OBJECTIVES: In 2017, a study assessed the Health Technology Assessments (HTA) in the Brazilian public healthcare system performed by the National Commission for Incorporation of Technologies (CONITEC). This study is an update of this analysis to evaluate whether there is a decision threshold based on cost-effectiveness ratio (ICER) results of CONITECs decisions over the last 3 years.

METHODS: We assessed 308 CONITEC reports between 01/01/2016 to 05/05/2020 for type of economic analyses, type of health benefit measure decision outcome and ICER results measured as cost (BRL) per quality adjusted Life Year (QALY). Each HTA indications was categorized per International Statistical Classification of Diseases (ICD-10) Chapters.

RESULTS: Among 185 reports on specific technologies, 116 reported cost-effectiveness analyses. Of 33 reports with cost-utility analyses (CUA) analyses, 11 were published for ICD-10 Chapter-VI, 4 for Chapters-II and 4 for Chapter X. Among the HTA reports with CUA, 14 were rejected. Of all 56 reports on technologies for rare diseases, 37 included an economic analysis, of which 19 were CUA. Among incorporated technologies, ICERs results varied between dominant and BRL2,516,286.14/QALY gained, while among not incorporated technologies, ICER results varied between dominant and BRL816,089.17. Among rare diseases, ICERs results varied between dominant and BRL2,516,286.14/QALY gained. Only 3 of incorporated technologies showed ICER below 1GDP per capita (34,533BRL), and 6 showed ICER below 3 GDP per capita.

CONCLUSIONS: Most HTA reports consider economic analyses, however only few use QALY as health benefit measure. There is still an absence of pattern for HTA decisions based on ICER results.