0915 ndash 1030 Session 1

EvelindaTrindadeInCorUSPbr for the

bull The Information Resources Group of HTAi bull the Brazilian Cochrane Centre and bull the Iberoamerican Cochrane Centre

A brief history and current status of HTA organizations and

networks in Latin America

HTA products and other Latin American HTA organizations in

general

How HTA is used to inform research at InCor (specific) and

other Latin American health organizations in general

Search methods and practices including what sources are

recommended by health research educators

Search guidance updating of searches reference

management etc

HTA in Latin America is starting

But efforts are being made since mid 1980rsquos

For example

Efectiveness of perinatal technologies (Panerai et al 1989) PAHOWHO sponsored

Outpatient Continuous Peritoneal Dialysis - Current situation (CAPD) in Brazil (Cubas e Riella 1987)

Breast Radiology ndash mammography quality (Koch et al 1996)

Banta D The uses of modern technologies Problems and perspectives for industrialized and developing countries Bull PAHO 198418139-150

Pentildea Mohr J Coe G Investigacioacuten en Tecnologiacutea de Salud OPS January 1986

PAHO Regional strategy for health technology assessment Washington DC Pan American Health Organization 1998

PAHO Developing health technology assessment in Latin America and the Caribbean ISBN 92 75 07377 5Washington DC Pan American Health Organization 1998

PAHOrsquos Technology Development Unit Dr David Banta Mr Jorge Pentildea and Dr Gloria Coe

PNSP850411Washington 1985-1991

Panerai RB Almeida RT Freire SM Chaim DM Miranda MZ Madureira LC

Aguiar Neto MA Perspectives on health technology assessment in Latin

America The case of perinatal care in the literature Int J Technol Assess

Health Care 1993 Winter9(1)76-84

Does medical literature support technology assessments in

perinatal care

- studied references Latin America for the period 1984-88

Information on effectiveness safety costs and social impact of

perinatal technologies was extremely limited (A total of 1074 out gt

40000 references)

Conclusion immediate action needs to be taken to create the

necessary conditions for health technology assessment in Latin

America

HTA in Latin America is starting

But efforts are being made since mid 1980rsquos

For example

Efectiveness of perinatal technologies (Panerai et al 1989) PAHOWHO sponsored

Outpatient Continuous Peritoneal Dialysis - Current situation (CAPD) in Brazil (Cubas e Riella 1987)

Breast Radiology ndash mammography quality (Koch et al 1996)

Banta D The uses of modern technologies Problems and perspectives for industrialized and developing countries Bull PAHO 198418139-150

Pentildea Mohr J Coe G Investigacioacuten en Tecnologiacutea de Salud OPS January 1986

PAHO Regional strategy for health technology assessment Washington DC Pan American Health Organization 1998

PAHO Developing health technology assessment in Latin America and the Caribbean ISBN 92 75 07377 5Washington DC Pan American Health Organization 1998

PAHOrsquos Technology Development Unit Dr David Banta Mr Jorge Pentildea and Dr Gloria Coe

PNSP850411Washington 1985-1991

Panerai RB Almeida RT Freire SM Chaim DM Miranda MZ Madureira LC

Aguiar Neto MA Perspectives on health technology assessment in Latin

America The case of perinatal care in the literature Int J Technol Assess

Health Care 1993 Winter9(1)76-84

Does medical literature support technology assessments in

perinatal care

- studied references Latin America for the period 1984-88

Information on effectiveness safety costs and social impact of

perinatal technologies was extremely limited (A total of 1074 out gt

40000 references)

Conclusion immediate action needs to be taken to create the

necessary conditions for health technology assessment in Latin

America

Banta D The uses of modern technologies Problems and perspectives for industrialized and developing countries Bull PAHO 198418139-150

Pentildea Mohr J Coe G Investigacioacuten en Tecnologiacutea de Salud OPS January 1986

PAHO Regional strategy for health technology assessment Washington DC Pan American Health Organization 1998

PAHO Developing health technology assessment in Latin America and the Caribbean ISBN 92 75 07377 5Washington DC Pan American Health Organization 1998

PAHOrsquos Technology Development Unit Dr David Banta Mr Jorge Pentildea and Dr Gloria Coe

PNSP850411Washington 1985-1991

Panerai RB Almeida RT Freire SM Chaim DM Miranda MZ Madureira LC

Aguiar Neto MA Perspectives on health technology assessment in Latin

America The case of perinatal care in the literature Int J Technol Assess

Health Care 1993 Winter9(1)76-84

Does medical literature support technology assessments in

perinatal care

- studied references Latin America for the period 1984-88

Information on effectiveness safety costs and social impact of

perinatal technologies was extremely limited (A total of 1074 out gt

40000 references)

Conclusion immediate action needs to be taken to create the

necessary conditions for health technology assessment in Latin

America

Panerai RB Almeida RT Freire SM Chaim DM Miranda MZ Madureira LC

Aguiar Neto MA Perspectives on health technology assessment in Latin

America The case of perinatal care in the literature Int J Technol Assess

Health Care 1993 Winter9(1)76-84

Does medical literature support technology assessments in

perinatal care

- studied references Latin America for the period 1984-88

Information on effectiveness safety costs and social impact of

perinatal technologies was extremely limited (A total of 1074 out gt

40000 references)

Conclusion immediate action needs to be taken to create the

necessary conditions for health technology assessment in Latin

America

Developing Health Technology Assessment in Latin America and the Caribbean 1999

Latin American and Caribbean (LAC) countries represent one of the most important emerging markets for HT and health authorities public and private insurers health professionals patients and the communications media and public opinion are gradually becoming more aware of the importance of HT and its evaluation

ldquoHTA is an essential component of the regulatory role of the health authorities and can help to strengthen their leadershiprdquo

Health Sector Reform Health Technology

There were deconcentration andor decentralization of services

The needs were growing and challenges were multiplying

There were incomplete transfer of technologies perfected in the developed countries

- incomplete adaptationplanning of the technologies to the organizational economic social and cultural situation of the receiving countries

the scarcity of many basic technologies

the excessive and indiscriminate use of expensive HT

the dearth of policies and standards to regulate the introduction and use of HT

the underdevelopment of support technologies (especially management information systems) and

inequalities in access to available HT were some of the more commonly cited problems in the Region

The more commonly cited problems in the region

2009 exploratory study to identify HTA programs in LA

An electronic search through two databases was performed to identify HTA programs in LA A content analysis was performed on HTA documents (n = 236) produced by six programs between January 2000 and March 2007 Results were analyzed by comparing document content with the main goals of HTA

Arellano LE Reza M Blasco JA Andradas E A content analysis of Health Technology Assessment

programs in Latin America Int J Technol Assess Health Care 2009 Oct25(4)570-6 PMID 19845988

