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[:pb]It is known that, currently, technological innovation is present in all sectors, so it could not be different in the health area. Specifically in healthcare systems, healthcare technology assessment (HTA)is present in Brazil and worldwide. It should be remembered that the term health technologies refers to medicines, materials, equipment and procedures, as well as assistance programs and protocols through which health care and care are provided to the population.

In this article we will address the role of HTA in health systems in Brazil and worldwide, focusing on its importance, purpose, institutionalization and criteria.

How important is HTA?

HTA has established itself as an important technological and scientific practice that consists of evaluating the clinical, economic, humanistic, social, and epidemiological consequences in order to assess the diffusion and use of technology in the circumstances of the healthcare system and services.

Its application is wide and includes all interventions that are used in health promotion – individual or collective – such as mapping, analysis and clinical and economic projections for the various healthcare technologies, including diagnosis, treatment, rehabilitation or care for any and all types of illness.

Technologies are now an indispensable part of any health care system. HTA aims to verify whether a given technology is effective, safe and economically attractive when compared to alternatives.

It is characterized as an area of multidisciplinary activity, in which several professionals (doctors, pharmacists and other health professionals as well as economists, statisticians, among others) work together to prepare clinical and economic studies that evaluate the technology in question.

What is the purpose of HTA?

The main purpose of the HTA is to contribute to improving the decision-making process in the policies of health services in the public and private sectors, as well as in the care practices exercised by professionals. For this, the assessment of health technologies provides information on the risks, benefits and also the costs of new technologies and those that are already in use – this being a strategic purpose of the HTA.

Costs

Regarding costs,Evid Science technologists and scientists mention that there are several mechanisms that turn the medical literature into relevant evidence, such as meta-analysis, systematic review, and comparative studies of efficacy, safety and patient-reported outcomes

Furthermore, it is known that these efforts take significant time and that studies can be quite costly. According to estimates, the main pharmaceutical companies develop an average of 118 studies per year, at a cost of US$ 138,511.60 per research.

Medium and long term consequences

It is essential to know the consequences of using health technologies in the medium and long term. It is noteworthy that although the objective is to achieve the desired results, the incidence of unwanted effects, which can damage the health of individuals, is not ruled out. An example is drugs that initially bring benefits, but cause health problems with long-term use.

On the other hand, there are very satisfactory results such as a reduction in mortality, especially in the cardiovascular and perinatal areas. The increase in knowledge about medical technologies and the cost of medical care is also positive.

How was HTA institutionalized in different health systems around the world?

In the world, HTA emerged in the 1960s and became a fundamental tool to assist in decision-making in various areas related to health such as:

  • managers;
  • clinicians;
  • service heads;
  • patient organizations;
  • court system;
  • Ministers of health.

HTA spread to North America, Europe, Australia and, later, developing countries. The process of institutionalizing the HTAs was based on the creation of networks and a progressive increase in the number of member agencies of the International Network of Agencies for Healthcare Technology Assessment (INAHTA).

Most HTA agencies are scientifically independent, however they operate within broad governance structures and not without political independence. There are no standardized models or universal methods for developing and institutionalizing agencies, due to the great differences between countries (health systems, cultures, values, political priorities, etc.).

In Latin America, the development of the Health Economy was facilitated by the support of the Pan American Health Organization (PAHO) and the development banks operating in the region, the World Bank and the Inter-American Development Bank. In Brazil, HTA began to be developed in the 1980s, when government healthcare institutions addressed this issue, but without a fixed structure. Little by little, teaching and research institutions began to move towards the field of HTA, in a growing role, always installing a research capacity in the area.

With the creation of the Department of Science and Technology (DECIT) and the Secretariat of Science, Technology and Strategic Inputs (SCTIE), the Council of Science, Technology and Innovation in Health of the Ministry of Health (CCTI) was created, which directs the guidelines and provides technological assessment to incorporate new processes and products by service providers, managers and professionals of the Unified Health System (SUS)..

What are the criteria for a complete HTA in Brazil?

Brazilian policy has defined the following criteria to achieve a full HTA:

  • safety;
  • accuracy;
  • effectiveness;
  • efficiency;
  • costs;
  • cost-effectiveness.

There are also considerations related to equity, ethical, environmental and cultural impacts involved in the use of health technologies. In this sense, clinical, organizational, ethical-social, economic and development criteria are taken into account.

What is the future of Health Technology Assessment – HTA?

Recently, ANS (National Supplementary Health Agency) drew up a protocol to request the inclusion and exclusion of procedures covered by the operators, aiming to express a coverage policy based on scientific evidence studied by health technologies, that is, with the inclusion of scientific papers on the effects of the procedure, with estimated costs, in addition to the prices to be charged.

In addition to the details about the role of HTA in universal health systems in Brazil and worldwide, learn about some of these aspects in the solutions we have developed. Acesse o conteúdo

incorporação de tecnologia em saúde sistema publicoIncorporação de tecnologia em saúde sistema publico

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