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高值药品准入诉讼中的卫生技术评估影响

IMPACT OF HEALTH TECHNOLOGY ASSESSMENT IN LITIGATION CONCERNING ACCESS TO HIGH-COST DRUGS.

机构信息

Ministry of Health,Health Assessment

Ministry of Health,Health Assessment Division.

出版信息

Int J Technol Assess Health Care. 2017 Jan;33(4):411-414. doi: 10.1017/S0266462317000575. Epub 2017 Jul 31.

Abstract

OBJECTIVES

The impact of health technology assessment (HTA) in the judicialization of the right of health has not been deeply studied in Latin American countries. The purpose of this study is to review the process of judicialization of the access to high cost drugs in Uruguay and assess the impact HTAs have had on this process.

METHODS

The methodology used for this study included a comprehensive literature search in electronic databases, local journals, internal documents developed in the Ministry of Health, as well as conducting interviews with key informants.

RESULTS

Judicialization of the access of high cost drugs has been increasing since 2010. The strategy of the Ministry of Health of Uruguay to decrease this problem included the organization of roundtables with judges and other stakeholders on the basis of HTA, the training of defense lawyers in the use and interpretation of HTA, and the participation of a professional who develops HTA in the preparation of the defense arguments. A year after the implementation of this strategy, 25 percent of writs of protection were won by the Ministry of Health.

CONCLUSIONS

Even though the strategy implemented was effective in reducing the loss of litigations, it was not effective in reducing the growing number of writs of protection. It is essential to address this problem in a broad debate and to promote understanding between the parties.

摘要

目的

在拉丁美洲国家,卫生技术评估(HTA)对健康权司法化的影响尚未得到深入研究。本研究旨在回顾乌拉圭获取高价药物的司法化进程,并评估 HTA 在这一过程中的影响。

方法

本研究采用了综合文献检索,包括电子数据库、当地期刊、卫生部内部文件,并对关键知情人进行了访谈。

结果

自 2010 年以来,获取高价药物的司法化进程一直在增加。乌拉圭卫生部为解决这一问题而采取的策略包括基于 HTA 组织法官和其他利益相关者的圆桌会议、培训辩护律师使用和解释 HTA、以及让一名从事 HTA 的专业人员参与准备辩护论据。在实施这一策略的一年后,卫生部赢得了 25%的保护令。

结论

尽管实施的策略在减少诉讼损失方面是有效的,但在减少日益增多的保护令方面效果不佳。必须在广泛的辩论中解决这个问题,并促进各方之间的理解。

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