title: Cost-utility of reduction mammaplasty assessed for the Brazilian public health system.
abstract: BACKGROUND
  Economic evaluation is important for making decisions about resource allocation. Few cost-utility or cost-effectiveness studies on breast hypertrophy have been reported in the medical literature.
  
  
  OBJECTIVE
  The authors sought to determine the cost-utility of reduction mammaplasty in the Brazilian national health care system.
  
  
  METHODS
  This randomized controlled study was conducted in a university-affiliated hospital. Sixty patients with breast hypertrophy were enrolled prospectively and were assigned randomly to either the control group (n = 30 patients who received follow-up for 6 months) or the treatment group (n = 30 patients who underwent reduction mammaplasty). Direct costs were recorded, and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) was administered to both groups at the beginning of the study (preoperatively for the treatment group) and 3 and 6 months postoperatively. Utility was determined with Instrument 6D of the Brazilian version of the Short-Form Health Survey (SF-6D), from the SF-36 data.
  
  
  RESULTS
  At the 6-month follow-up, the treatment group showed an improvement in utility, with an average direct cost of approximately £104.
  
  
  CONCLUSIONS
  Reduction mammaplasty performed in the Brazilian national health care system provides a cost-utility ratio equivalent to approximately £142 per 1 quality-adjusted life year.
authors: Dr Araújo is a Preceptor in the Division of Orthopedics, Department of Surgery, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Veiga is an Associate Professor of the Plastic Surgery Postgraduate Program, Federal University of São Paulo, São Paulo, Brazil, and is an Associate Professor in the Division of Plastic Surgery, Department of Surgery, University of Vale do Sapucaí, Pouso Alegre, BrazilDrs Hochman and Abla are Associate Professors of the Plastic Surgery Postgraduate Program, Federal University of São Paulo, São Paulo, BrazilDr Oliveira is a medical student at the School of Medicine, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Novo is a Full Professor in the Department of Biostatistics, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Veiga-Filho is an Associate Professor in the Division of Plastic Surgery, Department of Surgery, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Ferreira is a Full Professor of the Plastic Surgery Postgraduate Program, Federal University of São Paulo, São Paulo, Brazil.
authors: Carlos Delano Mundim
authors: CD
authors: Araújo
authors: Dr Araújo is a Preceptor in the Division of Orthopedics, Department of Surgery, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Veiga is an Associate Professor of the Plastic Surgery Postgraduate Program, Federal University of São Paulo, São Paulo, Brazil, and is an Associate Professor in the Division of Plastic Surgery, Department of Surgery, University of Vale do Sapucaí, Pouso Alegre, BrazilDrs Hochman and Abla are Associate Professors of the Plastic Surgery Postgraduate Program, Federal University of São Paulo, São Paulo, BrazilDr Oliveira is a medical student at the School of Medicine, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Novo is a Full Professor in the Department of Biostatistics, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Veiga-Filho is an Associate Professor in the Division of Plastic Surgery, Department of Surgery, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Ferreira is a Full Professor of the Plastic Surgery Postgraduate Program, Federal University of São Paulo, São Paulo, Brazil danielafveiga@gmail.com.
authors: Daniela Francescato
authors: DF
authors: Veiga
authors: Dr Araújo is a Preceptor in the Division of Orthopedics, Department of Surgery, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Veiga is an Associate Professor of the Plastic Surgery Postgraduate Program, Federal University of São Paulo, São Paulo, Brazil, and is an Associate Professor in the Division of Plastic Surgery, Department of Surgery, University of Vale do Sapucaí, Pouso Alegre, BrazilDrs Hochman and Abla are Associate Professors of the Plastic Surgery Postgraduate Program, Federal University of São Paulo, São Paulo, BrazilDr Oliveira is a medical student at the School of Medicine, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Novo is a Full Professor in the Department of Biostatistics, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Veiga-Filho is an Associate Professor in the Division of Plastic Surgery, Department of Surgery, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Ferreira is a Full Professor of the Plastic Surgery Postgraduate Program, Federal University of São Paulo, São Paulo, Brazil.
authors: Bernardo Sérgio
authors: BS
authors: Hochman
authors: Dr Araújo is a Preceptor in the Division of Orthopedics, Department of Surgery, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Veiga is an Associate Professor of the Plastic Surgery Postgraduate Program, Federal University of São Paulo, São Paulo, Brazil, and is an Associate Professor in the Division of Plastic Surgery, Department of Surgery, University of Vale do Sapucaí, Pouso Alegre, BrazilDrs Hochman and Abla are Associate Professors of the Plastic Surgery Postgraduate Program, Federal University of São Paulo, São Paulo, BrazilDr Oliveira is a medical student at the School of Medicine, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Novo is a Full Professor in the Department of Biostatistics, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Veiga-Filho is an Associate Professor in the Division of Plastic Surgery, Department of Surgery, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Ferreira is a Full Professor of the Plastic Surgery Postgraduate Program, Federal University of São Paulo, São Paulo, Brazil.
