Availability of B-type natriuretic peptide testing in Brazilian public health system
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Novartis Biociencias, Brazil
Núcleo de Avaliação de Tecnologias em Saúde do Instituto Nacional de Cardiologia, Brazil
Núcleo de Avaliação de Tecnologias em Saúde do Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1537
Background and Objective: Early detection of heart failure allows an evaluation of risk factors and adequate pharmacotherapy in order to postpone or reversing cardiac remodeling. The diagnosis of heart failure can be supported by B-type Natriuretic Peptide measures (BNP or NTproBNP). These test should be performed before the patient can have free access to sacubitril valsartan. Despite the important role in diagnosis of heart failure and access to specific treatment, a small number of tests were recorded in Brazil between 2020 and 2021. This study aims to assess the availability of B-type Natriuretic Peptide testing in primary health care in Brazil. Methods: A cross-sectional study utilizing a telephone survey with 255 health departments among the 2849 counties available with primary health care units of medium complexity. Three telephone contact attempts were conducted with each municipality on alternating days, throughout the months of June and July 2022. After the unsuccessful attempts, the next county selected in the same region was contacted, and so on, until the necessary number of municipalities was attained. Results: The availability to perform these exams were recorded at 20.78% (53/255) of the municipalities and only 16.86% (43/255) the testing was carried out inside the county. These exams were unavailable in 78.03% (199/255). Conclusions: there are more municipalities without access to the test than those who have perform it (16,86% (43/255) x 4,63% (132/2849). It suggests that this exam is not solicited by physicians despite being offered in some counties. which could indicate that these professionals are unaware of its availability or about the Heart Failure diagnostic flow in Primary Care. The inability to perform these exams limits and delays Heart Failure`s diagnosis and proper care. Furthermore, it increases inequities of the Brazilian Health System, posing questions concerning the plan for conditional drug reimbursement based on test results.
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