[PubMed - indexed for MEDLINE]

ldquoHTA is an essential component of the regulatory role of the health authorities and can help to strengthen their leadershiprdquo

Health Sector Reform Health Technology

There were deconcentration andor decentralization of services

The needs were growing and challenges were multiplying

There were incomplete transfer of technologies perfected in the developed countries

- incomplete adaptationplanning of the technologies to the organizational economic social and cultural situation of the receiving countries

the scarcity of many basic technologies

the excessive and indiscriminate use of expensive HT

the dearth of policies and standards to regulate the introduction and use of HT

the underdevelopment of support technologies (especially management information systems) and

inequalities in access to available HT were some of the more commonly cited problems in the Region

The more commonly cited problems in the region

2009 exploratory study to identify HTA programs in LA

An electronic search through two databases was performed to identify HTA programs in LA A content analysis was performed on HTA documents (n = 236) produced by six programs between January 2000 and March 2007 Results were analyzed by comparing document content with the main goals of HTA

Arellano LE Reza M Blasco JA Andradas E A content analysis of Health Technology Assessment

programs in Latin America Int J Technol Assess Health Care 2009 Oct25(4)570-6 PMID 19845988

[PubMed - indexed for MEDLINE]

the scarcity of many basic technologies

the excessive and indiscriminate use of expensive HT

the dearth of policies and standards to regulate the introduction and use of HT

the underdevelopment of support technologies (especially management information systems) and

inequalities in access to available HT were some of the more commonly cited problems in the Region

The more commonly cited problems in the region

2009 exploratory study to identify HTA programs in LA

An electronic search through two databases was performed to identify HTA programs in LA A content analysis was performed on HTA documents (n = 236) produced by six programs between January 2000 and March 2007 Results were analyzed by comparing document content with the main goals of HTA

Arellano LE Reza M Blasco JA Andradas E A content analysis of Health Technology Assessment

programs in Latin America Int J Technol Assess Health Care 2009 Oct25(4)570-6 PMID 19845988

[PubMed - indexed for MEDLINE]

2009 exploratory study to identify HTA programs in LA

An electronic search through two databases was performed to identify HTA programs in LA A content analysis was performed on HTA documents (n = 236) produced by six programs between January 2000 and March 2007 Results were analyzed by comparing document content with the main goals of HTA

Arellano LE Reza M Blasco JA Andradas E A content analysis of Health Technology Assessment

programs in Latin America Int J Technol Assess Health Care 2009 Oct25(4)570-6 PMID 19845988

[PubMed - indexed for MEDLINE]

0

10

20

30

40

50

60

IECS ndash Argentina

SSS ndash Argentina

ETESA ndash Chile

GT-ATS ndash Brazil

IMSS ndash Mexico

CENETEC ndash Mexico

Published HTA Documents (2000ndash2007) in Latin America Arellano 2009

82 in short documents format but Indeed gt 50 target Third party payers And gt 40 targetting Government policy makers

In general the documents were clearly written and

contained three types of conclusions

(i) negative (n = 27 11 percent)

(ii) neutral (n = 90 38 percent) and

(iii) positive (n = 114 48 percent)

From January 2000 to March 2007

40 percent of published HTA documents in LA addressed clinical effectiveness

while 26 percent attempted to correlate the efficacy

and safety of a new technology in economic terms

The Pan American Health Organization (PAHO) Regional Office of the World Health Organization (WHO) for the Americas has tried to promote health technology assessment (HTA) in Latin America for 25 years

Health Technology Assessment in Latin America

Brazil Mexico Argentina

Health Technology Assessment in Latin America

Chile 1997 Ministry of Healthrsquos HTA office ETESAmdash the Unit for Health Technology Assessment a member of INAHTA

Colombia the Ministry of Social Protection plan an HTA Agency with the

academic sector

Cuba =gt HTA amp EBM in their healthcare system

Uruguay 2007 Ministry of Healthrsquos HTA program in the Department of Medical Technology

Health Technology Assessment in Latin America

Mexico National Centre for Excellence in Health Technology (CENETEC) programs and seminars related to health technology assessment and management

Health Technology Assessment in Latin America

Brazil

After important milestones

2nd National Conference on Science Technology and Innovation in Health

2004 - National Agenda of Priorities in Health Research

2006 =gt institutionalization DECIT-CGATS HTA in the national government and joined INAHTA

2007 DECIT-CGATS - National Policy on Health Technology Management

Health Technology Assessment in Latin America

Brazil

National Agency for Health Surveillance ANVISA

1999 Techno-Surveillance Medical Devices Post Market Surveillance

2000 - Network of Sentinel Hospitals

- National Register of Drug and Health Devices

- National System of Health Surveillance reinforced with States and Municipalities - VISAs

2003 =gt Health Ministry - VISAs Management Pact contracts with hospitals ndash Local networks under development

Latin American Regulatory authorities have being evolving regarding methods to evaluate health products

Professional Societies are adopting HTA methods to built guidelines An HTA status in depth survey in Latin America is ongoing (Ana Perez)

Health Technology Assessment in Latin America

Brazil

National Network of HTA REBRATS

2008 Brazilian Health Technology Assessment Network (Rede Brasileira de Avaliaccedilatildeo de Tecnologias em Sauacutede ndash REBRATS) a network of 24 Sentinel Hospitals and research institutions to congregate HTA stakeholders

The HTA REBRATS validated studies are disseminated to the Commission for Technology Incorporation from Ministry of Health

Research database created SISREBRATS

Review

Studies financed by DECIT Health Ministry

bull Near 100

bull Bilingual structured abstracts

bull 10 from NATS-HCFMUSP

NATS-HCFMUSP

Is the HTA Center InCor (Heart Institute) amp Clinics Hospital of the Satildeo Paulo University Medical School the HC-FMUSP

Brief Institutional highlights

2500 active beds 15 million outpatient visits 400 thousands emergency care 500 thousands imaging exams 72 thousands Inpatient care 50 thousands Surgeries 25 thousands High-risk deliveries and 600 organ amp tissue transplantations

bull internship and 12 thousands medical residency in 49 medical specialities

bull 500 studentship in 93 multi-professional post-graduate programs

bull produced 15 thousands MSc amp PhD in 2010

bull over 3 thousands Research published

Escola de Enfermagem

Instituto de Medicina Legal Instituto de Medicina Tropical

Emiacutelio Ribas

FACULDADE de MEDICINA SECRETARIA DE SAUacuteDE de SP CEFACS ndash Aperfeiccediloam Ciecircncias Sauacutede

The HC-FMUSP

WorkFlow New Technologies Adoption Proposals

Evaluation Proposal reception(Mini Assessment)

Responsible Reviewer amp Group Designation

Independent relevant scientific literature review amp previous local technology utilization

analysis (research(s) or alternative financing) or review utilization in other jurisdictions

