Economic analysis of a screening program for diabetes mellitus in Brazil

• Published in: Revista de saúde pública 2005-06, Vol.39 (3), p.452-460
• Main Authors: Georg, Alvaro E, Duncan, Bruce B, Toscano, Cristiana M, Schmidt, Maria Inês, Mengue, Sotero, Duarte, Cláudio, Polanczyk, Carísi A
• Format: Article
• Language: Portuguese
• Subjects: Adult; Blood Glucose - analysis; Brazil; Capillaries; Costs and Cost Analysis; Diabetes Mellitus - diagnosis; Diabetes Mellitus - economics; Fasting; Humans; Mass Screening - economics; National Health Programs - economics; Predictive Value of Tests; Sensitivity and Specificity
• ISSN: 0034-8910
• DOI: 10.1590/S0034-89102005000300017

Diabetes mellitus is a common disease and costly public health concern and an expressive number of affected individuals have undiagnosed diabetes mellitus. In 2001, the Brazilian Ministry of Health conducted a national diabetes screening campaign. The purpose of this study was to estimate the yield and economic impact of this screening strategy. Based on positive screenees (fasting glucose >100 mg/dL or nonfasting >140 mg/dL) probable new cases of diabetes were estimated and a decision analytic model was built up. Primary and secondary data were used to estimate screening cost (in Brazilian Reais, R$) and yield (new cases of diabetes detected), assuming a single-payer-perspective. Sensitivity analyses were performed. Assuming a prevalence of undiagnosed diabetes mellitus of 4.8%, probable new cases of diabetes were 518,579 (23 new cases per 1,000 subjects screened), considering that 33% of positive-screening individuals underwent confirmatory glucose testing. The cost per new case of diabetes diagnosed would be R$89. The results were sensitive to percentage of confirmatory tests performed. The costs of nationwide community screening in Brazil were significant, however, in absolute terms lower than those described by other countries.