Loading...
Publication
Análise custo-efetividade da angioplastia pulmonar versus terapêutica vasodilatadora pulmonar em doentes diagnosticados com hipertensão pulmonar tromboembólica crónica
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 831.12 KB | Adobe PDF |
Authors
Abstract(s)
A hipertensão pulmonar tromboembólica crónica (HPTEC) é uma doença crónica e progressiva, que limita significativamente a vida dos doentes. A estratégia terapêutica para os doentes diagnosticados com HPTEC inoperável ou persistente/recorrente pós cirurgia, passa pela angioplastia pulmonar de balão (BPA) e/ou terapêutica vasodilatadora pulmonar (TVP). Sabendo que o critério de eficiência económica deve estar presente, mas que os custos devem ser ajustados à efetividade, este trabalho foi estruturado em dois artigos. O primeiro é uma revisão sistemática dedicada à efetividade, intitulado “Angioplastia pulmonar por balão e riociguat no manejo da hipertensão pulmonar tromboembólica crónica: uma revisão sistemática”, que concluiu que a BPA concomitantemente com o riociguat aparenta ser mais efetiva do que a monoterapia, não estando associada a eventos adversos major. O segundo artigo, um estudo de avaliação económica, intitulado “Análise Custo-efetividade da Angioplastia Pulmonar sob Terapêutica Vasodilatadora Pulmonar versus Terapêutica Vasodilatadora Pulmonar isolada em doentes diagnosticados com Hipertensão Pulmonar Tromboembólica Crónica”, foi conduzido como uma coorte retrospetiva em um único centro. Este estudo demonstrou que a BPA sob TVP é mais custo-efetiva em comparação com a TVP isolada na maioria dos indicadores de efetividade avaliados. Concluiu-se que a adoção da terapêutica combinada resulta em uma redução de custos de 8860€±32€ por doente/ano. Este estudo sugere que, de acordo com a evidência demonstrada, a estratégia terapêutica que envolva a BPA sob TVP deverá ser a primeira opção para estes doentes, pois não só demonstrou ser mais efetiva em termos de resultados clínicos, como menos dispendiosa face à alternativa.
ABSTRACT: Chronic thromboembolic pulmonary hypertension (CTEPH) is a chronic and progressive disease that significantly limits patients' lives. The therapeutic strategy for patients diagnosed with inoperable CTEPH or persistent/recurrent CTEPH after surgery involves balloon pulmonary angioplasty (BPA) and/or pulmonary vasodilator therapy (PVT). Considering that economic efficiency criteria must be present, and costs should be adjusted to effectiveness, this work was structured into two articles. The first is a systematic review focused on effectiveness, titled "Balloon Pulmonary Angioplasty and Riociguat in the management of Chronic Thromboembolic Pulmonary Hypertension: A Systematic Review," which concluded that the BPA with riociguat appears to be more effective than monotherapy and is not associated with major adverse events. The second article, an economic evaluation study, titled "Cost-effectiveness analysis of Balloon Pulmonary Angioplasty under Pulmonary Vasodilator Therapy versus isolated Pulmonary Vasodilator Therapy in patients diagnosed with Chronic Thromboembolic Pulmonary Hypertension," is a retrospective cohort study conducted at a single center. The study demonstrated that BPA under PVT was more cost-effective compared to isolated PVT across most of the evaluated effectiveness indicators. The findings suggest that opting for the combined therapy results in a cost savings of €8860±€32 per patient per year. This study suggests that, based on the demonstrated evidence, the therapeutic strategy involving BPA in conjunction with PVT should be the first option for these patients. It proved to be more effective in terms of clinical outcomes and less expensive than the alternative.
ABSTRACT: Chronic thromboembolic pulmonary hypertension (CTEPH) is a chronic and progressive disease that significantly limits patients' lives. The therapeutic strategy for patients diagnosed with inoperable CTEPH or persistent/recurrent CTEPH after surgery involves balloon pulmonary angioplasty (BPA) and/or pulmonary vasodilator therapy (PVT). Considering that economic efficiency criteria must be present, and costs should be adjusted to effectiveness, this work was structured into two articles. The first is a systematic review focused on effectiveness, titled "Balloon Pulmonary Angioplasty and Riociguat in the management of Chronic Thromboembolic Pulmonary Hypertension: A Systematic Review," which concluded that the BPA with riociguat appears to be more effective than monotherapy and is not associated with major adverse events. The second article, an economic evaluation study, titled "Cost-effectiveness analysis of Balloon Pulmonary Angioplasty under Pulmonary Vasodilator Therapy versus isolated Pulmonary Vasodilator Therapy in patients diagnosed with Chronic Thromboembolic Pulmonary Hypertension," is a retrospective cohort study conducted at a single center. The study demonstrated that BPA under PVT was more cost-effective compared to isolated PVT across most of the evaluated effectiveness indicators. The findings suggest that opting for the combined therapy results in a cost savings of €8860±€32 per patient per year. This study suggests that, based on the demonstrated evidence, the therapeutic strategy involving BPA in conjunction with PVT should be the first option for these patients. It proved to be more effective in terms of clinical outcomes and less expensive than the alternative.
Description
Mestrado em Gestão e Avaliação de Tecnologias em Saúde
Keywords
Hipertensão pulmonar tromboembólica crónica Angioplastia pulmonar por balão Terapêutica vasodilatadora pulmonar Análise custo-efetividade Chronic thromboembolic pulmonary hypertension Balloon pulmonary angioplasty Pulmonary vasodilator therapy Cost-effectiveness analysis MGATS
Citation
Araújo PC. Análise custo-efetividade da angioplastia pulmonar versus terapêutica vasodilatadora pulmonar em doentes diagnosticados com hipertensão pulmonar tromboembólica crónica [dissertation]. Lisboa: Escola Superior de Tecnologia da Saúde de Lisboa/Instituto Politécnico de Lisboa; Escola Superior de Saúde da Universidade do Algarve; 2024.
Publisher
Instituto Politécnico de Lisboa