The fragility of information on the incidence and prevalence of HPV infection in Brazil is great. The available data derive from data reported by the municipal health departments. The most reliable values are from 2012, performed by INCA,...
moreThe fragility of information on the incidence and prevalence of HPV infection in Brazil is great. The available data derive from data reported by the municipal health departments. The most reliable values are from 2012, performed by INCA, one of the main references in consolidated information on cervical cancer. However, as the response to the forms by the municipalities is not frequently updated in the DATASUS system, the resulting information does not correspond to the entire population undergoing treatment. In this context, information on the prevalence of HPV in this population is marked by the difficulty of differentiating official municipal information from the actual incidence of both the virus and the cases of preventive measures performed. As a result of these limits, the model tested admitted using data from the World Health Organization (WHO) and the population projected for 2016 by the IBGE from the census carried out in 2010, which may not match the Brazilian reality, given its derivation from an international study and data not consolidated by the Ministry of Health itself.
Regardless of the absolute numbers, there were no problems found in estimating the target population based on the scientific studies obtained, it is evident the drop in the rate of cervical cancer cases and the consequent deaths caused by HPV infection in the population that participated in the several scientific studies since 2007. The fact that the FDA of the United States accepts the HPV DNA as a primary test, associated with greater knowledge of the mechanisms that cause carcinoma of the virus and the rigor incorporated into biosafety practices over the last few years, point out for a future trend towards Invasive cancer rates closer to zero with the use of self-collection kits, reducing the number of candidates for cervical cancer treatment due to HPV infection in the female population.
From this finding, it becomes evident that, although the application of the DNA self-collection kit for HPV in the target population implies an increase in system costs, the comparison of these with the amount spent to guarantee current prevention and replacement therapies treatment therapies to only women who test positive for virus types with a high carcinogenic risk factor demonstrates that their relative weight is small.
In conclusion, some remarks on the results obtained should be made. The importance of budget impact analysis as an additional instrument for incorporating health technology assessments in the context of the SUS is highlighted, since the availability of information on the amount to be spent with the adoption of a given strategy, over time, allows the manager greater security to choose this or that option. In addition, the construction of mathematical models allows, with small variations of parameters, estimating different compositions in the standard of care offered, in order to obtain the greatest possible benefits in the face of budget limitations.
Considering that budget impact studies are linked to the application of their results in the context of a health care system, the information that supports the analysis should reflect, as much as possible, reality. An important limitation of this study was the use of estimates derived from the international literature, replacing unavailable information about the condition studied in the national scenario. In this sense, due to the high cost of procedures related to the population undergoing treatment therapies for cervical cancer and high morbidity rates due to late diagnosis, the search for initiatives capable of adding information about the results of the care offered to this group should be valued.
