SUS Andre L F AzeredoDaSilva MD MSc PhD andrehtanalyzecom HTAnalyze Consulting Brazil Presentation outline Brazilian HTA organizations Brazilian HTA context Case Study 1 Rifampicin for postexposure prophylaxis in leprosy contacts ID: 1042893
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1. Disinvestment of Health Technologies in the Brazilian Public Healthcare System (SUS)Andre L F Azeredo-Da-Silva MD MSc PhDandre@htanalyze.comHTAnalyze Consulting- Brazil
2. Presentation outlineBrazilian HTA organizations / Brazilian HTA contextCase Study 1 - Rifampicin for post-exposure prophylaxis in leprosy contactsCase Study 2 - Beta Interferon for Multiple SclerosisCase Study 3 - How phosphoetanolamine became a popular alternative cancer treatment in Brazil
3. A Primer on HTA in BrazilGovernmentAcademic InstitutionsMinistry of HealthSecretariat of Science, TechnologyAnd Strategic Inputs Department of Science and technology(DECIT)IATSNATSANVISAANSCONTECRegulatory Agencies9 Universities1 Research CenterOriginal HTA researchCommisioned HTA24 Teaching Hospitals- Local HTARebratsBrazilian Network for HTAJoin Venture of Government + Academic Institutions
4. Brazil: a complex HTA contextMassuda, et al. BMJ Glob Health 2018;3:e000829. doi:10.1136/bmjgh-2018-000829
5. Brazil: Overview of disinvestment policy in the SUS (2021-2022)80 health technologies have been effectively disinvested in the 2021-2022 periodThere is no specific disinvestment program, disinvestment should be requested by the same pathway that is used for investment / incorporationThe main clinical indications of the disinvested drugs were: rheumatoid arthritis, HIV, hepatitis C, and Crohn's disease.The main justifications were expired market approval for the drug in Brazil (24.1%) and problems related to safety (20.6%) and effectiveness (19.9%).All requests were from the Brazilian Ministry of Health.Public Consultation was carried out in 36% of the situations.Fernandes, Bárbara da Silva. Desinvestimento de tecnologias em saúde no Sistema Único de Saúde: um perfil no período 2012-2022 / Bárbara da Silva Fernandes. – 2023.
6. Brazil: Overview of disinvestment policy in the SUS (2021-2022) n=80Restriction of use(1.3%)Exclusion of presentation / indication(10%)Exclusion of presentation(27.5%)Exclusion indication(31.3%)Exclusion from the SUS(30%)Fernandes, Bárbara da Silva. Desinvestimento de tecnologias em saúde no Sistema Único de Saúde: um perfil no período 2012-2022 / Bárbara da Silva Fernandes. – 2023.
7. Case Study 1 - Rifampicin for post-exposure prophylaxis in leprosy contacts
8. Public Responses to Conitec's Decision
9. Case Study 2 - Beta Interferon for Multiple Sclerosis
10. Patient Advocacy Groups / Patients
11. Government Response
12. Case 3 - How phosphoetanolamine became a popular alternative cancer treatment in Brazil
13. Regulatory issues surrounding phosphoetanolamine use in Brazil, including the lack of clinical trials and official approval by regulatory agencies like ANVISA
14. Regulatory issues surrounding phosphoetanolamine use in Brazil, including the lack of clinical trials and official approval by regulatory agencies like ANVISA
15. Public Response to the Ban on Phosphoetanolamine
16.
17. Conclusionandre@htanalyze.comDisinvestment of health technologies is an important strategy for optimizing healthcare resources.The inclusion of society in the decision-making process is essential to ensure transparency, accountability, and legitimacy.