1st WG Report

Report Review by peers

Report adjustment public presentation and discussion

Interview Proponent Complete or Defend | ambiguous topics

NATS

SP

EC

IFIC

WG

Economic factibility analysis

Favorable Report

NATS Report with economic file

HC LIST INCORPORATION ADMINISTRACcedilAtildeO

SUPERIOR

Decision Aproval or Non-aproval

Evaluation Proposal reception(Mini Assessment) completed with Executive Direction SignatureAdmInst

Adjust amp Process Aquisition planning for Program

Proponent Requisition ndash Specify Bid

Non-aprovalProponent revision claim

WG Review claim

Proponent Information

Existing HTAs regarding efficacy safety effectiveness

or economic aspects if applicable are used or

updated with independent literature searches

If data published is applicable it is reanalyzed and

adapted for the aspect under assessment

Else primary studies are searched systematically

Local data is used to contextualize adapt and cross-

validate applicability or other aspects

HTA reviewing data on HT utilization and on outcomes

research is being used to analyze consistency across

jurisdictions

Structured searches published when applicable are

reproduced to update or adapt for particular aspects

under assessment

NATS-HCFMUSP Scientific Evidence Working Grouprsquos

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

NATS-HCFMUSP

EXAMPLES HTAs completed

bull Positron Emission TomographyOncology

bull Multi-Slices Tomography Coronary Angiography

bull Tacrolimus in Pediatric Heart Transplantation

bull Technologies in Surgical Arrhythmia Ablation

bull Adult heart transplantation cohort study

bull Biologic Agents in Rheumatoid Arthritis

bull Administrative Public Data Mining OLAP instrument

bull Post-marketing surveillance of infusion sets

bull Cohort study congenital heart deffects surgeries

NATS-HCFMUSP EXAMPLES HTAs ongoing

bull Intravascular Ultrasound with virtual histology

bull Cost-effectiveness of Hepatic transplantation

bull Municipal Investigation Methods Coronary Disease

bull Endobronchial Ultrasound Lung Cancer Biopsies

bull Siphon Valves in Hydrocephalus Control

bull Mofetil mycophenolate in immuno-modulation

bull Implantable Devices for Emphysemas

bull Valve implants for Glaucoma control

bull News and existing drugs protocol for neuropathic pain

bull Surgical sutures postmarketing surveillance assessment

bull Cardiac valves replacement costs and effects

bull Lung transplantation cost-effectiveness

Cochrane Handbook for

Systematic Reviews of

Interventions

copy The Cochrane Collaboration

Above cited references are being used for training

graduate and post-graduation students how to do

structured searches in big medical schools

published when applicable are reproduced to

update or adapt for particular aspects under

assessment

NATS-HCFMUSP Scientific Evidence Working Group

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

the active Scientific Evidence Working Group use

specific management software mentioned previously

to perform systematic update alerts for Medical or

Multi-professional Faculty or students and update

searches at main bibliographic databases or editor

sites

You are the experts

Thank you for your attention

In general the documents were clearly written and

contained three types of conclusions

(i) negative (n = 27 11 percent)

(ii) neutral (n = 90 38 percent) and

(iii) positive (n = 114 48 percent)

From January 2000 to March 2007

40 percent of published HTA documents in LA addressed clinical effectiveness

while 26 percent attempted to correlate the efficacy

and safety of a new technology in economic terms

The Pan American Health Organization (PAHO) Regional Office of the World Health Organization (WHO) for the Americas has tried to promote health technology assessment (HTA) in Latin America for 25 years

Health Technology Assessment in Latin America

Brazil Mexico Argentina

Health Technology Assessment in Latin America

Chile 1997 Ministry of Healthrsquos HTA office ETESAmdash the Unit for Health Technology Assessment a member of INAHTA

Colombia the Ministry of Social Protection plan an HTA Agency with the

academic sector

Cuba =gt HTA amp EBM in their healthcare system

Uruguay 2007 Ministry of Healthrsquos HTA program in the Department of Medical Technology

Health Technology Assessment in Latin America

Mexico National Centre for Excellence in Health Technology (CENETEC) programs and seminars related to health technology assessment and management

Health Technology Assessment in Latin America

Brazil

After important milestones

2nd National Conference on Science Technology and Innovation in Health

2004 - National Agenda of Priorities in Health Research

2006 =gt institutionalization DECIT-CGATS HTA in the national government and joined INAHTA

2007 DECIT-CGATS - National Policy on Health Technology Management

Health Technology Assessment in Latin America

Brazil

National Agency for Health Surveillance ANVISA

1999 Techno-Surveillance Medical Devices Post Market Surveillance

2000 - Network of Sentinel Hospitals

- National Register of Drug and Health Devices

- National System of Health Surveillance reinforced with States and Municipalities - VISAs

2003 =gt Health Ministry - VISAs Management Pact contracts with hospitals ndash Local networks under development

Latin American Regulatory authorities have being evolving regarding methods to evaluate health products

Professional Societies are adopting HTA methods to built guidelines An HTA status in depth survey in Latin America is ongoing (Ana Perez)

Health Technology Assessment in Latin America

Brazil

National Network of HTA REBRATS

2008 Brazilian Health Technology Assessment Network (Rede Brasileira de Avaliaccedilatildeo de Tecnologias em Sauacutede ndash REBRATS) a network of 24 Sentinel Hospitals and research institutions to congregate HTA stakeholders

The HTA REBRATS validated studies are disseminated to the Commission for Technology Incorporation from Ministry of Health

Research database created SISREBRATS

Review

Studies financed by DECIT Health Ministry

bull Near 100

bull Bilingual structured abstracts

bull 10 from NATS-HCFMUSP

NATS-HCFMUSP

Is the HTA Center InCor (Heart Institute) amp Clinics Hospital of the Satildeo Paulo University Medical School the HC-FMUSP

Brief Institutional highlights

2500 active beds 15 million outpatient visits 400 thousands emergency care 500 thousands imaging exams 72 thousands Inpatient care 50 thousands Surgeries 25 thousands High-risk deliveries and 600 organ amp tissue transplantations

bull internship and 12 thousands medical residency in 49 medical specialities

bull 500 studentship in 93 multi-professional post-graduate programs

bull produced 15 thousands MSc amp PhD in 2010

bull over 3 thousands Research published

Escola de Enfermagem

Instituto de Medicina Legal Instituto de Medicina Tropical

Emiacutelio Ribas

FACULDADE de MEDICINA SECRETARIA DE SAUacuteDE de SP CEFACS ndash Aperfeiccediloam Ciecircncias Sauacutede

The HC-FMUSP

WorkFlow New Technologies Adoption Proposals

Evaluation Proposal reception(Mini Assessment)

Responsible Reviewer amp Group Designation

Independent relevant scientific literature review amp previous local technology utilization

analysis (research(s) or alternative financing) or review utilization in other jurisdictions

