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Use of Incremental Cost-Effectiveness Ratio (Icer) in Recommending Technologies Incorporation in the Brazilian Public Health System (Sus), 2012-2015

2015; Elsevier BV; Volume: 18; Issue: 7 Linguagem: Inglês

10.1016/j.jval.2015.09.1604

1524-4733

TY Yuba, HM Novaes, PC De Soárez,

Pharmaceutical Economics and Policy

CONITEC has recommended for incorporation part of the technologies analyzed. Among the requested documents, applicants must provide a Health Economic Evaluation (HEE) under the SUS perspective, including an incremental cost-effectiveness ratio (ICER). However in the legal documents there is no explicit recommendation on the use of ICER and cost-effectiveness threshold (CET) as a criteria for technology recommendation. To analyze the CONITEC reports that recommended the incorporation of the technologies in the SUS from July 2012 to April 2015, and compare the values of the ICERs with CETs suggested in the literature. Descriptive study, based on the reports available at the CONITEC website from July 2012 to April 2015. Reports were classified according to: type of technology, type of applicant, type of report, presence of HEE, and the type of HEE. ICER was compared with the CET recommended by WHO and Center of Health Economics (CHE)-University of York. Seventy-two reports recommended the incorporation of the technology in the SUS. The most common technologies recommended were drugs (51.4%), procedures (30.6%) and materials (8.3%). The major applicant was the Public Health System (70.8%), followed by the pharmaceutical industry (8.3%). Most reports were classified as Technology Description (65.3%), followed by Rapid Review (19.4%), Mini Health Technology Assessment (8.3%), and only 6.9% the reports were Full HTA. Fifty-five reports conducted HEE, 80% (n = 44) were partial and 20% (n = 11) were full. Of the Seventy-two technologies recommended for incorporation, only 8(11.1%) presented a full HEE with ICER. Seven technologies presented ICER below the CET proposed by WHO and only one below the CET proposed by CHE. Most of the technologies recommended for incorporation were demanded by the Public Health System and were based on Technology Descriptions and Rapid Reviews. Use of a CET was not an essential criterion for recommending technology incorporation.