Produção científica em avaliação de tecnologias em saúde no Brasil

Abstract

Health technology assessment (HTA) focuses on understanding the clinical, economic, environmental, social, political, and legal implications of new technologies, or changes in established ones. This multidisciplinary field can provide various decision-makers with hierarchical analyses of the available options for health policy implementation.This Supplement of Cadernos de Saúde Pública is a strategy for publicizing Brazilian experiences in HTA and reflects the growth in the field's scientific output. An open call for papers was conducted resulting in 104 submissions. With the manuscripts' quality as the priority, 48 were referred for peer review, of which 15 were finally selected for publication. An effort was made to promote diversity in the themes, types of studies, and institutional and regional participation.The institutional development of HTA has occurred progressively at the three management levels in health, as well as in academia and health services themselves. The Special Article analyzes participation by the Brazilian Ministry of Health's Department of Science and Technology in the Commission for Health Technology Incorporation, demonstrating that a methodological and political learning process is under way on the use of HTA in Brazil.The articles range from systematic reviews and meta-analyses -relating to efficacy and safety of biomedicines in the treatment of psoriasis and idursulfase in mucopolysaccharidosis type II -to partial and complete economic assessments of interventions, such as cost-effectiveness analyses of immunosuppressants used in renal transplant maintenance therapy and expenditures related to rheumatoid arthritis treatment. An important study examines the value of different health states among the dimensions measured by the EQ-5D instrument in Brazil.The articles also discuss a wide range of types of interventions, including a meta-analysis on the efficacy of commercially available HPV vaccines and cost-effectiveness studies on preventive methods in oral health; diagnostics -such as economic assessment of the reuse of coronary angiography catheters; and therapeutics, such as a cost-effectiveness analysis of the inclusion of slow virological responders in the treatment of hepatitis C/HIV co-infection, and evaluation of the demand for antidotes in the country's health services. The issue also includes studies with a focus on home care effectiveness through a medical cooperative and the cost-effectiveness of a breast cancer screening program.Other studies focus on HTA management processes such as legal action to obtain access to medicines and the assessment and incorporation of technologies by hospitals.Importantly, the studies come from high-level universities and research institutes, and more than half involve collaboration between different institutions. The mix of articles represents three regions of Brazil, but there is a need for greater promotion of HTA in the North and Northeast.This Supplement thus reiterates the importance, need, usefulness, and relevance of HTA research in Br...