{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T05:54:38Z","timestamp":1776318878294,"version":"3.50.1"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Brazil is the second highest worldwide regarding new cases of Hansen\u2019s disease (HD), with over 20,000 diagnoses annually. Late detection often results in severe disabilities that impair daily functioning, reduce work capacity, and increase reliance on state financial assistance, which contribute to public expenditure. This study quantified the economic impact of Hansen\u2019s disease by analyzing social security benefits in relation to the disease\u2019s epidemiological profile from the late 20th century to the first two decades of the 21st century.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective, longitudinal, descriptive study applied a cost-of-illness (COI) approach from a societal perspective. Indirect costs attributable to Hansen\u2019s disease were estimated using social security transfer payments as proxies for productivity loss. Administrative data from the National Institute of Social Security were obtained for all benefits granted between 2000 and 2019. These records included temporary, long-term, and lifetime benefits, which were categorized by type, duration, sex, geographic location, and total financial disbursement. The economic evaluation considered both annual and accumulated payments over the study period. To contextualize the burden of disease, benefit data were analyzed alongside epidemiological indicators from the Ministry of Health\u2019s Notifiable Diseases Information System, allowing the examination of the relationship between Hansen\u2019s disease trends and variations in benefit concessions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Systematic variations were identified in the number of benefits granted, with a marked increase until 2005, followed by an abrupt drop and a subsequent gradual decline. These fluctuations were influenced by exogenous monetary and political factors and changes in benefit requests. Long-term benefits followed the same pattern, stabilizing at approximately 1,000 grants per year. Temporary benefits showed recurrent oscillations and later declined from 4,283 in 2000 to 3,525 in 2019, remaining substantially more frequent than lifetime benefits. Data segmentation showed the following: (I) age at entry into the social security system peaked at 45 to 55\u202fyears for both sexes; (II) men received 2.7 times more benefits; (III) benefit duration was similar for men and women, with 52.0% ending within 18\u202fmonths and 85.0% within 120\u202fmonths; (IV) the Southeast region accounted for 21.8% of benefits and 24.8% of new cases; and (V) total payments increased over 60-fold, reaching US$ 91 million in 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Social security expenditures for beneficiaries with Hansen\u2019s disease totaled US$ 924.6 million, representing a substantial economic burden relative to the disease\u2019s epidemiological characteristics in Brazil. Although incidence has declined and benefit concessions have gradually decreased, partly due to improvements in administrative processes and Hansen\u2019s disease control, the financial impact remains significant. Given that Hansen\u2019s disease is curable, and treatment is freely available in the public health system, current resource allocation prioritizes compensation for productivity loss over early diagnosis and prevention. The identified disparities, including gender differences and concentration of benefits in wealthier regions, warrant further investigation to inform mitigation strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1672733","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T05:24:41Z","timestamp":1776317081000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Economic cost of Hansen\u2019s disease: an overview of social security expenditures"],"prefix":"10.3389","volume":"14","author":[{"given":"Jose Marcelo","family":"Castro","sequence":"first","affiliation":[{"name":"Department of Business Administration, School of Economics, Business Administration and Accounting at Ribeir\u00e3o Preto, University of S\u00e3o Paulo","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filipe","family":"Rocha Lima","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Internal Medicine, National Referral Center for Sanitary Dermatology and Hansen\u2019s Disease, Ribeir\u00e3o Preto Medical School, University of S\u00e3o Paulo","place":["S\u00e3o Paulo, Brazil"]},{"name":"Department of Biochemistry and Immunology, Ribeir\u00e3o Preto Medical School, University of S\u00e3o Paulo","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco Andrey","family":"Cipriani Frade","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Internal Medicine, National Referral Center for Sanitary Dermatology and Hansen\u2019s Disease, Ribeir\u00e3o Preto Medical School, University of S\u00e3o Paulo","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Souza Passador","sequence":"additional","affiliation":[{"name":"Department of Business Administration, School of Economics, Business Administration and Accounting at Ribeir\u00e3o Preto, University of S\u00e3o Paulo","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"ref1","volume-title":"Global Population Growth and Sustainable Development","year":"2021"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1007\/s43546-024-00640-7","article-title":"Health status, life expectancy, and early claiming of pension","volume":"4","author":"Aakvik","year":"2024","journal-title":"SN Bus Econ"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"100631","DOI":"10.1016\/j.lana.2023.100631","article-title":"Brazil's unified health system: 35 years and future challenges","volume":"28","author":"Ortega","year":"2023","journal-title":"Lancet Reg Health Am"},{"key":"ref4","volume-title":"Brazilian Social Policy: Outcomes and Dilemmas","author":"Matijascic","year":"2019"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1590\/S0102-30982011000100003","article-title":"Reforma da Previd\u00eancia Social: simula\u00e7\u00f5es e impactos sobre os diferenciais de sexo","volume":"28","author":"Marri","year":"2011","journal-title":"Rev Bras Estud Popul"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1038\/s41572-024-00575-1","article-title":"Leprosy","volume":"10","author":"Grijsen","year":"2024","journal-title":"Nat Rev Dis Primers"},{"key":"ref7","first-page":"417","article-title":"Global leprosy (Hansen disease) update, 2019: time to step-up prevention initiatives","volume":"95","year":"2020","journal-title":"Wkly Epidemiol Rec"},{"key":"ref8","volume-title":"Anu\u00e1rio Estat\u00edstico da Previd\u00eancia Social \u2013 2018","year":"2019"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"100181","DOI":"10.1016\/j.lana.2021.100181","article-title":"Impact of the COVID-19 pandemic on the diagnosis of leprosy in Brazil: an ecological and population-based study","volume":"9","author":"da Paz","year":"2022","journal-title":"Lancet Reg Health"},{"key":"ref10","volume-title":"Boletim Epidemiol\u00f3gico Hansen\u00edase 2024. 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