Centre of Health Technology Assessment of Hospital Sírio-Libanês. Using EBM to qualify and promote the sustainability of Brazilian public health system (SUS)

Article type
Authors
1Centre of Health Technology Assessment (HTA), Hospital Sírio-Libanês; Universidade Federal de São Paulo
2Centre of Health Technology Assessment (HTA), Hospital Sírio-Libanês
Abstract
Background: PROADI-SUS is an innovative program, from Brazilian Ministry of Health, through which five non-profit hospitals, including Hospital Sírio-Libanês (HSL), began to conduct projects using their skills to qualify and promote the improvement of the Brazilian public health system (SUS). In order to provide scientific and methodological support for these projects, based on principles of evidence-based medicine (EBM), it was created the Centre of Health Technology Assessment in HSL (C-HTA-HSL).

Objectives:To describe the creation of the HTA Centre in Hospital Sírio-Libanês and to present the initial activities and the main EBM-related projects implemented so far.

Methods: Descriptive case study.

Results: The C-HTA-HSL was created in 2018 and it is currently a formal member of Brazilian HTA Network (REBRATS) and HTA Network of the Americas (RedETSA). Since it has been launched, the centre has supported the following projects of PROADI-SUS: (1) through a collaboration with Agência Nacional de Vigilância Sanitaria (Anvisa, the Brazilian national health surveillance and regulatory agency), we are mapping the evidence on the efficacy and safety of the use of platelet-rich plasma (PRP) for non-transfusion purposes in order to support the regulatory framework for the use of PRP in Brazil; (2) through a collaboration with the National Council of Justice, we are implementing a set of strategies to provide evidence-based support during the judicial process on healthcare in Brazil; (3) through a collaboration with Agência Nacional de Saúde Suplementar (ANS, the Brazilian regulatory agency for health insurance), we are providing evidence-based advices to the technical staff of the agency during the process of evaluating proposals for incorporating technologies into the list of products offered to users; in addition, we are reviewing the content of the scientific reports about evidences on clinical effects, cost-effectiveness and budgetary impact of 40 proposals; and (4) through collaboration with the local laboratory of tissue bioengineering, we are in charge of methodology for planning, conducting, analysing and reporting costs-effectiveness analyses along two randomised clinical trials: use of stem cells for children cleft lip and palate and use of stem cells for children with craniofacial microsomia.

Conclusions:We believe that the creation of C-NATS-HSL can enhance the methodological rigor of the projects of PROADI-SUS, by the systematic adoption of EBM concepts, so that reliable research can support the decision-making process within a public, universal and equitable health system.

Patient or healthcare consumer involvement:We believe that the creation of C-NATS-HSL can enhance the methodological rigor of the projects of PROADI-SUS, by the systematic adoption of EBM concepts, so that reliable research can support the decision-making process within a public, universal and equitable health system.

Support: Brazilian Ministry of Health / PROADI – SUS, Hospital Sírio-Libanês.