Análise de impacto orçamentário: Diferenças entre evidências do mundo real e modelo teórico

• Ano de defesa: 2016
• Autor(a) principal: Daniel Resende Faleiros
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; UFMG
• Palavras-chave em Português: Sistema Único de Saúde; Economia da Saúde; Avaliação da Tecnologia Biomédica; Orçamentos; Inovações tecnologicas; Impacto orçamentário; Economia da saúde; Tecnologia biomédica; Sistema Único de Saúde (Brasil); Orçamento
• Link de acesso: http://hdl.handle.net/1843/BUOS-ASXJYE

Technological innovations create new economic, social and cultural realities. Evaluations of Health Technologies aim at (re) evaluating technological possibilities, subsidizing decision-making by health authorities. Analysis of Budgetary Impact, as part of these evaluations, seeks to know the financial consequences of approving a technology in each health system, pointing out if such technology is accessible to system users. Although it is a recent technique, it has been required by many health systems worldwide. However, studies suggest that few publications meet the definitions established by the guidelines and do not reach the desired quality, presenting questionable results. To verify such hypotheses, this study aims to investigate the differences between the real-world evidence and the theoretical model. Also through the verification of existing publications, based on the adherence of these studies to the main key characteristics for these analyzis. Also by verifying how the results of the Brazilian method approach the results of the real-world. A systematic review selected 92 international publications, making it possible to know how much the studies in the real-world move away from the theoretical model. Most published studies are still far from achieving a standard of excellence, indicating low adherence to key characteristics. In addition, many studies report conflicts of interest and funding of pharmaceutical companies. On the other hand, a comparative analysis made it possible to know how much the results of the theoretical model deviate from the real-life results. This study showed great differences between theoretical findings and real-world evidence regarding the budgetary impact of Adalimumab for rheumatoid arthritis, incorporated by the Unified Health System (SUS). Together, the results point to the need to improve the method of Budget Impact Analysis with the revision of the Brazilian Guidelines, aiming to increase methodological advances.