THE DIRECT COST OF BLADDER CANCER TO THE BRAZILIAN PUBLIC HEALTHCARE SYSTEM (SUS)

OBJECTIVES: To identify direct costs of bladder cancer management in the Brazilian public health system. METHODS: Direct costs referring to inpatient and outpatient treatment for bladder cancer were obtained from national databases available at official information systems in 2014 (Hospital Information System, SIH/SUS and Outpatient Information System, SIA/SUS). Bladder cancer patients were identified using ICD-10 code. RESULTS: In 2014, 85,302 outpatient procedures were performed for bladder cancer treatment, resulting in direct outpatient costs of US$8,455,086. The Southeast region was responsible for major proportion of procedures performed in the country (45%). The intravesical chemotherapy was accounted for the highest share of total direct outpatient costs (more than US$4.8 million). Regarding inpatient procedures, there were 15,341 procedures performed, resulting in direct inpatient costs of US$21,424,079. The proportion of inpatient procedures among men was 2-3 higher than women. Of note, only US$6,231,257 of costs were related to treatment of female patients. The inpatient procedure performed more often was the resection of vesical lesion (more than 9,000 times); resulting in the highest share of direct inpatient costs (US$11,295,324). CONCLUSIONS: Considering the prevalence of bladder cancer in Brazil, the disease has significant economic impacts in the Brazilian public health system with a total direct medical cost of US$29,879,165. Although this amount corresponds to most of treatment cost, including for example chemotherapy, resection and radiotherapy, it is still underestimated by not including the costs related to adverse effects management. The results presented have potential to contribute to support strategic actions of public policies in health directed towards prevention and early diagnosis of bladder cancer.