Cost-effectiveness thresholds and the Brazilian Unified National Health System.
نویسندگان
چکیده
Correspondence H. M. D. Novaes Universidade de São Paulo. Av. Dr. Arnaldo 455, 2o andar, São Paulo, SP 01246-903, Brasil. [email protected] The Brazilian Senate is currently reviewing Bill of Law n. 415 of 2015 (PLS 415; http://www25. senado.leg.br/web/atividade/materias/-/materia/122071), which requires defining, regulating, and publishing the cost-effectiveness parameter used for analyzing requests for the incorporation of technologies in the Brazlian Unified National Health System (SUS). According to the bill’s author, Senator Cássio Cunha Lima: “The legal basis is not clear by which CONITEC [the National Commission for the Incorporation of Technologies in the SUS] analyzes a given medical procedure’s cost-effectiveness, nor the threshold used to consider a procedure cost-effective. This gap often leads the public administration to apply low-quality technical discretion”. In his arguments for the bill, Senator Cunha Lima cites the examples of European countries, Canada, and Australia and two internationally accepted parameters: (i) fifty thousand dollars per year of life saved (YLS); and (ii) the World Health Organization (WHO) recommendation of three times the per capita gross domestic product (GDP) per quality-adjusted life year (QALY) or disability-adjusted life year (DALY). In September 2016, as a technical argument to back the measures recommended by PLS 415, Senator Ana Amélia presented a scientific article that defends the adoption of a threshold 1. Before embarking on (or getting carried away by) this wave, which involves setting cost-effectiveness thresholds that are transformed into simple decision-making tools, it is important to discuss the factors that influence how they are calculated and to identify important issues in the adoption of such a threshold, rather than accepting international rules and stubbornly adopting arbitrary numbers that do not apply to the Brazilian context.
منابع مشابه
The Brazilian Unified National Health System: Proposal of a Cost-effectiveness Evaluation Model
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ورودعنوان ژورنال:
- Cadernos de saude publica
دوره 33 4 شماره
صفحات -
تاریخ انتشار 2017