1st WG Report

Report Review by peers

Report adjustment public presentation and discussion

Interview Proponent Complete or Defend | ambiguous topics

NATS

SP

EC

IFIC

WG

Economic factibility analysis

Favorable Report

NATS Report with economic file

HC LIST INCORPORATION ADMINISTRACcedilAtildeO

SUPERIOR

Decision Aproval or Non-aproval

Evaluation Proposal reception(Mini Assessment) completed with Executive Direction SignatureAdmInst

Adjust amp Process Aquisition planning for Program

Proponent Requisition ndash Specify Bid

Non-aprovalProponent revision claim

WG Review claim

Proponent Information

Existing HTAs regarding efficacy safety effectiveness

or economic aspects if applicable are used or

updated with independent literature searches

If data published is applicable it is reanalyzed and

adapted for the aspect under assessment

Else primary studies are searched systematically

Local data is used to contextualize adapt and cross-

validate applicability or other aspects

HTA reviewing data on HT utilization and on outcomes

research is being used to analyze consistency across

jurisdictions

Structured searches published when applicable are

reproduced to update or adapt for particular aspects

under assessment

NATS-HCFMUSP Scientific Evidence Working Grouprsquos

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

NATS-HCFMUSP

EXAMPLES HTAs completed

bull Positron Emission TomographyOncology

bull Multi-Slices Tomography Coronary Angiography

bull Tacrolimus in Pediatric Heart Transplantation

bull Technologies in Surgical Arrhythmia Ablation

bull Adult heart transplantation cohort study

bull Biologic Agents in Rheumatoid Arthritis

bull Administrative Public Data Mining OLAP instrument

bull Post-marketing surveillance of infusion sets

bull Cohort study congenital heart deffects surgeries

NATS-HCFMUSP EXAMPLES HTAs ongoing

bull Intravascular Ultrasound with virtual histology

bull Cost-effectiveness of Hepatic transplantation

bull Municipal Investigation Methods Coronary Disease

bull Endobronchial Ultrasound Lung Cancer Biopsies

bull Siphon Valves in Hydrocephalus Control

bull Mofetil mycophenolate in immuno-modulation

bull Implantable Devices for Emphysemas

bull Valve implants for Glaucoma control

bull News and existing drugs protocol for neuropathic pain

bull Surgical sutures postmarketing surveillance assessment

bull Cardiac valves replacement costs and effects

bull Lung transplantation cost-effectiveness

Cochrane Handbook for

Systematic Reviews of

Interventions

copy The Cochrane Collaboration

Above cited references are being used for training

graduate and post-graduation students how to do

structured searches in big medical schools

published when applicable are reproduced to

update or adapt for particular aspects under

assessment

NATS-HCFMUSP Scientific Evidence Working Group

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

the active Scientific Evidence Working Group use

specific management software mentioned previously

to perform systematic update alerts for Medical or

Multi-professional Faculty or students and update

searches at main bibliographic databases or editor

sites

You are the experts

Thank you for your attention

The Pan American Health Organization (PAHO) Regional Office of the World Health Organization (WHO) for the Americas has tried to promote health technology assessment (HTA) in Latin America for 25 years

Health Technology Assessment in Latin America

Brazil Mexico Argentina

Health Technology Assessment in Latin America

Chile 1997 Ministry of Healthrsquos HTA office ETESAmdash the Unit for Health Technology Assessment a member of INAHTA

Colombia the Ministry of Social Protection plan an HTA Agency with the

academic sector

Cuba =gt HTA amp EBM in their healthcare system

Uruguay 2007 Ministry of Healthrsquos HTA program in the Department of Medical Technology

Health Technology Assessment in Latin America

Mexico National Centre for Excellence in Health Technology (CENETEC) programs and seminars related to health technology assessment and management

Health Technology Assessment in Latin America

Brazil

After important milestones

2nd National Conference on Science Technology and Innovation in Health

2004 - National Agenda of Priorities in Health Research

2006 =gt institutionalization DECIT-CGATS HTA in the national government and joined INAHTA

2007 DECIT-CGATS - National Policy on Health Technology Management

Health Technology Assessment in Latin America

Brazil

National Agency for Health Surveillance ANVISA

1999 Techno-Surveillance Medical Devices Post Market Surveillance

2000 - Network of Sentinel Hospitals

- National Register of Drug and Health Devices

- National System of Health Surveillance reinforced with States and Municipalities - VISAs

2003 =gt Health Ministry - VISAs Management Pact contracts with hospitals ndash Local networks under development

Latin American Regulatory authorities have being evolving regarding methods to evaluate health products

Professional Societies are adopting HTA methods to built guidelines An HTA status in depth survey in Latin America is ongoing (Ana Perez)

Health Technology Assessment in Latin America

Brazil

National Network of HTA REBRATS

2008 Brazilian Health Technology Assessment Network (Rede Brasileira de Avaliaccedilatildeo de Tecnologias em Sauacutede ndash REBRATS) a network of 24 Sentinel Hospitals and research institutions to congregate HTA stakeholders

The HTA REBRATS validated studies are disseminated to the Commission for Technology Incorporation from Ministry of Health

Research database created SISREBRATS

Review

Studies financed by DECIT Health Ministry

bull Near 100

bull Bilingual structured abstracts

bull 10 from NATS-HCFMUSP

NATS-HCFMUSP

Is the HTA Center InCor (Heart Institute) amp Clinics Hospital of the Satildeo Paulo University Medical School the HC-FMUSP

Brief Institutional highlights

2500 active beds 15 million outpatient visits 400 thousands emergency care 500 thousands imaging exams 72 thousands Inpatient care 50 thousands Surgeries 25 thousands High-risk deliveries and 600 organ amp tissue transplantations

bull internship and 12 thousands medical residency in 49 medical specialities

bull 500 studentship in 93 multi-professional post-graduate programs

bull produced 15 thousands MSc amp PhD in 2010

bull over 3 thousands Research published

Escola de Enfermagem

Instituto de Medicina Legal Instituto de Medicina Tropical

Emiacutelio Ribas

FACULDADE de MEDICINA SECRETARIA DE SAUacuteDE de SP CEFACS ndash Aperfeiccediloam Ciecircncias Sauacutede

The HC-FMUSP

WorkFlow New Technologies Adoption Proposals

Evaluation Proposal reception(Mini Assessment)

Responsible Reviewer amp Group Designation

Independent relevant scientific literature review amp previous local technology utilization

analysis (research(s) or alternative financing) or review utilization in other jurisdictions

