Abstract
The steady increase in the number of health technologies and advances in associated research generate management challenges in the choice of technologies to be made available to the public. From 2011, the process of inclusion, exclusion and alteration of technologies to the Brazilian Unified Health System (SUS) has undergone major transformations, such as the creation of the National Committee on Technology Incorporation (CONITEC). This study analyzed the decisions of CONITEC since its inception until July 2015. The analyzed variables were: type of technology, reason for application, name of the technology, indication, claimant and CONITEC decision status. We found that the Government was the main claimant, accounting for 58.1% of the 420 cases. The most frequent request was inclusion (93.8%) and the technology type was medicine (61.4%). Of the incorporated medicines, the classes of antineoplastic/immunomodulatory were the most frequent (39.47%). Society's desire for inclusion of an increasing amount of health technology contrasts with the limited resources available to management, which causes budget concerns. Using Health Technology Assessment (HTA), advances resulting from these innovations in the process were highlighted, and challenges were identified for the management and the academic community.
Highlights
The steady increase in the number of health technologies available on the market and the advances in research have created management challenges regarding the choice of technologies to be made available to the population (Banta, Almeida, 2009)
The changes affect directly the users and the managers of SUS, and all the pharmaceutical and healthcare industry in general. Understanding that these institutional and legislative innovations set a new framework of Health Technology Assessment (HTA) in Brazil, with repercussions, since 2012, on the course and result of the process of incorporation, exclusion and modification of technologies made available by Brazilian public health system and their availability to the assisted population, this study aimed to analyze the demands submitted to CONITEC, during a period of three years since its creation, and to examine the possible improvements of this new framework over previous models adopted by the country
The data was collected through document analysis, by research from secondary sources, in the databases available for consultation from the MH’s websites, namely: 1) application forms of the inclusion, exclusion and alteration technologies to SUS; 2) classification and categorization reports of the demands submitted to CONITEC; 3) individualized reports containing the foundations, decisions and recommendations regarding the demands evaluated by the CONITEC; 4) contributions and public consultations forms, relating to demands for the inclusion, exclusion and alteration technologies to SUS and, 5) ordinances of the Secretariat of Science, Technology and Strategic Inputs of the Ministry of Health (SCTIE/MH), with the publication of the decisions in these processes
Summary
The steady increase in the number of health technologies available on the market and the advances in research have created management challenges regarding the choice of technologies to be made available to the population (Banta, Almeida, 2009). A major goal of HTA is to guide decision-making by managers responsible for health policies, especially in regard to incorporating, Brazil has made official lists of the medicines to be provided by its public health system since 1964. These lists were initially updated by a public agency called “Drugs Central Office” (CEME) and, since 1975, they have been called the National List of Essential Medicines (RENAME), which currently is in its 9th modern edition, of 2014, encompassing 840 items (Brasil, 2007). There was not a defined frequency nor even a time frame for the list to be reviewed (Brasil, 2007)
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