Review Article
Volume 3 Issue 7 - 2021
Cost-Minimization and Budgetary Impact of the Use of Cycloserine in the Treatment of Resistant Tuberculosis
Alessandra Santos Portela1*, Andrea dos Santos Garcia1, Daniel Aragão Machado2, Antônio Augusto de Freitas Peregrino3, Cristiano Bertolossi Marta4, Carlos Roberto Lyra da Silva3 and Roberto Carlos Lyra da Silva3
1Doctoral Student in the Postgraduate Program in Nursing and Biosciences, Academic Nursing Unit, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
2Doctor of the Graduate Program in Technology in the Hospital Space, Academic Nursing Unit, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
3Doctor of the Graduate Program in Nursing and Biosciences, Academic Nursing Unit, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
4Doctor at the School of Nursing, Academic Nursing Unit, State University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
*Corresponding Author:Alessandra Santos Portela, Doctoral Student in the Postgraduate Program in Nursing and Biosciences, Academic Nursing Unit, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.
Received: September 17, 2020; Published: June 28, 2021


Objective: To carry out a cost-minimization and budgetary impact assessment for the incorporation of cycloserine as a second-line drug in the treatment scheme for multidrug-resistant tuberculosis in the Brazilian Unified Health System (SUS).

Methods: The analysis of cost-minimization and budgetary impact followed the recommendations of the Methodological Guideline for Economic Evaluation and the Methodological Guideline for the Assessment of Budgetary Impact. A model was proposed using a simple decision tree with a base case composed of two scenarios: the reference one, using terizidone as a second-line medication standardized by the Ministry of Health in the therapeutic regimen of patients with MDR-TB, and the alternative scenario, using cycloserine.

Results: The safety outcomes were not considered to be adverse effects. No studies were found that assessed the cure rate outcome. A single study estimated the relative risk (RR) for treatment failure or relapse outcome for longer MDR-TB regimens, suggesting that cycloserine and terizidone have the same efficacy, considering the analyzed outcomes.

Conclusion: Cycloserine can be cost-effective. It must be considered that the incremental cost of incorporating cycloserine can be R$ 2,829,825.60, with a budgetary impact that can reach more than R$ 12 million, resulting in an increase of 26% to 29% in public spending in 5 years. These resources could be applied to other measures that may represent greater benefits for these patients.

Keywords: Cycloserine; Terizidone; Tuberculosis; Cost-Benefit Analysis; Budgetary Impact Analysis


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Citation: Alessandra Santos Portela., et al. “Cost-Minimization and Budgetary Impact of the Use of Cycloserine in the Treatment of Resistant Tuberculosis”. EC Nursing and Healthcare 3.7 (2021): 98-108.

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