1st WG Report

Report Review by peers

Report adjustment public presentation and discussion

Interview Proponent Complete or Defend | ambiguous topics

NATS

SP

EC

IFIC

WG

Economic factibility analysis

Favorable Report

NATS Report with economic file

HC LIST INCORPORATION ADMINISTRACcedilAtildeO

SUPERIOR

Decision Aproval or Non-aproval

Evaluation Proposal reception(Mini Assessment) completed with Executive Direction SignatureAdmInst

Adjust amp Process Aquisition planning for Program

Proponent Requisition ndash Specify Bid

Non-aprovalProponent revision claim

WG Review claim

Proponent Information

Existing HTAs regarding efficacy safety effectiveness

or economic aspects if applicable are used or

updated with independent literature searches

If data published is applicable it is reanalyzed and

adapted for the aspect under assessment

Else primary studies are searched systematically

Local data is used to contextualize adapt and cross-

validate applicability or other aspects

HTA reviewing data on HT utilization and on outcomes

research is being used to analyze consistency across

jurisdictions

Structured searches published when applicable are

reproduced to update or adapt for particular aspects

under assessment

NATS-HCFMUSP Scientific Evidence Working Grouprsquos

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

NATS-HCFMUSP

EXAMPLES HTAs completed

bull Positron Emission TomographyOncology

bull Multi-Slices Tomography Coronary Angiography

bull Tacrolimus in Pediatric Heart Transplantation

bull Technologies in Surgical Arrhythmia Ablation

bull Adult heart transplantation cohort study

bull Biologic Agents in Rheumatoid Arthritis

bull Administrative Public Data Mining OLAP instrument

bull Post-marketing surveillance of infusion sets

bull Cohort study congenital heart deffects surgeries

NATS-HCFMUSP EXAMPLES HTAs ongoing

bull Intravascular Ultrasound with virtual histology

bull Cost-effectiveness of Hepatic transplantation

bull Municipal Investigation Methods Coronary Disease

bull Endobronchial Ultrasound Lung Cancer Biopsies

bull Siphon Valves in Hydrocephalus Control

bull Mofetil mycophenolate in immuno-modulation

bull Implantable Devices for Emphysemas

bull Valve implants for Glaucoma control

bull News and existing drugs protocol for neuropathic pain

bull Surgical sutures postmarketing surveillance assessment

bull Cardiac valves replacement costs and effects

bull Lung transplantation cost-effectiveness

Cochrane Handbook for

Systematic Reviews of

Interventions

copy The Cochrane Collaboration

Above cited references are being used for training

graduate and post-graduation students how to do

structured searches in big medical schools

published when applicable are reproduced to

update or adapt for particular aspects under

assessment

NATS-HCFMUSP Scientific Evidence Working Group

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

the active Scientific Evidence Working Group use

specific management software mentioned previously

to perform systematic update alerts for Medical or

Multi-professional Faculty or students and update

searches at main bibliographic databases or editor

sites

You are the experts

Thank you for your attention

Health Technology Assessment in Latin America

Chile 1997 Ministry of Healthrsquos HTA office ETESAmdash the Unit for Health Technology Assessment a member of INAHTA

Colombia the Ministry of Social Protection plan an HTA Agency with the

academic sector

Cuba =gt HTA amp EBM in their healthcare system

Uruguay 2007 Ministry of Healthrsquos HTA program in the Department of Medical Technology

Health Technology Assessment in Latin America

Mexico National Centre for Excellence in Health Technology (CENETEC) programs and seminars related to health technology assessment and management

Health Technology Assessment in Latin America

Brazil

After important milestones

2nd National Conference on Science Technology and Innovation in Health

2004 - National Agenda of Priorities in Health Research

2006 =gt institutionalization DECIT-CGATS HTA in the national government and joined INAHTA

2007 DECIT-CGATS - National Policy on Health Technology Management

Health Technology Assessment in Latin America

Brazil

National Agency for Health Surveillance ANVISA

1999 Techno-Surveillance Medical Devices Post Market Surveillance

2000 - Network of Sentinel Hospitals

- National Register of Drug and Health Devices

- National System of Health Surveillance reinforced with States and Municipalities - VISAs

2003 =gt Health Ministry - VISAs Management Pact contracts with hospitals ndash Local networks under development

Latin American Regulatory authorities have being evolving regarding methods to evaluate health products

Professional Societies are adopting HTA methods to built guidelines An HTA status in depth survey in Latin America is ongoing (Ana Perez)

Health Technology Assessment in Latin America

Brazil

National Network of HTA REBRATS

2008 Brazilian Health Technology Assessment Network (Rede Brasileira de Avaliaccedilatildeo de Tecnologias em Sauacutede ndash REBRATS) a network of 24 Sentinel Hospitals and research institutions to congregate HTA stakeholders

The HTA REBRATS validated studies are disseminated to the Commission for Technology Incorporation from Ministry of Health

Research database created SISREBRATS

Review

Studies financed by DECIT Health Ministry

bull Near 100

bull Bilingual structured abstracts

bull 10 from NATS-HCFMUSP

NATS-HCFMUSP

Is the HTA Center InCor (Heart Institute) amp Clinics Hospital of the Satildeo Paulo University Medical School the HC-FMUSP

Brief Institutional highlights

2500 active beds 15 million outpatient visits 400 thousands emergency care 500 thousands imaging exams 72 thousands Inpatient care 50 thousands Surgeries 25 thousands High-risk deliveries and 600 organ amp tissue transplantations

bull internship and 12 thousands medical residency in 49 medical specialities

bull 500 studentship in 93 multi-professional post-graduate programs

bull produced 15 thousands MSc amp PhD in 2010

bull over 3 thousands Research published

Escola de Enfermagem

Instituto de Medicina Legal Instituto de Medicina Tropical

Emiacutelio Ribas

FACULDADE de MEDICINA SECRETARIA DE SAUacuteDE de SP CEFACS ndash Aperfeiccediloam Ciecircncias Sauacutede

The HC-FMUSP

WorkFlow New Technologies Adoption Proposals

Evaluation Proposal reception(Mini Assessment)

Responsible Reviewer amp Group Designation

Independent relevant scientific literature review amp previous local technology utilization

analysis (research(s) or alternative financing) or review utilization in other jurisdictions

1st WG Report

Report Review by peers

Report adjustment public presentation and discussion

Interview Proponent Complete or Defend | ambiguous topics

NATS

SP

EC

IFIC

WG

Economic factibility analysis

Favorable Report

NATS Report with economic file

HC LIST INCORPORATION ADMINISTRACcedilAtildeO

SUPERIOR

Decision Aproval or Non-aproval

Evaluation Proposal reception(Mini Assessment) completed with Executive Direction SignatureAdmInst

