Factors associated with the diffusion rate of innovations: a pilot study from the perspective of the Brazilian Unified National Health System

Abstract

Budget Impact Analyses require a set of essential information on health technology innovation, including expected rates of adoption. There is an absence of studies investigating trends, magnitude of budgetary effects and determinants of diffusion rates for health technology innovations worldwide during the last decades. The present study proposes a pilot assessment on main determinants influencing diffusion rates of pharmaceutical innovations within the Brazilian Unified National Health System (SUS). Data from the Brazilian Health Informatics Department (DATASUS) was gathered to establish the main determinants of diffusion rates of health technology innovations in Brazil, specifically referring to pharmaceutical innovations incorporated in the Brazilian Program for Specialized Pharmaceutical Services (CEAF) at SUS. Information was retrieved on DATASUS relating to patients who had used one of the medicines incorporated into CEAF at least three years prior to the beginning of the study (2015) for treatment of each health condition available. Thus, data from patients adopting 10 different medicines were analyzed in the study. Results from the zero-one inflated beta model showed a higher influence on diffusion rates of pharmaceutical innovations due to: number of pharmaceutical competitors for treatment of the same disease available at CEAF (negative); medicine used in combination with other medication (positive); and innovative medicine within the SUS (positive). Further research on diffusion rates of health technology innovations is required, including wider scope of diseases and medications, potential confusion factors and other variables that may influence rates of adoption in different health systems.

The Budget Impact of Monoclonal Antibodies Used to Treat Metastatic Colorectal Cancer in Minas Gerais, Brazil

“…With respect to diffusion rates, BEVA had with the greatest number of judicial requests and was perceived to have the highest uptake. Highest diffusion was anticipated for BEVA as it has been registered in Brazil since 2006 and has been widely prescribed for other therapeutic indications including breast cancer, lung cancer, macular degeneration, and ovarian cancer (61,70).…”

“…It is noteworthy that CONITEC was created, established by Law 12,401, of April 28, 2011, which performs cost-effectiveness assessments, including antineoplastics (66). * The reference numbers mentioned in the tables refer to the studies that explain each parameter (31,41,43,57,58,60,67,68,70,71,72,73,74).…”

Medicamentos e pesquisa translacional: etapas, atores e políticas de saúde no contexto brasileiro

“…Moreover, it is known that there is a delay for it to be, in fact, widely used. Several factors influence the rate of diffusion of technology, such as availability and access to technology, training of health professionals, acceptability and preference of patients and professionals, organizational culture, media pressure and lobbying, presence or prioritization of the topic on the agenda health, judicialization, aspects of the clinical condition, availability of other medicines, among others 47,48 .…”

Terapia-alvo versus dacarbazina no tratamento de primeira linha do melanoma avançado não cirúrgico e metastático: análise de impacto orçamentário na perspectiva do Sistema Único de Saúde, 2018-2020*

“…The diffusion rate of new technology in SUS and the market-share rate in relation to the standard therapy and between different modalities of target therapies, over the study time horizon, were not considered, given the inherent uncertainty of these suppositions: there are gaps in the scientific evidence as to the most appropriate methodology to determine these rates. 15 Pharmaceutical innovations that are more efficacious compared to other drugs available usually become widespread quickly within SUS. 15 Moreover, according to INCA clinical oncologists, consulted through a semi-structured interview, target therapy, once it has been incorporated, could become a substitute within the first year of use.…”

“…15 Pharmaceutical innovations that are more efficacious compared to other drugs available usually become widespread quickly within SUS. 15 Moreover, according to INCA clinical oncologists, consulted through a semi-structured interview, target therapy, once it has been incorporated, could become a substitute within the first year of use.…”