Most biologic DMARDs (bDMARDs) used in the treatment of rheumatoid arthritis (RA) require special temperature control (2°C – 8°C) in their supply management such as cold chain logistics (CC) to ensure the effectiveness and quality of those products1,2,3. Acknowledging that CC is complex and involves various challenges, this study estimated the wastage costs in the management of temperature sensitive bDMARDs used in the treatment of RA, from the perspectives of the Brazilian health systems (public [SUS] and supplementary [SSS]). An estimative of annual wastage costs in the logistics management of temperature sensitive bDMARDs was performed, using literature data over rates of wastage in CC (1.5%)4 and physical loss of temperature sensitive drugs (2.96%)5, as well as annual data of treatment costs with the bDMARDs etanercept (ETN), adalimumab (ADA), infliximab (INF), abatacept (ABA), golimumab (GOL), certolizumab pegol (CZP) and rituximab (RTX), obtained from SUS and SSS databases, encompassing a sample of 1,000 patients with RA for each one of the listed treatments. Estimates of annual wastage costs in the logistics management of temperature sensitive bDMARDs for SUS and SSS, assuming a wastage rate of 4.5% (managing rate of CC + material loss rate) were: BRL883.615,20 - BRL3.601.276,95 ETN, BRL947.323,62 - BRL3.827.004,69 ADA, BRL753.941,59 - BRL2.474.714,49 INF, BRL735.974,93 - BRL2.608.404,24 ABA, BRL731.821,78 - BRL2.018.972,42 GOL, BRL712.832,88 - BRL1.704.242,71 CZP, BRL507.829,87 - BRL1.043.959,34 RTX, respectively. The analysis suggests that the waste caused by the use of temperature sensitive bDMARDs has a significantly impact in the Brazilian healthcare systems, which could be used to supply an annual treatment of approximately 44 RA patients, regardless the bDMARDs treatment of choice, should be considered other alternatives that not include the CC in the logistic management.
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