Adjust amp Process Aquisition planning for Program

Proponent Requisition ndash Specify Bid

Non-aprovalProponent revision claim

WG Review claim

Proponent Information

Existing HTAs regarding efficacy safety effectiveness

or economic aspects if applicable are used or

updated with independent literature searches

If data published is applicable it is reanalyzed and

adapted for the aspect under assessment

Else primary studies are searched systematically

Local data is used to contextualize adapt and cross-

validate applicability or other aspects

HTA reviewing data on HT utilization and on outcomes

research is being used to analyze consistency across

jurisdictions

Structured searches published when applicable are

reproduced to update or adapt for particular aspects

under assessment

NATS-HCFMUSP Scientific Evidence Working Grouprsquos

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

NATS-HCFMUSP

EXAMPLES HTAs completed

bull Positron Emission TomographyOncology

bull Multi-Slices Tomography Coronary Angiography

bull Tacrolimus in Pediatric Heart Transplantation

bull Technologies in Surgical Arrhythmia Ablation

bull Adult heart transplantation cohort study

bull Biologic Agents in Rheumatoid Arthritis

bull Administrative Public Data Mining OLAP instrument

bull Post-marketing surveillance of infusion sets

bull Cohort study congenital heart deffects surgeries

NATS-HCFMUSP EXAMPLES HTAs ongoing

bull Intravascular Ultrasound with virtual histology

bull Cost-effectiveness of Hepatic transplantation

bull Municipal Investigation Methods Coronary Disease

bull Endobronchial Ultrasound Lung Cancer Biopsies

bull Siphon Valves in Hydrocephalus Control

bull Mofetil mycophenolate in immuno-modulation

bull Implantable Devices for Emphysemas

bull Valve implants for Glaucoma control

bull News and existing drugs protocol for neuropathic pain

bull Surgical sutures postmarketing surveillance assessment

bull Cardiac valves replacement costs and effects

bull Lung transplantation cost-effectiveness

Cochrane Handbook for

Systematic Reviews of

Interventions

copy The Cochrane Collaboration

Above cited references are being used for training

graduate and post-graduation students how to do

structured searches in big medical schools

published when applicable are reproduced to

update or adapt for particular aspects under

assessment

NATS-HCFMUSP Scientific Evidence Working Group

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

the active Scientific Evidence Working Group use

specific management software mentioned previously

to perform systematic update alerts for Medical or

Multi-professional Faculty or students and update

searches at main bibliographic databases or editor

sites

You are the experts

Thank you for your attention

Health Technology Assessment in Latin America

Mexico National Centre for Excellence in Health Technology (CENETEC) programs and seminars related to health technology assessment and management

Health Technology Assessment in Latin America

Brazil

After important milestones

2nd National Conference on Science Technology and Innovation in Health

2004 - National Agenda of Priorities in Health Research

2006 =gt institutionalization DECIT-CGATS HTA in the national government and joined INAHTA

2007 DECIT-CGATS - National Policy on Health Technology Management

Health Technology Assessment in Latin America

Brazil

National Agency for Health Surveillance ANVISA

1999 Techno-Surveillance Medical Devices Post Market Surveillance

2000 - Network of Sentinel Hospitals

- National Register of Drug and Health Devices

- National System of Health Surveillance reinforced with States and Municipalities - VISAs

2003 =gt Health Ministry - VISAs Management Pact contracts with hospitals ndash Local networks under development

Latin American Regulatory authorities have being evolving regarding methods to evaluate health products

Professional Societies are adopting HTA methods to built guidelines An HTA status in depth survey in Latin America is ongoing (Ana Perez)

Health Technology Assessment in Latin America

Brazil

National Network of HTA REBRATS

2008 Brazilian Health Technology Assessment Network (Rede Brasileira de Avaliaccedilatildeo de Tecnologias em Sauacutede ndash REBRATS) a network of 24 Sentinel Hospitals and research institutions to congregate HTA stakeholders

The HTA REBRATS validated studies are disseminated to the Commission for Technology Incorporation from Ministry of Health

Research database created SISREBRATS

Review

Studies financed by DECIT Health Ministry

bull Near 100

bull Bilingual structured abstracts

bull 10 from NATS-HCFMUSP

NATS-HCFMUSP

Is the HTA Center InCor (Heart Institute) amp Clinics Hospital of the Satildeo Paulo University Medical School the HC-FMUSP

Brief Institutional highlights

2500 active beds 15 million outpatient visits 400 thousands emergency care 500 thousands imaging exams 72 thousands Inpatient care 50 thousands Surgeries 25 thousands High-risk deliveries and 600 organ amp tissue transplantations

bull internship and 12 thousands medical residency in 49 medical specialities

bull 500 studentship in 93 multi-professional post-graduate programs

bull produced 15 thousands MSc amp PhD in 2010

bull over 3 thousands Research published

Escola de Enfermagem

Instituto de Medicina Legal Instituto de Medicina Tropical

Emiacutelio Ribas

FACULDADE de MEDICINA SECRETARIA DE SAUacuteDE de SP CEFACS ndash Aperfeiccediloam Ciecircncias Sauacutede

The HC-FMUSP

WorkFlow New Technologies Adoption Proposals

Evaluation Proposal reception(Mini Assessment)

Responsible Reviewer amp Group Designation

Independent relevant scientific literature review amp previous local technology utilization

analysis (research(s) or alternative financing) or review utilization in other jurisdictions

1st WG Report

Report Review by peers

Report adjustment public presentation and discussion

Interview Proponent Complete or Defend | ambiguous topics

NATS

SP

EC

IFIC

WG

Economic factibility analysis

Favorable Report

NATS Report with economic file

HC LIST INCORPORATION ADMINISTRACcedilAtildeO

SUPERIOR

Decision Aproval or Non-aproval

Evaluation Proposal reception(Mini Assessment) completed with Executive Direction SignatureAdmInst

