Inconsistencies in SUS outpatient therapeutic practices in the treatment of exudative retinal diseases

Abstract

We sought to explore the coherence of SUS outpatient therapeutic practices for diagnosis and treatment in relation to the criteria for use of Anti-Vascular Endothelial Growth Factor (anti-VEGF) drugs described in the Clinical Protocols and Therapeutic Guidelines (PCDTs) for age-related macular degeneration (AMD) and diabetic retinopathy (DR). This is a cross-sectional study based on SUS outpatient data. Outpatient records were included between January/2019 and December/2023 for patients with AMD or DR, and for specific treatment procedures and diagnostic tests. After April/, 6,064 patients with AMD started drug treatment for retinal disease aged <60 years, and 20.6% of the records recorded in this period were inconsistent with the age criterion imposed by the PCDT, leading to an approximate cost of R$12.58 million. Only 55% of patients with DR underwent a diagnostic test for diabetic macular edema (DME), which is mandatory for the use of anti-VEGFs. Therapeutic practices for AMD and DR/EMD in the SUS outpatient system are inconsistent, causing unnecessary costs to the public health system. It is necessary to review the mechanisms that guarantee the coherence of SUS therapeutic practices with the PCDTs, enabling the effective implementation of public policies.