THE ECONOMIC IMPACT AND ON ACCESS OF THE USE OF HYPOFRACTIONATED RADIOTHERAPY FOR THE TREATMENT OF WOMEN WITH EARLY BREAST CANCER IN BRAZILIAN PUBLIC HEALTH SYSTEM

Teresa Raquel de Moraes Andrade, Afonso Celso Pinto Nazário, Marcelo Cunio Machado da Fonseca

Institution: Universidade Federal de São Paulo

OBJECTIVES: To evaluate the economic impact of increasing the use of hypofractionated radiotherapy for the treatment of women older than 50 years, with early breast cancer (stages I and II) within the Brazilian National Health System (SUS). METHODS: We built a budget impact model, in Excel, to simulate Brazilian women older than 50 years with early breast cancer. The model compares hypofractionated radiotherapy (2,66 Gy/day) with conventional radiotherapy (2 Gy/day). We determined the number of women over 50 years with malignant neoplasm of the breast, stages 1 and 2, that underwent adjuvant radiotherapy in 2013 and 2014 (available data), and projected these populations for the years of 2016 to 2020. We considered the costs of planning the radiotherapy, using the photon beams linear accelerator and check-film. We considered a yearly increase of 20% participation of hypofractionated radiotherapy for the years 2016 to 2019 (2016 20%; 2017 40%; 2018 60%; 2019 80% and 2020 90%). The duration of each treatment fraction is 15 minutes. RESULTS: Based on this analysis, the incremental impact would be of -R$ 770,190.31, -R$ 1,552,696.03, -R$ 2,346,919.18, -R$ 3,152,263.20 and -R$ 3,571,315.88 providing 3,040, 6,129, 9,264, 12,443 and 14.097 free hours of the linear accelerator for the years 2016, 2017, 2018, 2019 and 2020, respectively. These free hours may allow 551, 1,201, 1,983, 2,887 and 3,397 additional patients to have access to breast cancer treatment in years 2016 to 2020 respectively. CONCLUSIONS: Considering the conditions proposed in this model increasing the use of hypofractionation as a radiotherapy technique to treat women older than 50 years, with early breast cancer within (SUS) seems to increase the system efficiency saving money, optimizing the treatment schedule and providing access to treatment for more patients.