Adjust amp Process Aquisition planning for Program

Proponent Requisition ndash Specify Bid

Non-aprovalProponent revision claim

WG Review claim

Proponent Information

Existing HTAs regarding efficacy safety effectiveness

or economic aspects if applicable are used or

updated with independent literature searches

If data published is applicable it is reanalyzed and

adapted for the aspect under assessment

Else primary studies are searched systematically

Local data is used to contextualize adapt and cross-

validate applicability or other aspects

HTA reviewing data on HT utilization and on outcomes

research is being used to analyze consistency across

jurisdictions

Structured searches published when applicable are

reproduced to update or adapt for particular aspects

under assessment

NATS-HCFMUSP Scientific Evidence Working Grouprsquos

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

NATS-HCFMUSP

EXAMPLES HTAs completed

bull Positron Emission TomographyOncology

bull Multi-Slices Tomography Coronary Angiography

bull Tacrolimus in Pediatric Heart Transplantation

bull Technologies in Surgical Arrhythmia Ablation

bull Adult heart transplantation cohort study

bull Biologic Agents in Rheumatoid Arthritis

bull Administrative Public Data Mining OLAP instrument

bull Post-marketing surveillance of infusion sets

bull Cohort study congenital heart deffects surgeries

NATS-HCFMUSP EXAMPLES HTAs ongoing

bull Intravascular Ultrasound with virtual histology

bull Cost-effectiveness of Hepatic transplantation

bull Municipal Investigation Methods Coronary Disease

bull Endobronchial Ultrasound Lung Cancer Biopsies

bull Siphon Valves in Hydrocephalus Control

bull Mofetil mycophenolate in immuno-modulation

bull Implantable Devices for Emphysemas

bull Valve implants for Glaucoma control

bull News and existing drugs protocol for neuropathic pain

bull Surgical sutures postmarketing surveillance assessment

bull Cardiac valves replacement costs and effects

bull Lung transplantation cost-effectiveness

Cochrane Handbook for

Systematic Reviews of

Interventions

copy The Cochrane Collaboration

Above cited references are being used for training

graduate and post-graduation students how to do

structured searches in big medical schools

published when applicable are reproduced to

update or adapt for particular aspects under

assessment

NATS-HCFMUSP Scientific Evidence Working Group

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

the active Scientific Evidence Working Group use

specific management software mentioned previously

to perform systematic update alerts for Medical or

Multi-professional Faculty or students and update

searches at main bibliographic databases or editor

sites

You are the experts

Thank you for your attention

Health Technology Assessment in Latin America

Brazil

After important milestones

2nd National Conference on Science Technology and Innovation in Health

2004 - National Agenda of Priorities in Health Research

2006 =gt institutionalization DECIT-CGATS HTA in the national government and joined INAHTA

2007 DECIT-CGATS - National Policy on Health Technology Management

Health Technology Assessment in Latin America

Brazil

National Agency for Health Surveillance ANVISA

1999 Techno-Surveillance Medical Devices Post Market Surveillance

2000 - Network of Sentinel Hospitals

- National Register of Drug and Health Devices

- National System of Health Surveillance reinforced with States and Municipalities - VISAs

2003 =gt Health Ministry - VISAs Management Pact contracts with hospitals ndash Local networks under development

Latin American Regulatory authorities have being evolving regarding methods to evaluate health products

Professional Societies are adopting HTA methods to built guidelines An HTA status in depth survey in Latin America is ongoing (Ana Perez)

Health Technology Assessment in Latin America

Brazil

National Network of HTA REBRATS

2008 Brazilian Health Technology Assessment Network (Rede Brasileira de Avaliaccedilatildeo de Tecnologias em Sauacutede ndash REBRATS) a network of 24 Sentinel Hospitals and research institutions to congregate HTA stakeholders

The HTA REBRATS validated studies are disseminated to the Commission for Technology Incorporation from Ministry of Health

Research database created SISREBRATS

Review

Studies financed by DECIT Health Ministry

bull Near 100

bull Bilingual structured abstracts

bull 10 from NATS-HCFMUSP

NATS-HCFMUSP

Is the HTA Center InCor (Heart Institute) amp Clinics Hospital of the Satildeo Paulo University Medical School the HC-FMUSP

Brief Institutional highlights

2500 active beds 15 million outpatient visits 400 thousands emergency care 500 thousands imaging exams 72 thousands Inpatient care 50 thousands Surgeries 25 thousands High-risk deliveries and 600 organ amp tissue transplantations

bull internship and 12 thousands medical residency in 49 medical specialities

bull 500 studentship in 93 multi-professional post-graduate programs

bull produced 15 thousands MSc amp PhD in 2010

bull over 3 thousands Research published

Escola de Enfermagem

Instituto de Medicina Legal Instituto de Medicina Tropical

Emiacutelio Ribas

FACULDADE de MEDICINA SECRETARIA DE SAUacuteDE de SP CEFACS ndash Aperfeiccediloam Ciecircncias Sauacutede

The HC-FMUSP

WorkFlow New Technologies Adoption Proposals

Evaluation Proposal reception(Mini Assessment)

Responsible Reviewer amp Group Designation

Independent relevant scientific literature review amp previous local technology utilization

analysis (research(s) or alternative financing) or review utilization in other jurisdictions

1st WG Report

Report Review by peers

Report adjustment public presentation and discussion

Interview Proponent Complete or Defend | ambiguous topics

NATS

SP

EC

IFIC

WG

Economic factibility analysis

Favorable Report

NATS Report with economic file

HC LIST INCORPORATION ADMINISTRACcedilAtildeO

SUPERIOR

Decision Aproval or Non-aproval

Evaluation Proposal reception(Mini Assessment) completed with Executive Direction SignatureAdmInst

Adjust amp Process Aquisition planning for Program

Proponent Requisition ndash Specify Bid

Non-aprovalProponent revision claim

WG Review claim

Proponent Information

Existing HTAs regarding efficacy safety effectiveness

or economic aspects if applicable are used or

updated with independent literature searches

If data published is applicable it is reanalyzed and

adapted for the aspect under assessment

Else primary studies are searched systematically

Local data is used to contextualize adapt and cross-

validate applicability or other aspects

HTA reviewing data on HT utilization and on outcomes

research is being used to analyze consistency across

jurisdictions

Structured searches published when applicable are

reproduced to update or adapt for particular aspects

under assessment

NATS-HCFMUSP Scientific Evidence Working Grouprsquos

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

NATS-HCFMUSP

EXAMPLES HTAs completed

bull Positron Emission TomographyOncology

bull Multi-Slices Tomography Coronary Angiography

bull Tacrolimus in Pediatric Heart Transplantation

bull Technologies in Surgical Arrhythmia Ablation

bull Adult heart transplantation cohort study

bull Biologic Agents in Rheumatoid Arthritis

bull Administrative Public Data Mining OLAP instrument

bull Post-marketing surveillance of infusion sets

bull Cohort study congenital heart deffects surgeries

NATS-HCFMUSP EXAMPLES HTAs ongoing

bull Intravascular Ultrasound with virtual histology

bull Cost-effectiveness of Hepatic transplantation

bull Municipal Investigation Methods Coronary Disease

bull Endobronchial Ultrasound Lung Cancer Biopsies

bull Siphon Valves in Hydrocephalus Control

bull Mofetil mycophenolate in immuno-modulation

bull Implantable Devices for Emphysemas

bull Valve implants for Glaucoma control

bull News and existing drugs protocol for neuropathic pain

bull Surgical sutures postmarketing surveillance assessment

bull Cardiac valves replacement costs and effects

bull Lung transplantation cost-effectiveness

Cochrane Handbook for

Systematic Reviews of

Interventions

copy The Cochrane Collaboration

Above cited references are being used for training

graduate and post-graduation students how to do

structured searches in big medical schools

published when applicable are reproduced to

update or adapt for particular aspects under

assessment

NATS-HCFMUSP Scientific Evidence Working Group

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

the active Scientific Evidence Working Group use

specific management software mentioned previously

to perform systematic update alerts for Medical or

Multi-professional Faculty or students and update

searches at main bibliographic databases or editor

sites

You are the experts

Thank you for your attention

Health Technology Assessment in Latin America

Brazil

National Agency for Health Surveillance ANVISA

1999 Techno-Surveillance Medical Devices Post Market Surveillance

2000 - Network of Sentinel Hospitals

- National Register of Drug and Health Devices

- National System of Health Surveillance reinforced with States and Municipalities - VISAs

