The cost of tobacco-related diseases for Brazil's Unified National Health System

Este estudo teve como objetivo calcular os custos diretos de interna????es por doen??as tabaco-relacionadas em 2005, sob a perspectiva do Sistema ??nico de Sa??de (SUS) para tr??s grupos de doen??as: c??ncer, aparelhos circulat??rio e respirat??rio. Para o c??ncer, os custos com quimioterapia tamb??m foram considerados. Foram utilizados dados das bases administrativas dos sistemas de informa????o do SUS e indicadores epidemiol??gicos, como preval??ncia e riscos relativos de cada doen??a analisada. Os custos atribu??veis ao tabagismo foram de R$ 338.692.516,02, representando 27,6% dos custos totais dos procedimentos analisados para os tr??s grupos. Se consideradas as interna????es e procedimentos de quimioterapia pagos para todas as patologias, os custos alcan??aram 7,7% dos custos totais. Ainda, 0,9% das despesas com a????es e servi??os de sa??de financiados com recursos pr??prios da esfera federal podem ser atribu??dos ao tabagismo em 2005. Os resultados s??o conservadores para o Brasil e sugerem a necessidade de dar continuidade ??s pesquisas que mensurem a carga total do tabagismo sob a perspectiva da sociedade.This study aimed to identify the direct costs of hospitalizations due to three smoking-related groups of diseases ??? cancer and circulatory and respiratory diseases ??? in Brazil???s Unified National Health System (SUS) in 2005. For cancer, the cost of chemotherapy was also included. The study derived cost estimates using administrative databases, relative risks, smoking prevalence, and smoking-attributable fraction. According to the estimates, smoking- attributable medical expenditures for the three disease groups amounted to R$338,692,516.02 (approximately U$185 million), accounting for 27.6% of total medical expenditures. Considering all hospitalizations and chemotherapy provided by the National Health System, tobacco-related diseases accounted for 7.7% of total medical expenditures. These costs also represented 0.9% of expenditures by federally funded public health services. This study provides a conservative estimate of smoking-related costs and suggests the need for continued research on comprehensive approaches to measure the total burden of smoking for society