Faculty of Health Sciences, University of Brasília, Brasília, Brazil.
Oswaldo Cruz Foundation, Brasília, Brazil.
PLoS One. 2019 Jul 29;14(7):e0220131. doi: 10.1371/journal.pone.0220131. eCollection 2019.
The reassessment of technologies and services offered by healthcare systems is recent initiative and still without a widely adopted and evaluated method. To a better understanding of this process in Brazil, we have described the health technology reassessment (HTR) performed by the National Committee for Health Technology Incorporation (Conitec) into Brazilian public health system (SUS).
A documental, exploratory, descriptive, retrospective study with qualitative-quantitative approach regarding the HTR performed by Conitec from January 2012 to November 2017.
After applying the criteria of inclusion and exclusion, we selected 47 technologies for this study. The vast majority of the demands (41 demands) came from the public sector, and only six from the private sector. Most of the requests referred to the exclusion of specific indication; followed by extension of use, withdraw of the technology from SUS, maintenance, and restriction of use. The dimensions of analysis found in the recommendation reports were scientific evidence on efficacy, effectiveness and safety, disease-related issues, issues related to the use of technology, costs, and social participation. However, these dimensions were not included in all analysis, and a standardized structure of the reports has not been observed. The most relevant decision factors considered for decision-making were efficacy, safety and use of the technology.
During a six-year period of Conitec actuation, we could find some reassessments of technologies that are available in SUS. We observed that these activities had enabled progress, however, they are still not yet structured, with gaps in the selection process, and the assessment since no methodology and criteria for proper conduct were established.
医疗保健系统提供的技术和服务的重新评估是最近的一项举措，仍然没有广泛采用和评估的方法。为了更好地了解巴西的这一过程，我们描述了国家卫生技术纳入委员会（Conitec）对巴西公共卫生系统（SUS）进行的卫生技术评估（HTR）。
采用文件、探索性、描述性、回顾性研究方法，对 Conitec 于 2012 年 1 月至 2017 年 11 月进行的 HTR 进行了定性-定量研究。
经过纳入和排除标准的应用，我们选择了 47 项技术进行本研究。绝大多数需求（41 项需求）来自公共部门，只有 6 项来自私营部门。大多数请求涉及特定适应症的排除；其次是扩大使用范围、将技术从 SUS 中撤出、维护和限制使用。在建议报告中发现的分析维度包括疗效、有效性和安全性、与疾病相关的问题、与技术使用相关的问题、成本和社会参与的科学证据。然而，并非所有分析都包含这些维度，也没有观察到报告的标准化结构。决策时考虑的最重要的决策因素是技术的疗效、安全性和使用。
在 Conitec 运作的六年期间，我们发现了一些 SUS 中可用技术的重新评估。我们观察到这些活动取得了进展，但它们仍未结构化，在选择过程和评估中存在差距，因为没有建立适当行为的方法和标准。
