Systematic Reviews
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. Feb 6, 2016; 7(1): 162-170
Published online Feb 6, 2016. doi: 10.4292/wjgpt.v7.i1.162
Economic evaluations in gastroenterology in Brazil: A systematic review
Luciana Bertocco de Paiva Haddad, Tassia Cristina Decimoni, Jose Antonio Turri, Roseli Leandro, Patrícia Coelho de Soárez
Luciana Bertocco de Paiva Haddad, Jose Antonio Turri, Department of Transplantation, Gastroenterology Division, University of São Paulo School of Medicine Hospital das Clínicas, São Paulo 05403-010, Brazil
Tassia Cristina Decimoni, Roseli Leandro, Patrícia Coelho de Soárez, Department of Preventive Medicine, University of São Paulo School of Medicine, São Paulo 01246-903, Brazil
Author contributions: Decimoni TC and de Soárez PC designed the research; Decimoni TC, Leandro R and de Soárez PC performed the research; de Paiva Haddad LB, Decimoni TC, Turri JA, Leandro R and de Soárez PC analyzed the data; de Paiva Haddad LB and de Soárez PC wrote the paper.
Supported by The Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP, São Paulo Research Foundation), as part of a larger project entitled “Systematic review of health economic evaluations conducted in Brazil, 1980-2013”, carried out under the leadership of Professor Patricia Coelho de Soárez, No. 2012/22126-3.
Conflict-of-interest statement: None of the authors has received fees for serving as a speaker, consultant or advisory board member for any organization that might have a stake in the results of this study; nor do any of the authors owns stocks in or shares of any such organization. None of the authors owns any patents related to the materials, devices or procedures mentioned in the manuscript.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Patrícia Coelho de Soárez, PhD, Department of Preventive Medicine, University of São Paulo School of Medicine, Av. Dr. Arnaldo 455, 2 Andar Sala 2228, São Paulo 01246-903, Brazil. patricia.soarez@usp.br
Telephone: +55-11-30617290 Fax: +55-11-30618466
Received: April 14, 2015
Peer-review started: April 16, 2015
First decision: July 1, 2015
Revised: November 13, 2015
Accepted: December 1, 2015
Article in press: December 2, 2015
Published online: February 6, 2016
Abstract

AIM: To systematically review economic evaluations in gastroenterology, relating to Brazil, published between 1980 and 2013.

METHODS: We selected full and partial economic evaluations from among those retrieved by searching the following databases: MEDLINE (PubMed); Excerpta Medica; the Latin American and Caribbean Health Sciences Literature database; the Scientific Electronic Library Online; the database of the Centre for Reviews and Dissemination; the National Health Service (NHS) Economic Evaluation Database; the NHS Health Technology Assessment database; the Health Economics database of the Brazilian Virtual Library of Health; Scopus; Web of Science; and the Brazilian Network for the Evaluation of Health Technologies. Two researchers, working independently, selected the studies and extracted the data.

RESULTS: We identified 535 health economic evaluations relating to Brazil and published in the 1980-2013 period. Of those 535 articles, only 40 dealt with gastroenterology. Full and partial economic evaluations respectively accounted for 23 (57.5%) and 17 (42.5%) of the 40 studies included. Among the 23 full economic evaluations, there were 11 cost-utility analyses, seven cost-effectiveness analyses, four cost-consequence analyses, and one cost-minimization analysis. Of the 40 studies, 25 (62.5%) evaluated medications; 7 (17.5%) evaluated procedures; and 3 (7.5%) evaluated equipment. Most (55%) of the studies were related to viral hepatitis, and most (63.4%) were published after 2010. Other topics included gastrointestinal cancer, liver transplantation, digestive diseases and hernias. Over the 33-year period examined, the number of such economic evaluations relating to Brazil, especially of those evaluating medications for the treatment of hepatitis, increased considerably.

CONCLUSION: Further studies are needed in order to ensure that expenditures on health care in Brazil are made as fairly and efficiently as possible.

Keywords: Costs and cost analysis, Health care costs, Cost-benefit analysis, Gastroenterology, Brazil

Core tip: The volume and scope of economic evaluations relating to Brazil remain unknown. To improve understanding of what studies are available as inputs for resource-allocation decisions, as well as of how that body of knowledge can be expanded, we conducted a systematic review of such economic evaluations. Although there have been many economic evaluations related to gastroenterology in Brazil, most have analyzed medications for the treatment of viral hepatitis. In most cases, decisions to incorporate new technologies into the public health care system were made before such studies were conducted and were therefore not based on local cost-effectiveness analyses.