authors: Luiz Eduardo Felipe
authors: LE
authors: Abla
authors: Dr Araújo is a Preceptor in the Division of Orthopedics, Department of Surgery, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Veiga is an Associate Professor of the Plastic Surgery Postgraduate Program, Federal University of São Paulo, São Paulo, Brazil, and is an Associate Professor in the Division of Plastic Surgery, Department of Surgery, University of Vale do Sapucaí, Pouso Alegre, BrazilDrs Hochman and Abla are Associate Professors of the Plastic Surgery Postgraduate Program, Federal University of São Paulo, São Paulo, BrazilDr Oliveira is a medical student at the School of Medicine, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Novo is a Full Professor in the Department of Biostatistics, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Veiga-Filho is an Associate Professor in the Division of Plastic Surgery, Department of Surgery, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Ferreira is a Full Professor of the Plastic Surgery Postgraduate Program, Federal University of São Paulo, São Paulo, Brazil.
authors: Ana Carolina Salles
authors: AC
authors: Oliveira
authors: Dr Araújo is a Preceptor in the Division of Orthopedics, Department of Surgery, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Veiga is an Associate Professor of the Plastic Surgery Postgraduate Program, Federal University of São Paulo, São Paulo, Brazil, and is an Associate Professor in the Division of Plastic Surgery, Department of Surgery, University of Vale do Sapucaí, Pouso Alegre, BrazilDrs Hochman and Abla are Associate Professors of the Plastic Surgery Postgraduate Program, Federal University of São Paulo, São Paulo, BrazilDr Oliveira is a medical student at the School of Medicine, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Novo is a Full Professor in the Department of Biostatistics, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Veiga-Filho is an Associate Professor in the Division of Plastic Surgery, Department of Surgery, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Ferreira is a Full Professor of the Plastic Surgery Postgraduate Program, Federal University of São Paulo, São Paulo, Brazil.
authors: Neil Ferreira
authors: NF
authors: Novo
authors: Dr Araújo is a Preceptor in the Division of Orthopedics, Department of Surgery, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Veiga is an Associate Professor of the Plastic Surgery Postgraduate Program, Federal University of São Paulo, São Paulo, Brazil, and is an Associate Professor in the Division of Plastic Surgery, Department of Surgery, University of Vale do Sapucaí, Pouso Alegre, BrazilDrs Hochman and Abla are Associate Professors of the Plastic Surgery Postgraduate Program, Federal University of São Paulo, São Paulo, BrazilDr Oliveira is a medical student at the School of Medicine, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Novo is a Full Professor in the Department of Biostatistics, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Veiga-Filho is an Associate Professor in the Division of Plastic Surgery, Department of Surgery, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Ferreira is a Full Professor of the Plastic Surgery Postgraduate Program, Federal University of São Paulo, São Paulo, Brazil.
authors: Joel
authors: J
authors: Veiga-Filho
authors: Dr Araújo is a Preceptor in the Division of Orthopedics, Department of Surgery, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Veiga is an Associate Professor of the Plastic Surgery Postgraduate Program, Federal University of São Paulo, São Paulo, Brazil, and is an Associate Professor in the Division of Plastic Surgery, Department of Surgery, University of Vale do Sapucaí, Pouso Alegre, BrazilDrs Hochman and Abla are Associate Professors of the Plastic Surgery Postgraduate Program, Federal University of São Paulo, São Paulo, BrazilDr Oliveira is a medical student at the School of Medicine, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Novo is a Full Professor in the Department of Biostatistics, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Veiga-Filho is an Associate Professor in the Division of Plastic Surgery, Department of Surgery, University of Vale do Sapucaí, Pouso Alegre, BrazilDr Ferreira is a Full Professor of the Plastic Surgery Postgraduate Program, Federal University of São Paulo, São Paulo, Brazil.
authors: Lydia Masako
authors: LM
authors: Ferreira
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil; D003362:Cost-Benefit Analysis / Q000191:economics* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D016462:Mammaplasty / Q000191:economics* / Q000379:methods; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics* / Q000706:statistics & numerical data; D011446:Prospective Studies; D011634:Public Health / Q000191:economics* / Q000706:statistics & numerical data; D011788:Quality of Life; D055815:Young Adult
keywords: breast hypertrophy; cost-effectiveness; cost-utility; mammaplasty; quality-adjusted life years