Systematic Review of Economic Evaluation of Health Technologies Developed In Brazil From 1980-2013.

Abstract

The aim of this study is to review published economic evaluation of health technologies conducted in Brazil. Systematic review of economic evaluations studies published in MEDLINE, EMBASE, LILACS, SciELO, NHS EED, HTA Database, Web of Science, SCOPUS, BVS ECOS and SISREBRATS from 1980 to 2013. Full (Cost consequence analysis - CCA, cost minimization analysis - CMA, cost-effectiveness analysis - CEA, cost-utility analysis - CUA, and cost-benefit analysis - CBA) and partial (cost description - CD and cost analysis - CA) economic evaluation studies were eligible for inclusion if at least one of the authors was Brazilian and was affiliated to a Brazilian institution. Two independent reviewers screened articles for relevance and carried out data extraction. Disagreements were resolved through discussion or through consultation with a third reviewer. We performed a qualitative narrative synthesis. We identified 11946 records and 557 met inclusion criteria. One hundred and ninety (34.1%) were full (of these, 56.6% CEA, 20.3% CCA, 12.7% CUA, 5.6% CMA, and 4.7% CBA), and 367 were partial economic evaluation (of these, 64.7% CD and 32.3% CA). The main health problem studied were Infectious and Parasitic diseases (17.1%), Diseases of the Circulatory System (12.3%) and Neoplams (10.3%). The majority (72.9%) was conducted by authors from the southeast region, and south region (12.6%), mainly linked to academia (69.5%), and 54.2% were published in medical and 18.9% in public health journals. Seventy-two (14.7%) studies reported to be funded by industry and 16% was considered to have conflict of interest. There was a considerable growth in the conduct and publication of economic evaluation studies in Brazil. A qualitative evaluation of the methodology used in those studies is important to legitimize their use in the process of local decision-making.