Health technology assessment (HTA) organizations: dimensions of the institutional and political framework

Novaes, Hillegonda Maria Dutilh; Soárez, Patrícia Coelho de

doi:10.1590/0102-311x00022315

Cited by 31 publications

(37 citation statements)

References 21 publications

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“…In Brazil, the growth of scientific literature in this field of knowledge has occurred within the context of the process of devising the Brazilian Ministry of Health (MoH) statement of the National Policy on Health Technologies Management. In the second half of the preceding decade, there was a significant increase in the number of HEEs related to cancer in Brazil, most of which were published in indexed journals ( 4 ).…”

Section: Discussionmentioning

confidence: 99%

“…Since 2000, ANVISA has been regulating the sales of medications. In 2004, ANVISA required HEE as part of the decision-making process related to determining the price of any new medication ( 4 ).…”

Section: Discussionmentioning

confidence: 99%

“…In this scenario, health economic evaluations (HEEs) play a fundamental role by helping identify the best means of allocating the financial resources of a health care system to provide the maximum benefit to the population served ( 4 ). There are two major types of HEEs: partial and full ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

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Health Economic Evaluations of Cancer in Brazil: A Systematic Review

Campolina

et al. 2018

Front. Public Health

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Background: A large number of health economic evaluation (HEE) studies have been published in developed countries. However, Brazilian HEE literature in oncology has not been studied. Objective: To investigate whether the scientific literature has provided a set of HEE in oncology capable of supporting decision making in the Brazilian context.Methods: A systematic review was conducted to identify and characterize studies in this field. We searched multiple databases selecting partial and full HEE studies in oncology (1998-2013).Results: Fifty-five articles were reviewed, of these, 33 (60%) were full health economic evaluations. Type of cancers most frequently studied were: breast (38.2%), cervical (14.6%), lung (10.9%) and colorectal (9.1%). Procedures (47.3%) were the technologies most frequently evaluated. In terms of the intended purposes of the technologies, most (63.6%) were treatments. The majority of the incremental cost-effectiveness ratios (ICERs) reported have been below the cost-effectiveness threshold suggested by the World Health Organization (WHO).Conclusions: There has been an increase in the number of HEEs related to cancer in Brazil. These studies may support decision-making processes regarding the coverage of and reimbursement of healthcare technologies for cancer treatment in Brazil.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Health Economic Evaluations of Cancer in Brazil: A Systematic Review

Campolina

et al. 2018

Front. Public Health

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“…This is a study of Health Technology Assessment (HTA), which can be understood as a comprehensive way to investigate the technical (often clinical), economic and social consequences of the use of health technologies in the short and long term, as well as its direct and indirect effects, both desirable and undesirable (13) .…”

Section: Ethical Aspectsmentioning

confidence: 99%

Cost-effectiveness of infusion pumps to reduce errors in a Pediatric ICU

et al. 2019

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Objective: To analyze cost-effectiveness and to calculate incremental cost-effectiveness ratio of the use of infusion pumps with drug library to reduce errors in intravenous drug administration in pediatric and neonatal patients in Intensive Care Units. Methods: Mathematical modeling for economic analysis of the decision tree type. The base case was composed of reference and alternative settings. The target population was neonates and pediatric patients hospitalized in Pediatric and Neonatal Intensive Care Units, comprising a cohort of 15,034 patients. The cost estimate was based on the bottom-up and top-down approaches. Results: The decision tree, after RollBack, showed that the infusion pump with drug library may be the best strategy to avoid errors in intravenous drugs administration. Conclusion: The analysis revealed that the conventional pump, although it has the lowest cost, also has lower effectiveness. RESUMOObjetivo: Analisar o custo-efetividade e calcular a razão de custo-efetividade incremental do uso de bombas de infusão com biblioteca de fármacos para reduzir erros na administração de medicamento pela via intravenosa, em pacientes pediátricos e neonatais em Unidades de Terapia Intensiva. Método: Modelagem matemática para análise econômica, do tipo árvore de decisão. O caso-base foi composto pelos cenários de referência e alternativo. A população alvo foram pacientes neonatos e pediátricos internados em Unidades de Terapia Intensiva pediátrica e neonatal, compondo uma coorte de 15.034 pacientes. A estimativa de custos foi baseada nas abordagens bottom-up e top-down. Resultados: A árvore de decisão, após RollBack, mostrou que a bomba de infusão com biblioteca de fármacos pode ser a melhor estratégia para evitar erros na administração de medicamentos intravenosos. Conclusão: A análise revelou que a bomba convencional, embora tenha o menor custo, tem também menor efetividade. Descritores: Enfermagem; Avaliação da Tecnologia Biomédica; Análise Custo-Benefício; Preparações Farmacêuticas; Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos. RESUMENObjetivo: Analizar el costo-efectividad y calcular la razón de costo-efectividad incremental del uso de bombas de infusión con una biblioteca de fármacos para reducir errores en la administración de medicamentos por vía intravenosa, en pacientes pediátricos y neonatales en unidades de terapia intensiva. Método: Modelaje matemático para el análisis económico, del tipo árbol de decisión. El caso base se compone de escenarios de referencia y alternativo. La población objetivo fueron pacientes neonatos y pediátricos internados en unidades de terapia intensiva pediátrica y neonatal, componiendo una cohorte de 15.034 pacientes. La estimación de costos se basó en los enfoques bottom-up y top-down. Resultados: El árbol de decisión, después de Roll Back, mostró que la bomba de infusión con biblioteca de fármacos puede ser la mejor estrategia para evitar errores en la administración de medicamentos intravenosos. Conclusión: El análisis reveló que la bomba conv...

