Diretriz para análises de impacto orçamentário de tecnologias em saúde no Brasil

Ferreira-Da-Silva, André Luis; Ribeiro, Rodrigo Antonini; Santos, Vania Cristina Canuto; Elias, Flávia Tavares Silva; d'Oliveira, Alexandre Lemgruber Portugal; Polanczyk, Carísi Anne

doi:10.1590/s0102-311x2012000700002

Cited by 34 publications

(56 citation statements)

References 9 publications

(17 reference statements)

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“…The evidence about the cost-effectiveness of interventions is generally used to instruct decisions regarding the allocation of funds from the public sector, helping to identify interventions that represent the best use of resources. In addition to cost-effectiveness analyses, the evaluation of the budget impact can aid decision making by providing financial forecasts if the technology in question is adopted by national health systems (Ribeiro et al 2012). …”

Section: Resultsmentioning

confidence: 99%

G6PD deficiency in Latin America: systematic review on prevalence and variants

Monteiro

Val

Siqueira

et al. 2014

Mem. Inst. Oswaldo Cruz

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Plasmodium vivax radical cure requires the use of primaquine (PQ), a drug that induces haemolysis in glucose-6-phosphate dehydrogenase deficient (G6PDd) individuals, which further hampers malaria control efforts. The aim of this work was to study the G6PDd prevalence and variants in Latin America (LA) and the Caribbean region. A systematic search of the published literature was undertaken in August 2013. Bibliographies of manuscripts were also searched and additional references were identified. Low prevalence rates of G6PDd were documented in Argentina, Bolivia, Mexico, Peru and Uruguay, but studies from Curaçao, Ecuador, Jamaica, Saint Lucia, Suriname and Trinidad, as well as some surveys carried out in areas of Brazil, Colombia and Cuba, have shown a high prevalence (> 10%) of G6PDd. The G6PD A-202A mutation was the variant most broadly distributed across LA and was identified in 81.1% of the deficient individuals surveyed. G6PDd is a frequent phenomenon in LA, although certain Amerindian populations may not be affected, suggesting that PQ could be safely used in these specific populations. Population-wide use of PQ as part of malaria elimination strategies in LA cannot be supported unless a rapid, accurate and field-deployable G6PDd diagnostic test is made available.

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Section: Resultsmentioning

confidence: 99%

G6PD deficiency in Latin America: systematic review on prevalence and variants

Monteiro

Val

Siqueira

et al. 2014

Mem. Inst. Oswaldo Cruz

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“…BIA results include the projection of expenditures due to the incorporation of health technology innovations for diagnosis and treatment of populations during specific periods, based on a comparison of alternative scenarios, using payer perspectives 1,9,10 .…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2016

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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.

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“…A five-year time horizon was used disregarding conventional economic adjustments (discount rate and inflation) in accordance with recommendations from international methodological guidelines for budget impact analyses [17–19]. The calculations were performed using TreeAge ® Pro 2015 software.…”

Section: Methodsmentioning

confidence: 99%

Budget Impact of Long-Acting Insulin Analogues: The Case in Brazil

2016

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BackgroundLong-acting insulin analogues for type 1 diabetes (T1D) treatment have been available on the Brazilian market since 2002. However, the population cannot access the analogues through the public health system.ObjectiveTo estimate the incremental budget impact of long-acting insulin analogues coverage for T1D patients in the Brazilian public health system compared to NPH insulin.MethodsWe performed a budget impact analysis of a five-year period. The eligible population was projected using epidemiological data from the International Diabetes Federation estimates for patients between 0–14 and 20–79 years old. The prevalence of T1D was estimated in children, and the same proportion was applied to the 15-19-year-old group due to a gap in epidemiological information. We considered 4,944 new cases per year and a 34.61/100,000 inhabitants mortality rate. Market share for long-acting insulin analogues was assumed as 20% in the first year, reaching 40% in the fifth year. The mean daily dose was taken from clinical trials. We calculated the bargaining power of the Ministry of Health by dividing the price paid for human insulin in the last purchase by the average regulated price. We performed univariate and multivariate sensitivity analyses.ResultsThe incremental budget impact of long-acting insulin analogues was US$ 28.6 million in the first year, and reached US$ 58.7 million in the fifth year. The total incremental budget impact was US$ 217.9 million over the five-year period. The sensitivity analysis showed that the percentage of T1D among diabetic adults and the insulin analogue price were the main factors that affected the budget impact.ConclusionsThe cost of the first year of long-acting insulin analogue coverage would correspond to 0.03% of total public health expenditure. The main advantage of this study is that it identifies potential bargaining power because it features more realistic profiles of resource usage, once centralized purchasing is established as an economically sustainable strategy. Clinical guidelines restricting the use of insulin analogues would make the decision towards insulin analogue coverage more affordable.

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Diretriz para análises de impacto orçamentário de tecnologias em saúde no Brasil

Cited by 34 publications

References 9 publications

G6PD deficiency in Latin America: systematic review on prevalence and variants

G6PD deficiency in Latin America: systematic review on prevalence and variants

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

Budget Impact of Long-Acting Insulin Analogues: The Case in Brazil

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