Pamela Santos Azevedo ¹ Isabella de Figueiredo Zuppo ¹ Deborah Marta do Santos Oliveira ¹ Adriano Sabino ² Marina Morgado Garcia ¹ Isabela Cristina Menezes de Freitas ^1,3 Wallace Mateus Prata ^1,4 Mariangela Leal Cherchiglia ⁵ Juliana Alvares-Teodoro ^1,3 Francisco De Assis Acurcio ^1,3 Augusto Afonso Guerra Júnior ^1,3*

• ¹ Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil
• ² Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Mato Grosso, Brazil
• ³ Collaborating Centre for Health Technology Assessment and Excellence (CCATES), Belo Horizonte, Mato Grosso, Brazil
• ⁴ Ezequiel Dias Foundation (FUNED), Belo Horizonte, Brazil
• ⁵ Department of Preventive and Social Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Mato Grosso, Brazil

Follicular lymphoma (FL) is a common type of non-Hodgkin lymphoma that is incurable but often follows an indolent course. While survival is improving thanks to advances in diagnosis, supportive care, and new therapies, understanding outcomes and their impact on overall survival is still limited. There are few studies on FL in Brazil, so this study aims to evaluate the patient's profile, morbidity and mortality treated by the Brazilian national health service (SUS) and evaluate risk factors associated to treatment failure. This is a nationwide sixteen years cohort with patients that underwent chemotherapy in the SUS (2000 to 2015). The Kaplan-Meier method was used to estimate survival until treatment failure, and the Cox proportional hazards model was used to evaluate risk factors. The cohort included 10,009 patients and survival rates were 73.3%, 45.3%, and 30.7% for the 1 st , 5 th and 10 th year respectively. The median overall survival was approximately 4.1 years. The most used regimen was CHOP (13%), followed by CVP (9.7%) and R-CHOP (3.3%). Four hundred and ninetyeight patients (4.9%) used rituximab-containing regimens. Univariate analysis indicated worse survival rates for male patients, those over 65 years of age, clinical stage III or IV and those using nonrituximab-containing regimens. The health technology performance assessment related to oncology schemes for FL suggests that rituximab-based regimens has shown best survival probability (0,52 CI 0.39-0.69) in 78 months of follow up with a HR 1.5 times better than other schemes (HR 0.67;CI 0.55-Formatado: Inglês (Estados Unidos) Formatado: Inglês (Estados Unidos) Formatado: Inglês (Estados Unidos) 0.81). In light of the substantial advancements achieved by the SUS, there is a need for CONITEC to expedite decision-making processes in order to enhance patients' access to new oncology drugs. This should be done while upholding health technology assessment standards. Timely integration and sufficient funding for oncology services have the potential to save lives, especially when compared to the treatments available within SUS at that time.