The Evolution of HTA in Emerging Markets Health-Care ... - TREE

OHE Consulting Report for PhRMA
5 January 2011
Appendix 6: Interview Summaries
The following summaries are based on feedback received from the local team members on the
interviews which have been conducted. The key points which can be drawn from the interviews are
outlined below. Where appropriate this material has been incorporated into the market summaries
in Appendices 1 – 3.
A6.1 Brazil
Industry View
Although HTA has been a formal process at the federal level since 2006, it has low influence on the
decision-­‐making process and there have been few responses for the dossiers submitted to the
government. In the private system there is no formal process for the incorporation of new
technologies, though industry leaders may get organized.
There is a published guideline for the development of HTA dossiers for submission to CITEC, very
much inspired in the guidelines from NICE. However, despite this guideline and the associated
formal process, the results from CITEC are not clear. Patients can get access to treatments without
the formal approval of CITEC because states can create their own formularies.
In theory, recommendations from CITEC could be also used by the private payers to deny
reimbursement for new technologies (Technologies with a negative recommendation from CITEC
can be denied for reimbursement also by private payers). This influence from HTA in the private
sector is still not clear.
In terms of role that HTA could play, the government should identify and evaluate the technologies
that add value to the health system. But the timelines need to be defined and the whole process
made more transparent. Also, there should be more participation of the society in the decision
process, involving citizens, physicians and providers.
Academic view
HTA is an integral and relevant part of a Policy for Management of Health Technologies created by
the Secretary for Science and Technology of the MS in 2003.
As in the case of NICE-­‐UK, manufacturers and other health organizations (Medical Specialty
Societies, Patient Organizations, etc.) could have a seat in the council of CITEC (Commission for
Incorporation of Health Technologies) to state their points of view and possible counter-­‐parts in the
process, for example proposing risk-­‐sharing programmes, transfer of scientific knowledge, among
others.
If HTA is to make a difference, it will be important to gain legitimacy with all the actors involved in
the process of HTA.
109