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Vol. 39. Issue 12.
Pages 549-553 (December 2003)
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Vol. 39. Issue 12.
Pages 549-553 (December 2003)
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Estudio farmacoeconómico del tratamiento antibiótico de las agudizaciones de la bronquitis crónica y la EPOC en Latinoamérica
Pharmacoeconomic Study of Antibiotic Therapy for Exacerbations of Chronic Bronchitis and Chronic Obstructive Pulmonary Disease in Latin America
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M. Miravitllesa,
Corresponding author
marcm@clinic.ub.es

Correspondencia: Servei de Pneumologia. Hospital Clínic. Villarroel, 170 (UVIR, esc. 2, planta 3). 08036 Barcelona. España
, J.R. Jardimb, T. Zittoc, J.E. Rodriguesd, H. Lópezc
a Servei de Pneumologia. Institut Clínic de Pneumologia i Cirurgia Toràcica (IDIBAPS). Hospital Clínic. Barcelona. España
b Servicio de Neumología y Grupo de Farmacoeconomía en EPOC. Universidade Federal de São Paulo. São Paulo. Brasil
c Centro de Infectología. Facultad de Medicina. Universidad de Buenos Aires. Buenos Aires. Argentina
d Grupo de Farmacoeconomía en EPOC. Universidade Federal de São Paulo. São Paulo. Brasil
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La bronquitis crónica y la enfermedad pulmonar obstructiva crónica (EPOC) son enfermedades de elevada prevalencia. Los estudios destinados a conocer el impacto económico de estas enfermedades en países de Latinoamérica son inexistentes. En el presente trabajo se analizan los costes sanitarios directos originados por la atención a los pacientes con agudizaciones de la bronquitis crónica y la EPOC, mediante las estimaciones de tratamiento y evolución obtenidas a partir de un estudio realizado en el ámbito de la atención primaria en España, y aplicando los costes reales de los fármacos y las actuaciones sanitarias de los siguientes países: Argentina, Brasil, Colombia, Ecuador, México, Perú y Venezuela.

El coste sanitario directo medio osciló desde los 98 dólares americanos en Colombia hasta los 329 de Argentina. La parte más importante del coste correspondió al fracaso terapéutico, que en conjunto supuso el 52% del coste de la agudización, con un mínimo del 28,6% para Colombia y un máximo del 59,3% para Ecuador. El coste del tratamiento antibiótico representó globalmente el 19% del coste total; el resto se debió a los otros fármacos y a la visita médica.

Las agudizaciones originan un coste importante para los sistemas de salud. Existen importantes variaciones debidas sobre todo a diferencias en los sistemas sanitarios. El tratamiento antibiótico constituye una pequeña parte del coste global. La utilización de antibióticos más eficaces puede ser una estrategia costeefectiva si logran reducir la tasa de fracasos.

Palabras clave:
Bronquitis crónica
Enfermedad pulmonar obstructiva crónica (EPOC)
Agudizaciones
Antibióticos
Costes
Farmacoeconomía

Chronic obstructive pulmonary disease (COPD) and chronic bronchitis are highly prevalent diseases. Studies designed to analyze the economic impact of these diseases in Latin American countries have not previously been published. In the present study we analyzed the direct health care costs of treating patients with exacerbations of chronic bronchitis and COPD in Argentina, Brazil, Colombia, Ecuador, Mexico, Peru, and Venezuela, applying the real cost of drugs and medical acts in those 7 countries to the pattern of treatment and outcomes obtained from a study carried out in primary care settings in Spain. The mean direct health care cost ranged from US $98 in Colombia to $329 in Argentina. Most of the cost was related to failure of therapy, which accounted for 52% of the total cost of exacerbation, with the lowest rate in Colombia at 28.6% and the highest in Ecuador at 59.3% The cost of antibiotic therapy represented 19% of the total cost; the rest was owing to other drugs or medical visits.

Exacerbations generate significant costs for health care systems. There are considerable variations related mainly to differences between systems. Antibiotic therapy represents a small part of the overall cost. The use of more effective antibiotics, if they can reduce failure rates, may be a cost-effective strategy.

Keywords:
Chronic bronchitis
Chronic obstructive pulmonary disease (COPD)
Exacerbations
Antibiotics
Costs
Pharmacoeconomics
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El presente trabajo ha sido financiado por QF Bayer

Copyright © 2003. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
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