Palavras-chave: Avaliação da Tecnologia Biomédica, hospitaisABSTRACT: Objective: To analyze the structural characteristics and work processes after two years of the implementation of assessment centers of technology in teaching hospitals in Brazil. Method: This study used a online self-administered questionnaire that surveyed managers of the twenty-four centers that attended of the public call 2009. Results: a total of twenty managers completed the survey. Fourteen centers answered that occurred the formalization of the area into the hospital. All of them reported difficulties in trained personnel and financial resources, the teams were able to offer courses (sixteen centers) and produce some assessments as the scientific expert advice (twelve centers). Nineteen adopted the methodological guidelines of REBRATS. Conclusion: It was realized that two years of implementation of this centers were not enough for achieve structural and procedural characteristics considering the survey. The dissemination of HTA culture in a country with no tradition like Brazil should be a permanent action for quality of healthcare.1 Pesquisador em saúde pública na Fiocruz Brasília, perfil avaliação de tecnologia e de programas em saúde. Brasília, DF.

Contexto: O gasto elevado com medicamentos biológicos ameaça a sustentabilidade dos serviços de saúde. O objetivo da presente re-visão rápida foi embasar a discussão da Política Nacional de Medi-camentos Biológicos no âmbito do Sistema Único de Saúde (SUS), por meio da identificação de barreiras de acesso a esses medica-mentos. Metodologia: Revisão rápida da literatura nas fontes de infor-mação Medline via PubMed, EMBASE, Biblioteca Cochrane e Center for Review and Dissemination (CRD). Resultados: Foram incluídos nove estudos com delineamento transversal. No contexto do usuário, as barreiras foram a falta de conhecimento sobre o medicamento, a dis-tância entre a moradia e o serviço de saúde, os longos períodos de espera por atendimento e a passividade sobre decisão de tratamen-to. Para os profissionais de saúde, as barreiras referem-se a aceitabi-lidade em relação ao medicamento, intercambialidade e substituição, percepção de ausência de dados clínicos que favoreçam eficácia e segurança. No contexto do gestor, as barreiras foram alto custo do medicamento, problemas de reembolso e de assistência. Não foram encontradas barreiras no âmbito governamental do sistema de saúde nos estudos incluídos, apenas no âmbito privado, isto é, a proprieda-de industrial. Conclusão: Para que políticas de saúde sejam efetivas, é essencial o emprego de evidências científicas. São necessárias soluções para as barreiras de acesso de medicamentos biológicos.

IntroductionDue to the high judicialization rates which pressure the financing of biologic medicines by the Brazilian Unified Health System (Sistema Único de Saúde - SUS), it has been decided to formulate the National Policy for Biologic Medicines. After identification of problems and prioritization, interchangeability based only on economic criteria was the main problem to be confronted. The primary objective of this study was to identify political options to approach the problem of interchangeability in systematic reviews.MethodsWe conducted a rapid evidence synthesis for policy based on an adaptation of the SUPPORT tools, and searched in six literature databases. The selection of studies was performed in a systematic, transparent and independent manner. The International Network of Agencies in Health Technology Assessment (INAHTA) members were consulted to learn how this practice occurs worldwide.ResultsWe included seven systematic reviews and one policy brief, whose options to approach the problem were: production of robust scientific evidence on interchangeability; implementation of a pharmacovigilance system; appreciation of the clinical efficacy in the practice of interchangeability; and educational strategies for healthcare professionals in Brazil. Nine countries responded to our query.ConclusionsEvidence-informed policy has a central role for the Brazilian Ministry of Health. The present rapid evidence synthesis for policy will subsidize decision making regarding the interchangeability of biologic medicines within the Brazilian Unified Health System.

IntroductionThe Department of Sciences and Technology (Decit) of the Brazilian Government has played a vital role in drafting of the National Policy for Biologic Medicines. Decit has provided methodological support to the working group, conducting a rapid review and a rapid evidence synthesis to subsidize decisions and recommendations.MethodsWe used the Methodological Guidelines for the Elaboration of Evidence Synthesis for Health Policies, which is a product of our own team, based on the SUPporting POlicy relevant Reviews and Trials (SUPPORT) Tools for evidence-informed health Policymaking.ResultsThe Decit team participated in the key steps to develop an evidence-informed policy. Our product, “Barriers to Access to Biologic Products: a Rapid Review” was used for the prioritization of health problems and the description of the problem. We then proceeded to the evidence synthesis planning and definition of the research question from an acronym. Together with the coordination of the working group, we decided to tackle the problem of interchangeability of biologic products motivated solely by economic factors in a synthesis of policy evidence. Our evidence synthesis went so far as to describe policy options. The working group used this product to inform a Policy Dialog.ConclusionsThis was the first time that the Decit team provided hands-on methodological assistance the development of a health policy. Not all steps recommended in the SUPPORT Tools were feasible due to time restraints. We observed that rapid evidence synthesis products were helpful to inform decision-making.