Análise de viabilidade econômica de um modelo centralizado para ajuste de insulina em pacientes diabéticos dependentes do SUS

Abstract

This study presents an economic feasibility analysis for implementing a systematic insulin dosage adjustment model for diabetic patients treated by Brazil’s Unified Health System (SUS) in three scenarios: in the city of Itajubá (Minas Gerais), in the microregion of Itajubá and in the southern region of Minas Gerais. Considering the rising prevalence of diabetes mellitus, a global public health challenge, the limited availability of endocrinologists in SUS, and barriers to accessing modern glucose monitoring technologies, a centralized system for insulin adjustments is presented to improve patient access and quality of care. The methodology used combines quantitative modeling and financial simulation with the development of cash flow scenarios using Monte Carlo Simulation (MCS) to assess the costs and feasibility of implementing the model, aiming to calculate the minimum operating cost per adjustment in the three scenarios above-mentioned. The proposed model centralizes communication between specialist doctors and patients, through a computerized platform that allows continuous monitoring and adjustment of the dosage. The results of the analysis indicate that the average cost per adjustment when considering the implementation in Itajubá can reach around 25 reais and with the gain in scale considering implementation in the microregion of Itajuba and Southern Region of Minas Gerais this average cost can be reduced to around 22 and 20 reais respectively, which represents an economically viable alternative to the current limitations of the SUS in providing regular and specialized care. The potential impact of this system includes enhanced treatment efficacy and reduced complications related to ineffective glycemic control, in addition to the indirect positive impact on cost reduction, marking it as an innovative approach to diabetes management within the public health system. The proposed model not only represents a feasible economic alternative but also suggests a significant advancement in the quality of care for insulin-dependent patients and may be replicated in other regions of Brazil.