Nutrieconomics: Concept and Expert Consensus on Health Technology Assessment of Nutritional Interventions in Brazil
Author(s)
SARAH R. RODRIGUES, BSc, MSc1, Mayra B. Lemos, MSc2, Bruno dos Santos de Oliveira, BSc3, MATHEUS R. LUIZ, BSc4, Erica CAMARGO, BSc3.
1Medical Affairs, DANONE, São Paulo, Brazil, 2LEMOS HEALTH, Vitória, Brazil, 3Market Access, DANONE, SAO PAULO, Brazil, 4DANONE, SAO PAULO, Brazil.
1Medical Affairs, DANONE, São Paulo, Brazil, 2LEMOS HEALTH, Vitória, Brazil, 3Market Access, DANONE, SAO PAULO, Brazil, 4DANONE, SAO PAULO, Brazil.
OBJECTIVES: HTA has been extensively applied to the analysis of the impact of medications, medical devices, and surgical and diagnostic procedures. However, there is a noticeable gap in assessments focused on interventions involving nutritional care. This study aimed to map international discussions on Health Technology Assessment (HTA) for nutritional interventions and present expert recommendations for a proposed HTA framework in Brazil.
METHODS: A landscape review was conducted to identify discussions and specific criteria for HTA in nutrition. Subsequently, a Delphi panel was held with seven Brazilian experts, who rated 12 proposed criteria on a scale from 1 (not relevant) to 5 (extremely relevant), and responded to open-ended questions regarding management, risk-sharing, and the applicability of traditional HTA within the Brazilian Unified Health System (SUS).
RESULTS: There is a lack of robust evidence on long-term outcomes and costs, as well as standardized methodologies for clinical and economic evaluation of nutritional interventions in health systems. However, interest groups exist within global reference institutions in nutrition, HTA, and pharmacoeconomics to discuss this topic. For the proposed nutritional HTA in Brazil, most experts disagreed with the use of the traditional process and identified as relevant the evaluation of evidence on critical outcomes (mortality, survival, readmission), functional outcomes, real-world data, and financial feasibility through budget impact analysis. It was recommended that the acquisition, distribution, and monitoring of nutritional interventions be managed by the Federal and State levels of SUS, including risk-sharing agreements.
CONCLUSIONS: The need for standardized methods for economic and outcome evaluation of nutritional interventions is reinforced, with an adaptation of the HTA process. The concept of Nutrieconomics is proposed, integrating nutrition, health economics, and public health to assess the economic impact of these interventions within health systems.
METHODS: A landscape review was conducted to identify discussions and specific criteria for HTA in nutrition. Subsequently, a Delphi panel was held with seven Brazilian experts, who rated 12 proposed criteria on a scale from 1 (not relevant) to 5 (extremely relevant), and responded to open-ended questions regarding management, risk-sharing, and the applicability of traditional HTA within the Brazilian Unified Health System (SUS).
RESULTS: There is a lack of robust evidence on long-term outcomes and costs, as well as standardized methodologies for clinical and economic evaluation of nutritional interventions in health systems. However, interest groups exist within global reference institutions in nutrition, HTA, and pharmacoeconomics to discuss this topic. For the proposed nutritional HTA in Brazil, most experts disagreed with the use of the traditional process and identified as relevant the evaluation of evidence on critical outcomes (mortality, survival, readmission), functional outcomes, real-world data, and financial feasibility through budget impact analysis. It was recommended that the acquisition, distribution, and monitoring of nutritional interventions be managed by the Federal and State levels of SUS, including risk-sharing agreements.
CONCLUSIONS: The need for standardized methods for economic and outcome evaluation of nutritional interventions is reinforced, with an adaptation of the HTA process. The concept of Nutrieconomics is proposed, integrating nutrition, health economics, and public health to assess the economic impact of these interventions within health systems.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HTA258
Topic
Health Policy & Regulatory, Health Technology Assessment, Methodological & Statistical Research
Topic Subcategory
Value Frameworks & Dossier Format
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Nutrition