Critérios de escolha do tratamento no Sistema Único de Saúde
Denizar Vianna
Universidade do Estado do Rio de Janeiro Faculdade de Ciências Médicas
Departamento de Clínica Médica
"Promoting treatment irrespective of the evidence may garner votes, but will not create healthier voters."
Steven Woloshin, MD, MS; Lisa M. Schwartz, MD, MS VA Outcomes Group, White River Junction, Vermont, and the Dartmouth Institute for Health Policy and Clinical Practice, Hanover, New Hampshire.
SEGURANÇAEnsaios Clínicos
Fases I e II
EFICÁCIAEnsaios Clínicos
Fase III
EFETIVIDADEEstudos
Observacionais /Ensaios Clínicos
Pragmáticos
Etapas da Avaliação de Tecnologias em Saúde
EFICIÊNCIAAnálise de
Custo-Efetividade
FACTIBILIDADEImpacto
Orçamentário
Etapas da Avaliação de Tecnologias em Saúde
“The use of explicit, standard metrics such as cost-per-QALY ratios has the advantage of transparency and can help direct our resources toward the greatest health gains”.
“The cost for treating early-stage breast cancer
is $78 per DALY with surgery and radiotherapy
vs $4,986 per DALY with systemic chemotherapy
for metastatic disease”.
“These sorts of data allow health and finance
ministers to focus investment on interventions
that provide a cost-effective benefit and to
conclude, for example, that it is rational to
detect and treat early breast cancer”.
Summary of Therapy Value FrameworksOrganization Factors ConsideredAmerican Society of Clinical Oncology (ASCO) Clinical benefit
•Overall survival•Progression-free survival•Response rateToxicityBonus factors•Palliation•Time off all treatmentCost per month
Memorial Sloan Kettering Cancer Center Efficacy (survival)ToxicityNoveltyResearch and development costRarityPopulation health burden
Source: Neumann PJ, Cohen JT. Measuring the Value of Prescription Drugs. N Engl J Med. 2015;373(27):2595-7.
"Price is what you pay, value is what you get"
Warren Buffett
OBRIGADO
Universidade do Estado do Rio de Janeiro Faculdade de Ciências Médicas
Departamento de Clínica Médica
