Article type
Abstract
Background: supplementary healthcare in Brazil is regulated by an autonomous government agency, the Agência Nacional de Saúde Suplementar (ANS). ANS is responsible for regulating the relationship between 50 million health plan users and health insurance operators, and for updating a catalogue with drugs, devices, and procedures that should be, at least, provided by health plans. The updating considers Evidence-based Medicine and Health Technology Assessment (HTA) concepts and includes social involvement as a key component for decision-making.
Objectives: to report the ANS process for evaluating the contributions from public consultations when assessing technologies for incorporation into its catalogue.
Methods: case study conducted at the HTA Centre of Hospital Sírio-Libanês (HTA-HSL), São Paulo, Brazil, as part of the project ‘Health Technology Assessment actions for supporting the Agência Nacional de Saúde Suplementar’, in place since 2019 and funded by Brazilian Ministry of Health (PROADI-SUS initiative).
Results: after the ANS preliminary recommendation, in favour or against the incorporation of a specific technology in the catalogue, society (patients, caregivers, relatives, scientific or professional entities, pharmaceutical companies, etc) can consult the documents supporting the preliminary recommendation and collaborate with the ANS final decision. Contributions are submitted through an electronic form on the ANS website, and may comprise positions that agree or oppose the preliminary recommendation, personal experiences, technical arguments, or scientific evidence. All contributions are carefully analysed by NATS-HSL, which identifies those with technical-scientific content, proposes consolidated responses, and elaborates a report that is further validated by ANS. The responses are based on a set of scientific documents containing a systematic review of efficacy and safety, an economic evaluation, and a budget impact for the technology. The report, the scientific documents, and the resolutions from a virtual open meeting involving representatives of different sectors of society are considered for the final decision.
Conclusions: social involvement ensures transparency and trustworthiness in the decision-making process from ANS. The consolidated analysis of social contributions is feasible and identifies aspects from different perspectives.
Patient, public and/or healthcare consumer involvement: the responses to the social contributions may represent a valuable educational strategy for enhancing health literacy in society.
Objectives: to report the ANS process for evaluating the contributions from public consultations when assessing technologies for incorporation into its catalogue.
Methods: case study conducted at the HTA Centre of Hospital Sírio-Libanês (HTA-HSL), São Paulo, Brazil, as part of the project ‘Health Technology Assessment actions for supporting the Agência Nacional de Saúde Suplementar’, in place since 2019 and funded by Brazilian Ministry of Health (PROADI-SUS initiative).
Results: after the ANS preliminary recommendation, in favour or against the incorporation of a specific technology in the catalogue, society (patients, caregivers, relatives, scientific or professional entities, pharmaceutical companies, etc) can consult the documents supporting the preliminary recommendation and collaborate with the ANS final decision. Contributions are submitted through an electronic form on the ANS website, and may comprise positions that agree or oppose the preliminary recommendation, personal experiences, technical arguments, or scientific evidence. All contributions are carefully analysed by NATS-HSL, which identifies those with technical-scientific content, proposes consolidated responses, and elaborates a report that is further validated by ANS. The responses are based on a set of scientific documents containing a systematic review of efficacy and safety, an economic evaluation, and a budget impact for the technology. The report, the scientific documents, and the resolutions from a virtual open meeting involving representatives of different sectors of society are considered for the final decision.
Conclusions: social involvement ensures transparency and trustworthiness in the decision-making process from ANS. The consolidated analysis of social contributions is feasible and identifies aspects from different perspectives.
Patient, public and/or healthcare consumer involvement: the responses to the social contributions may represent a valuable educational strategy for enhancing health literacy in society.