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dc.contributor.authorBen, Ângela Jornadapt_BR
dc.contributor.authorNeyeloff, Jeruza Lavanholipt_BR
dc.contributor.authorSouza, Camila Furtado dept_BR
dc.contributor.authorRosses, Ana Paula Oliveirapt_BR
dc.contributor.authorAraújo, Aline Lutz dept_BR
dc.contributor.authorSzortika, Adriana Dietrichpt_BR
dc.contributor.authorLocatelli, Franciele Daianept_BR
dc.contributor.authorCarvalho, Gabriela dept_BR
dc.contributor.authorNeumann, Cristina Rolimpt_BR
dc.date.accessioned2020-03-14T04:19:27Zpt_BR
dc.date.issued2020pt_BR
dc.identifier.issn1179-1896pt_BR
dc.identifier.urihttp://hdl.handle.net/10183/206809pt_BR
dc.description.abstractObjective: To perform a cost-utility analysis of diabetic retinopathy (DR) screening strategies from the perspective of the Brazilian Public Healthcare System. Methods: A model-based economic evaluation was performed to estimate the incremental costs per quality-adjusted life-year (QALY) gained between three DR screening strategies: (1) the opportunistic ophthalmology referral-based (usual practice), (2) the systematic ophthalmology referral-based, and (3) the systematic teleophthalmology-based. The target population included individuals with type 2 diabetes (T2D) aged 40 years, without retinopathy, followed over a 40-year time horizon. A Markov model was developed with five health states and a 1-year cycle. Model parameters were based on literature and country databases. One-way and probabilistic sensitivity analyses were performed to assess model parameters’ uncertainty. WHO willingness-to-pay (WHO-WTP) thresholds were used as reference (i.e. one and three times the Brazilian per capita Gross Domestic Product of R$32747 in 2018). Results: Compared to usual practice, the systematic teleophthalmology-based screening was associated with an incremental cost of R$21445/QALY gained ($9792/QALY gained). The systematic ophthalmology referral-based screening was more expensive (incremental costs = R$4) and less effective (incremental QALY = −0.012) compared to the systematic teleophthalmology-based screening. The probability of systematic teleophthalmology-based screening being cost-effective compared to usual practice was 0.46 and 0.67 at the minimum and the maximum WHO-WTP thresholds, respectively. Conclusion: Systematic teleophthalmology-based DR screening for the Brazilian population with T2D would be considered very cost effective compared to the opportunistic ophthalmology referral-based screening according to the WHO-WTP threshold. However, there is still a considerable amount of uncertainty around the results.en
dc.format.mimetypeapplication/pdfpt_BR
dc.language.isoengpt_BR
dc.relation.ispartofApplied health economics and health policy. Auckland. vol. 18 (2020), p. 57-68pt_BR
dc.rightsOpen Accessen
dc.subjectSistema Único de Saúdept_BR
dc.subjectRetinopatia diabéticapt_BR
dc.subjectAnálise custo-benefíciopt_BR
dc.titleCost-utility analysis of opportunistic and systematic diabetic retinopathy screening strategies from the perspective of the Brazilian Public Healthcare Systempt_BR
dc.typeArtigo de periódicopt_BR
dc.identifier.nrb001113402pt_BR
dc.type.originEstrangeiropt_BR


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