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- ItemDupilumabe para asma grave não controlada(Instituto Nacional de Cardiologia, 2023)
- ItemStated Preferences in Non-Small-Cell Lung Cancer: A Discrete Choice Experiment.(Patient Prefer Adherence, 2021)Introduction The different alternatives for non-small-cell lung cancer (NSCLC) treatment can increase survival but cause important adverse events. Therefore, patients’ preference can play a critical role in decision-making. Among stated preference methods, discrete choice experiment (DCE) is the most applied in health care to elicit preferences. This research aims to elicit patients’ preference evaluating the trade-off between the risks (adverse events) and benefits (survival) of systemic treatments, from the perspective of Brazilian patients with locally advanced, metastatic or recurrent NSCLC. Methods A DCE was performed following the steps of attributes selection; construction of tasks and respondents’ preference elicitation. Patients chose between 2 hypothetical treatments described by the attributes tiredness, hair loss, skin rash, hospitalization, administration mode and survival. A paper-and-pencil survey method was used to elicit the answers from the participants. The statistical data analysis used a mixed logit model to predict the relative importance of the attributes. Results Most of the 65 patients interviewed were men (53.8%), mean age of 65 (95% confidence interval [CI]: 63–67) years and lung cancer stage IV (67.7%). Except for hospitalization and administration mode, the attributes coefficients were statistically significant (p < 0.005) for patients’ preferences. Patients would require a minimum survival gain of 11.72 (CI: 10.28–4.22) months and 19.72 (CI: 17.31‐7.09) months to accept a treatment that causes severe tiredness and severe skin rash, respectively. The market share of the treatments was calculated according to the DCE aggregate-level estimation, considering the impact of each treatment’s side effects. Paclitaxel plus carboplatin had an estimated market share of 31%, followed by gefitinib (27%), erlotinib (24%) and docetaxel (18%). Conclusion In general, less than a year of survival gain would not suffice for the appearance of severe skin rash or tiredness.
- ItemArcabouço legal da incorporação e acesso a dispositivos médicos no Brasil: estrutura, tipos de avaliação e oportunidades para avanços(Jornal Brasileiro de Economia da Saúde, 2020)Objective: Present in a structured way the Brazilian legal framework related to the classification, nomenclatures and stages of adoption of medical devices into SUS and into Supplementary Health. Methods: Review and critical analysis of official publications and legal frameworks applicable to the regulation, adoption and access of medical devices in Brazil. Results: Based on the findings, it was possible to define the classifications and nomenclatures used by government agencies and mapping the flow of technological adoption, comprising four stages: a first national macroprocess of market incorporation from obtaining the health register at Anvisa, when the device becomes available for sale in the country; two other national macroprocesses for the definition of reimbursement and financing policies for the SUS and for the Supplementary Health that occur from submissions to Conitec and ANS; and, one process of local adoption with the acquisition by health facilities and services, representing the effective access to the population. Conclusion: The wide heterogeneity of medical devices makes the promotion of access to these technologies more challenging, requiring by Health Technology Assessment specialists a broader understanding of flows, classifications, strategies of assessment and possibilities for financing and reimbursement that have significant differences from those applicable to medicines. This work allowed to identify the main stages of adoption, suggesting the correction of detected weaknesses, as well as advances in order to promote medical devices access to the population with greater speed and efficiency
- ItemPMS18 - Budget impact analysis of knee osteoarthritis viscosupplementation treatment in Brazil(Value in Health, 2018)Knee osteoarthritis is the most common form of joint disease and has been shown to be associated with aging. It affects 3.8% of the population, worldwide, and causes significant disability, impairing patient’s quality of life. Current treatment options are as follows: pharmacological, non-pharmacological and surgical. Viscosupplementation is a treatment with exogenous hyaluronic acid applied to the knees for symptom relief and postponing surgery. This study aims to estimate the budget impact of viscosupplementation treatment for knee osteoarthritis.
- ItemAlerta de monitoramento do horizonte tecnológico: Ivacaftor (Kalydeco®) para fibrose cística(Ministério da Saúde, 2017)O presente alerta destina-se a informar a sociedade (pacientes, operadores do direito, profissionais da saúde e formuladores de políticas, entre outros) quanto aos potenciais impactos de tecnologias emergentes (em estágio de desenvolvimento) e novas (em fase de aprovação ou recém-aprovadas por agências reguladoras) no cuidado aos pacientes, no sistema de saúde e na organização dos serviços. Este documento foi elaborado com base nas melhores evidências científicas disponíveis, mas não se trata de um guia de prática clínica e não representa posicionamento favorável ou desfavorável do Ministério da Saúde quanto à utilização das tecnologias em saúde analisadas.