 43% female, 34% diabetic, and 16% smoking cohort, as observed in
the Symplicity HTN-2 randomized controlled trial. Direct public health care costs
were estimated from the published literature and from governmental databases.
The incremental cost-effectiveness ratio (ICER) was computed as incremental costs
per life-year gained, discounted at 3%. Deterministic sensitivity analyses were
performed. RESULTS: RDN was projected to reduce cardiovascular endpoints by
22-32% over 10 yrs., and 7-17% over lifetime. The lifetime ICER was estimated at
MXN$ 194,128 (US$ 14,750) per LY gained, and had an incremental cost of MXN$
117,916 (US$ 8,959) compared to SoC. Application of higher discount rates led to
a measured increase in the ICER. CONCLUSIONS: Our model projections suggest
that RDN reduces and delays cardiovascular events and is a cost-effective therapy
in Mexico when considering most international willingness-to-pay thresholds, but
remains above the current national government threshold of one GDP/capita of
MXN$ 139,900 (US$ 10,630) per additional life year.
PCV22
COST-EFFECTIVENESS OF TRANSCATHETER AORTIC-VALVE IMPLANTATION FOR
SEVERE SYMPTOMATIC AORTIC STENOSIS IN INOPERABLE PATIENTS IN THE
BRAZILIAN PUBLIC HEALTH CARE SYSTEM
Nishikawa A.M.
1, Paladini L.
1, Borges L.
1, Queiroga M.
2, Lemos P.
2, Clark O.A.C.
1
1Evidencias, Campinas, Brazil, 2Sociedade Brasileira de Hemodinâmica e Cardiologia
Intervencionista (SBHCI), São Paulo, Brazil
OBJECTIVES: Aortic stenosis is the most common valvular heart disease in the elderly
– its prevalence is estimated to be up to 5% in individuals over 75 years. Surgical
replacement of the aortic valve is considered the standard care and in the absence
of serious coexisting conditions, the procedure is associated with low operative mor-
tality. However, a significant proportion of patients can not undergo surgery due to
a high surgical risk associated with advanced age or with the presence of multi-
ple coexisting conditions. Treatment with transcatheter aortic-valve implantation
(TAVI) is a therapy with potentially lower peri-procedure risk and has been used as
a therapeutic option in this group of patients considered inoperable. Therefore, this
study aims to develop a cost-effectiveness analysis of TAVI in patients with severe
aortic stenosis who are not suitable for surgical treatment. METHODS: A Markov
model was developed to compare the TAVI versus standard therapy (drug treatment
2011. One-year costs were identified by applying cost data to medical informa-
tion obtained by review of medical records. Costs included those for medications,
laboratory and diagnostic tests, clinic visits, emergency room visits and hospital
stays. Contemporary data were obtained from epidemiological studies, government
datasets, and other sources to estimate prevalence. National costs (US dollar 2012)
of treatment for PAH were estimated by extrapolation of mean cost estimate per
person to national incidence data for PAH. Because of uncertainties surrounding
some of our estimates such as prevalence, one way sensitivity analyses were under-
taken. RESULTS: A total of 113 PAH patients were identified and their demographic
and clinical characteristics, patterns of care were examined. The mean age was 38
years, and 83% were female. The average per patient annual cost was $ 10,869 with-
out specific treatment (min $ 137; max $155,928). The annual cost for the treatment
of a single PAH patient per year with specific therapy (Bosentan) was calculated in
$31.433. Aggregate national health care expenditures for treatment of PAH were
USD 46.6 million In multivariate analysis, length of hospital stay, stay in ICU, were
all significant independent predictors of treatment. CONCLUSIONS: There is a cor-
relation between the cost of HAP and disease severity with hospitalization owing
to disease severity being a major contributor to cost. With the expected increase in
the incidence of PAH in Mexico over the coming decades, these results emphasize
the need for effective preventive and acute medical care.
PCV17
COST-OF-ILLNESS STUDY OF PATIENTS SUBJECTED TO CARDIAC RHYTHM
MANAGEMENT DEVICES IMPLANTATION: RESULTS FROM A SINGLE TERTIARY
CENTRE
Fanourgiakis J.
