OP133 Health Technology Assessment In Brazil: A 5-year Review Of Brazilian Health System (CONITEC) Activities

Abstract

INTRODUCTION:Since the creation of the National Committee for Health Technology Incorporation in the Brazilian Health System (CONITEC), a new phase started in the public Brazilian Health System (SUS): a continuous updating of the system based on Health Technology Assessment (HTA). CONITEC was created by federal law in 2012 and is responsible for advising the Ministry of Health regarding the incorporation or disinvestment of health technologies. The whole process involves a strong interaction with society, including the composition of the committee, which has the participation of the National Health Council. The objective of this study was to describe the results of CONITEC in five years of operation.METHODS:This is a retrospective descriptive study, based on information from the database (period 2012–2016) and CONITEC's website.RESULTS:Since 2012, CONITEC assessed 541 technologies, including drugs (360), health products (71) and procedures (110); 303 assessment requests came from SUS agencies and institutions and the other 238 requests from pharmaceutical companies, medical societies, patient associations and the judiciary bodies. In this period, there were 190 public consultations, during which more than 24,000 feedback from society were received. The average time for evaluation was 146 days. The committee recommended the incorporation of 186 technologies into SUS, the disinvestment of 43 and was unfavorable to the incorporation of 88, generating a budgetary impact of approximately BRL2.5 billion (USD764 million).CONCLUSIONS:From 2012–2016, CONITEC tripled the average annual incorporation of new technologies compared to the period 2006–2011. In this process, it was necessary to assess efficacy, safety and cost-effectiveness of technologies, generating positive results for the expansion of access, health gains for patients and sustainability for the system. It should be considered that the use of evidence for decision making strengthens transparency in public management and the development of active processes of information, communication and social participation.

Incorporação de tecnologias nos sistemas de saúde do Canadá e do Brasil: perspectivas para avanços nos processos de avaliação

“…Como resultado, as decisões relativas à incorporação de tecnologias ocorrem, sobretudo, no nível nacional, embora estados e municípios possam decidir incluir ações e serviços não inseridos nessa tabela. Assim, não surpreende que os principais demandantes das avaliações produzidas pela Conitec sejam as próprias áreas internas do Ministério da Saúde 37 . No entanto, o caráter descentralizado (e regionalizado) do SUS demanda ações capazes de ampliar a capilaridade do sistema de ATS, dotando os estados e as regiões de saúde de mecanismos que promovam a gestão e o uso racional de tecnologias nestas esferas.…”

“…No Brasil, essa atividade foi estudada pela Rebrats, mas instituída somente em 2012 no âmbito da Conitec, com uma produção crescente, mas ainda pouco expressiva 39 , que deve ser fortalecida. Do mesmo modo, o sistema brasileiro de ATS tem concentrado sua produção na avaliação de medicamentos, que representou 66% do total das avaliações no período 2012-2016 37 . A criação de grupos especializados de ATS por tipo ou categoria de tecnologia (medicamentos, tecnologias não medicamentosas e intervenções de saúde e de serviços sociais), tal como adotado no Canadá, pode ser uma alternativa para o Brasil expandir e diversificar suas atividades.…”