RETROSPECTIVE ANALYSIS OF THE USE OF INCREMENTAL COST-EFFECTIVENESS RATIO (ICER) IN TECHNOLOGY INCORPORATION IN THE BRAZILIAN PUBLIC HEALTH SYSTEM (SUS), 2012-2016, PERSPECTIVES AND CHALLENGES FOR THE BRAZILIAN CONTEXT

Author(s)

Yuba TY1, Novaes HM2, De Soárez PC1
1University of Sao Paulo, Sao Paulo, Brazil, 2Universidade de São Paulo, Sao Paulo, Brazil

BACKGROUND: The National Committee for Technology Incorporation (CONITEC) was established in 2011, and is supervised by the Department of Management and Incorporation of Health Technology, Ministry of Health. Among the requested documents, applicants must provide a Health Economic Evaluation (HEE) under the SUS perspective, including an incremental cost-effectiveness ratio (ICER). OBJECTIVES:: To analyze the CONITEC reports that recommended the incorporation of the technologies, and compare the values of the ICERs with CETs suggested in the literature. METHODS::  Descriptive study, based on the reports available at the CONITEC website from July 2012 to December 2016. Reports were classified according to: type of technology, type of applicant, type of report, presence of HEE, and the type of HEE. ICER was compared with the CET by WHO and Center of Health Economics (CHE), University of York. RESULTS::  One hundred and one reports recommended the incorporation of the technology in the SUS, representing 50.75% of the reports produced in the period. The most common technologies recommended were drugs (68.3%), procedures (20.1%) and products (7.0%). Eighty reports included some economic data, 75% (n = 60) were classified as partial HEE and 25.0% (n = 20) were full HEE. Out of 20 full economic evaluations, 13 (65.0%) presented the incremental cost-effectiveness ratios (ICERs). Of all the reports recommended for incorporation (n = 101), only 12.9% (n = 13) performed a complete HEE with ICER. Twelve reports presented ICER below the CET proposed by WHO and only three below the CET proposed by CHE. CONCLUSIONS::  Most of the reports recommended included only partial HEE. Use of a cost-effectiveness threshold (CET) was not an essential criterion for recommending technology incorporation, even though it is an explicit criterion in the formal documents. This context reflects the current challenges in the implementation process of a Policy of Health Technology Management.

Conference/Value in Health Info

2017-09, ISPOR Latin America 2017, Sao Paulo, Brazil

Value in Health, Vol. 20, No. 9 (October 2017)

Code

PHP39

Topic

Health Policy & Regulatory, Health Technology Assessment

Topic Subcategory

Approval & Labeling, Decision & Deliberative Processes, Reimbursement & Access Policy

Disease

Multiple Diseases

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