University of Crete, Heraklion, Greece
OBJECTIVES: To estimate the procedure (implantation) cost, the total hospitalization
cost and annual follow-up cost, in patients subjected to pacemaker (PM) and implant-
able cardioverter-defibrillator (ICD) implantation. METHODS: A single-center, pro-
spective, cost-of-illness study was conducted between August 2008 and July 2009. In
total, 464 consecutive patients were recruited (370 were subjected to PM implantation
and 94 to ICD implantation). Resource data were assessed at patients’ enrolment in
the study and at 6th and 12th months of patients’ follow-up. Then, the procedure cost,
the total hospitalization cost as well as the annual patients’ follow up costs were cal-
culated using a bottom-up approach. RESULTS: The mean (95% confidence interval)
procedure cost of PM and ICD implantation (including the costs of devices, electrodes,
other supplies, and personnel’s time) was calculated to be 1803 ( 1758– 1858) and
13 521 ( 13 153– 13 892), respectively. The mean total hospitalization cost (includ-
ing procedure cost, hospitalization cost, cost of laboratory and imaging diagnostic
examinations and the indirect cost attributed to productivity lost due to patient’s
hospitalization) was 3926 ( 3711– 4167) for PM and 17 764 ( 16 852– 18 692) for ICD.
The mean annual cost (direct and indirect) was 1816 ( 1433– 2421) for PM and 2819
( 2115– 3703) for ICD. No difference was detected in the annual cost between patients
with initial implantation and replacement. CONCLUSIONS: These data revealed that
although these devices are associated with a relatively high upfront cost, the annual
societal cost following the implantation is low. Therefore, implantation of such devices
should be encouraged since these devices reduce the morbidity and mortality without
a high economic burden to society.
PCV18
ECONOMIC BURDEN OF CORONARY HEART DISEASE IN THE PATIENTS
ATTENDING NATIONAL HEART CENTER, KATHMANDU, NEPAL
Dangi A.
1, Lohani S.P.
2
1Nobel College, Pokhara University, Kathmandu, Nepal, 2Center for Health Research and
International Relations, Nobel College, Pokhara University, Kathmandu, Nepal
OBJECTIVES: To calculate cost of illness due to coronary heart disease in the patients
attending National Heart Center, Kathmandu, Nepal. METHODS: Descriptive cross
sectional survey was conducted. The total number of sample was 120. The sam-
ple was selected by non-probability purposive sampling method. Data entry and
analysis was done using SPSS 16.0. Categorical variables were compared using
Independent Sample t-test and cross tabulation was done and chi- square test was
applied to show significant difference between variables. RESULTS: Agriculture was
the main source of income of the coronary heart disease household and the aver-
age annual household income was NRs. 1, 54,000 (US $ 1792). The study estimated
the average cost of illness to be NRs. 30,888.14 (US $ 360) for an outpatient episode
of coronary heart disease which was 20.05% of the average annual income of CHD
household. The average total time loss of the CHD household was 8.75 person days.
The average total direct cost was NRs. 29,600 (US $ 344) of which medical cost was
the largest component. The average monetary value of time loss by the household
was found to be 2,981.18 (US $ 35). CONCLUSIONS: The study found high cost of
illness due to centralised system of health care.The findings of the study showed
that households struggled to cope and adopted unsustainable strategies that dam-
aged asset and caused or sustained impoverishment. Thus, estimated cost appears
to be sustained economic burden on the individual household.
PCV19
AFFORDABILITY OF ANTIHYPERTENSIVE TREATMENT IN MEXICO
Lemus F., Rivas R.
Minister of Health, Mexico, Mexico
OBJECTIVES: Hypertension (HT) is one of the most prevalent chronic diseases in
Mexico. In the last two decades, a substantial increase in the prevalence of HT was
observed in Mexico from 25% in 1993 to 43.2% in 2006 in adult population ( 20
years old). Almost 50% of population is not under a social security scheme and
many patients pay for medicines out-of-pocket. This study’s aim was to calculate
the affordability of different kinds of antihypertensive drugs in Mexico. METHODS:
Price data for 5 classes of antihypertensive drugs (diuretics, beta blockers, calcium
channel blockers, ACE inhibitors and angiotensin II receptor antagonists or ARBs)
were obtained from public internet sources, and the lowest price identified for
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