Post incorporation monitoring into the Brazilian Public Health System: an analysis of Infliximab, Vedolizumab and Tofacitinib for the treatment of ulcerative retocolitis

Resumo

Objective: to evaluate the implementation, use, cost of treatment per patient-year and

the budgetary impact of infliximab, vedolizumab and tofacitinib for the treatment of mo-
derate to severe ulcerative colitis in the SUS. Methods: A retrospective cohort study was

carried out using the Open Health Intelligence Situation Room, which originates from the
SUS Ambulatory Information System. All patients with primary ICD-10 ulcerative colitis
and using infliximab, vedolizumab or tofacitinib were included. The analysis period was
from May 2020 to December 2022. Results: After incorporation into the SUS, the time
for medicines to become available ranged from 7 to 20 months. Infliximab was the most
used (55%), but vedolizumab spread faster, with approximately 60 new patients per
month, followed by infliximab and tofacitinib with approximately 35 and 18 patients,

respectively. Unit prices for medicines were lower than those proposed in the incorpora-
tion, except for tofacitinib in the last acquisition. In 2021, the cost per patient-year was

similar for infliximab and vedolizumab. In 2022, vedolizumab had the highest cost. The

budgetary impact of infliximab and vedolizumab was similar in the first year of imple-
mentation and both had a lower budgetary impact than estimated at incorporation. In

the second year of infliximab implementation, the budgetary impact almost doubled due
to the greater dissemination of the drug. Conclusion: This analysis presents real-world
data, verifying the importance of monitoring the technologies incorporated by the SUS.