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“…In Brazil, HTA institutionalisation occurred through the creation of structures linked to the Brazilian Sistema Único de Saúde (SUS, Unified Healthcare System) [ 6 ]. In 2011, the Comissão Nacional de Incorporação de Tecnologias no SUS (CONITEC, National Committee for Health Technology Incorporation) was created, with the objective of advising the Ministry of Health (MoH) on policies regarding the incorporation of technologies.…”

Section: Introductionmentioning

confidence: 99%

Challenges to decision-making processes in the national HTA agency in Brazil: operational procedures, evidence use and recommendations

Yuba

Novaes

Soárez

2018

Health Res Policy Sys

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BackgroundThe quality of the evidence used in health technology assessment (HTA) agency reports has been considered essential for decision-making processes and their legitimacy. In Brazil, CONITEC is the agency responsible for defining data mandatory for the submission of proposals for the incorporation of new technologies. The objective of this study was to analyse CONITEC recommendation reports, the type of scientific evidence used in them and their compliance with operational procedures.MethodsThis is a descriptive study based on CONITEC official reports from July 2012 through December 2016. Data were collected with a specific extraction form and analysed using descriptive statistics.ResultsWe evaluated 199 CONITEC recommendation reports. The annual number of reports increased during the study period. The absolute annual number of new technologies incorporated in 2013 (n = 24) was similar to that observed for 2014 (n = 24) and 2015 (n = 22), decreasing in 2016 (n = 13). The type of technology most frequently evaluated was ‘drugs’ (68.3%), followed by ‘procedures’ (20.1%). Overall, 117 (58.8%) reports were internal demands, 75 (37.7%) were external demands and 7 (3.5%) were mixed demands. There were differences between internal and external demands in terms of the evidence used in the reports and the decision regarding the recommendation to incorporate the technologies. Among the internal demands, the recommendation to incorporate the new technology was made for 70.9% of the reports, only 9.6% of which included full HTAs. Among the external demands, the incorporation of the new technology was recommended for 17.3% of the reports, 76.9% of which included full HTAs. Of the 101 reports in which incorporation of the new technology was recommended, 88 (87.1%) did not include a full health economic evaluation and ICER calculation. There are compliance difficulties with the recommendations in the CONITEC internal regulations regarding the type and quality of evidence considered in the analysis of recommendation reports.ConclusionsThe characteristics of the evidence used in recommendation reports and those considered to be mandatory were very different, indicating problems in decision-making processes. There is a need to study, with a broader perspective, the factors that influence the type of evidence used in decision-making processes in order to contribute to the development of better practices and policies.

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Health technology assessment (HTA) organizations: dimensions of the institutional and political framework

Cited by 31 publications

References 21 publications

Health Economic Evaluations of Cancer in Brazil: A Systematic Review

Health Economic Evaluations of Cancer in Brazil: A Systematic Review

Cost-effectiveness of infusion pumps to reduce errors in a Pediatric ICU

Challenges to decision-making processes in the national HTA agency in Brazil: operational procedures, evidence use and recommendations

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