Key result
The total direct cost of systemic arterial hypertension and its attributable circulatory system diseases to the Brazilian public health system in 2019 was Int$ 581,135,374.73, with 97.3% of SAH costs incurred in primary care.
Why the study?
Systemic arterial hypertension has a significant financial impact on health systems, but its direct costs and attributable circulatory system disease costs in Brazil needed estimation.
Observational (n=28,118,310)
Systemic arterial hypertension imposes a massive financial burden on the Brazilian public health system, with the vast majority of costs driven by primary care provision of free antihypertensive medications.
INTRODUCTION: Systemic arterial hypertension (SAH), a global public health problem and the primary risk factor for cardiovascular diseases, has a significant financial impact on health systems. In Brazil, the prevalence of SAH is 23.7%, which caused 203,000 deaths and 3.9 million DALYs in 2015. OBJECTIVE: To estimate the cost of SAH and circulatory system diseases attributable to SAH from the perspective of the Brazilian public health system in 2019. METHODS: A prevalence-based cost-of-illness was conducted using a top-down approach. The population attributable risk (PAR) was used to estimate the proportion of circulatory system diseases attributable to SAH. The direct medical costs were obtained from official Ministry of Health of Brazil records and literature parameters, including the three levels of care (primary, secondary, and tertiary). Deterministic univariate analyses were also conducted. RESULTS: The total cost of SAH and the proportion of circulatory system diseases attributable to SAH was Int$ 581,135,374.73, varying between Int$ 501,553,022.21 and Int$ 776,183,338.06. In terms only of SAH costs at all healthcare levels (Int$ 493,776,445.89), 97.3% were incurred in primary care, especially for antihypertensive drugs provided free of charge by the Brazilian public health system (Int$ 363,888,540.14). Stroke accounted for the highest cost attributable to SAH and the third highest PAR, representing 47% of the total cost of circulatory diseases attributable to SAH. Prevalence was the parameter that most affected sensitivity analyses, accounting for 36% of all the cost variation. CONCLUSION: Our results show that the main Brazilian strategy to combat SAH was implemented in primary care, namely access to free antihypertensive drugs and multiprofessional teams, acting jointly to promote care and prevent and control SAH.
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Curado et al. (2021) conducted an observational in Systemic arterial hypertension (n=28,118,310). Systemic arterial hypertension was evaluated on Total direct cost of SAH and attributable circulatory system diseases. The total direct cost of systemic arterial hypertension and its attributable circulatory system diseases to the Brazilian public health system in 2019 was Int$ 581,135,374.73, with 97.3% of SAH costs incurred in primary care.
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