14.10.2014 Views

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

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

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

SHOW MORE
SHOW LESS

Create successful ePaper yourself

Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.

OHE Consult<strong>in</strong>g Report for PhRMA<br />

5 January 2011<br />

Appendix 6: Interview Summaries<br />

<strong>The</strong> follow<strong>in</strong>g summaries are based on feedback received from the local team members on the<br />

<strong>in</strong>terviews which have been conducted. <strong>The</strong> key po<strong>in</strong>ts which can be drawn from the <strong>in</strong>terviews are<br />

outl<strong>in</strong>ed below. Where appropriate this material has been <strong>in</strong>corporated <strong>in</strong>to the market summaries<br />

<strong>in</strong> Appendices 1 – 3.<br />

A6.1 Brazil<br />

Industry View<br />

Although <strong>HTA</strong> has been a formal process at the federal level s<strong>in</strong>ce 2006, it has low <strong>in</strong>fluence on the<br />

decision-­‐mak<strong>in</strong>g process and there have been few responses for the dossiers submitted to the<br />

government. In the private system there is no formal process for the <strong>in</strong>corporation <strong>of</strong> new<br />

technologies, though <strong>in</strong>dustry leaders may get organized.<br />

<strong>The</strong>re is a published guidel<strong>in</strong>e for the development <strong>of</strong> <strong>HTA</strong> dossiers for submission to CITEC, very<br />

much <strong>in</strong>spired <strong>in</strong> the guidel<strong>in</strong>es from NICE. However, despite this guidel<strong>in</strong>e and the associated<br />

formal process, the results from CITEC are not clear. Patients can get access to treatments without<br />

the formal approval <strong>of</strong> CITEC because states can create their own formularies.<br />

In theory, recommendations from CITEC could be also used by the private payers to deny<br />

reimbursement for new technologies (Technologies with a negative recommendation from CITEC<br />

can be denied for reimbursement also by private payers). This <strong>in</strong>fluence from <strong>HTA</strong> <strong>in</strong> the private<br />

sector is still not clear.<br />

In terms <strong>of</strong> role that <strong>HTA</strong> could play, the government should identify and evaluate the technologies<br />

that add value to the health system. But the timel<strong>in</strong>es need to be def<strong>in</strong>ed and the whole process<br />

made more transparent. Also, there should be more participation <strong>of</strong> the society <strong>in</strong> the decision<br />

process, <strong>in</strong>volv<strong>in</strong>g citizens, physicians and providers.<br />

Academic view<br />

<strong>HTA</strong> is an <strong>in</strong>tegral and relevant part <strong>of</strong> a Policy for Management <strong>of</strong> <strong>Health</strong> Technologies created by<br />

the Secretary for Science and Technology <strong>of</strong> the MS <strong>in</strong> 2003.<br />

As <strong>in</strong> the case <strong>of</strong> NICE-­‐UK, manufacturers and other health organizations (Medical Specialty<br />

Societies, Patient Organizations, etc.) could have a seat <strong>in</strong> the council <strong>of</strong> CITEC (Commission for<br />

Incorporation <strong>of</strong> <strong>Health</strong> Technologies) to state their po<strong>in</strong>ts <strong>of</strong> view and possible counter-­‐parts <strong>in</strong> the<br />

process, for example propos<strong>in</strong>g risk-­‐shar<strong>in</strong>g programmes, transfer <strong>of</strong> scientific knowledge, among<br />

others.<br />

If <strong>HTA</strong> is to make a difference, it will be important to ga<strong>in</strong> legitimacy with all the actors <strong>in</strong>volved <strong>in</strong><br />

the process <strong>of</strong> <strong>HTA</strong>.<br />

109

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!