2003 =gt Health Ministry - VISAs Management Pact contracts with hospitals ndash Local networks under development

Latin American Regulatory authorities have being evolving regarding methods to evaluate health products

Professional Societies are adopting HTA methods to built guidelines An HTA status in depth survey in Latin America is ongoing (Ana Perez)

Health Technology Assessment in Latin America

Brazil

National Network of HTA REBRATS

2008 Brazilian Health Technology Assessment Network (Rede Brasileira de Avaliaccedilatildeo de Tecnologias em Sauacutede ndash REBRATS) a network of 24 Sentinel Hospitals and research institutions to congregate HTA stakeholders

The HTA REBRATS validated studies are disseminated to the Commission for Technology Incorporation from Ministry of Health

Research database created SISREBRATS

Review

Studies financed by DECIT Health Ministry

bull Near 100

bull Bilingual structured abstracts

bull 10 from NATS-HCFMUSP

NATS-HCFMUSP

Is the HTA Center InCor (Heart Institute) amp Clinics Hospital of the Satildeo Paulo University Medical School the HC-FMUSP

Brief Institutional highlights

2500 active beds 15 million outpatient visits 400 thousands emergency care 500 thousands imaging exams 72 thousands Inpatient care 50 thousands Surgeries 25 thousands High-risk deliveries and 600 organ amp tissue transplantations

bull internship and 12 thousands medical residency in 49 medical specialities

bull 500 studentship in 93 multi-professional post-graduate programs

bull produced 15 thousands MSc amp PhD in 2010

bull over 3 thousands Research published

Escola de Enfermagem

Instituto de Medicina Legal Instituto de Medicina Tropical

Emiacutelio Ribas

FACULDADE de MEDICINA SECRETARIA DE SAUacuteDE de SP CEFACS ndash Aperfeiccediloam Ciecircncias Sauacutede

The HC-FMUSP

WorkFlow New Technologies Adoption Proposals

Evaluation Proposal reception(Mini Assessment)

Responsible Reviewer amp Group Designation

Independent relevant scientific literature review amp previous local technology utilization

analysis (research(s) or alternative financing) or review utilization in other jurisdictions

1st WG Report

Report Review by peers

Report adjustment public presentation and discussion

Interview Proponent Complete or Defend | ambiguous topics

NATS

SP

EC

IFIC

WG

Economic factibility analysis

Favorable Report

NATS Report with economic file

HC LIST INCORPORATION ADMINISTRACcedilAtildeO

SUPERIOR

Decision Aproval or Non-aproval

Evaluation Proposal reception(Mini Assessment) completed with Executive Direction SignatureAdmInst

Adjust amp Process Aquisition planning for Program

Proponent Requisition ndash Specify Bid

Non-aprovalProponent revision claim

WG Review claim

Proponent Information

Existing HTAs regarding efficacy safety effectiveness

or economic aspects if applicable are used or

updated with independent literature searches

If data published is applicable it is reanalyzed and

adapted for the aspect under assessment

Else primary studies are searched systematically

Local data is used to contextualize adapt and cross-

validate applicability or other aspects

HTA reviewing data on HT utilization and on outcomes

research is being used to analyze consistency across

jurisdictions

Structured searches published when applicable are

reproduced to update or adapt for particular aspects

under assessment

NATS-HCFMUSP Scientific Evidence Working Grouprsquos

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

NATS-HCFMUSP

EXAMPLES HTAs completed

bull Positron Emission TomographyOncology

bull Multi-Slices Tomography Coronary Angiography

bull Tacrolimus in Pediatric Heart Transplantation

bull Technologies in Surgical Arrhythmia Ablation

bull Adult heart transplantation cohort study

bull Biologic Agents in Rheumatoid Arthritis

bull Administrative Public Data Mining OLAP instrument

bull Post-marketing surveillance of infusion sets

bull Cohort study congenital heart deffects surgeries

NATS-HCFMUSP EXAMPLES HTAs ongoing

bull Intravascular Ultrasound with virtual histology

bull Cost-effectiveness of Hepatic transplantation

bull Municipal Investigation Methods Coronary Disease

bull Endobronchial Ultrasound Lung Cancer Biopsies

bull Siphon Valves in Hydrocephalus Control

bull Mofetil mycophenolate in immuno-modulation

bull Implantable Devices for Emphysemas

bull Valve implants for Glaucoma control

bull News and existing drugs protocol for neuropathic pain

bull Surgical sutures postmarketing surveillance assessment

bull Cardiac valves replacement costs and effects

bull Lung transplantation cost-effectiveness

Cochrane Handbook for

Systematic Reviews of

Interventions

copy The Cochrane Collaboration

Above cited references are being used for training

graduate and post-graduation students how to do

structured searches in big medical schools

published when applicable are reproduced to

update or adapt for particular aspects under

assessment

NATS-HCFMUSP Scientific Evidence Working Group

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

the active Scientific Evidence Working Group use

specific management software mentioned previously

to perform systematic update alerts for Medical or

Multi-professional Faculty or students and update

searches at main bibliographic databases or editor

sites

You are the experts

Thank you for your attention

Latin American Regulatory authorities have being evolving regarding methods to evaluate health products

Professional Societies are adopting HTA methods to built guidelines An HTA status in depth survey in Latin America is ongoing (Ana Perez)

Health Technology Assessment in Latin America

Brazil

National Network of HTA REBRATS

2008 Brazilian Health Technology Assessment Network (Rede Brasileira de Avaliaccedilatildeo de Tecnologias em Sauacutede ndash REBRATS) a network of 24 Sentinel Hospitals and research institutions to congregate HTA stakeholders

The HTA REBRATS validated studies are disseminated to the Commission for Technology Incorporation from Ministry of Health

Research database created SISREBRATS

Review

Studies financed by DECIT Health Ministry

bull Near 100

bull Bilingual structured abstracts

bull 10 from NATS-HCFMUSP

NATS-HCFMUSP

Is the HTA Center InCor (Heart Institute) amp Clinics Hospital of the Satildeo Paulo University Medical School the HC-FMUSP

Brief Institutional highlights

2500 active beds 15 million outpatient visits 400 thousands emergency care 500 thousands imaging exams 72 thousands Inpatient care 50 thousands Surgeries 25 thousands High-risk deliveries and 600 organ amp tissue transplantations

bull internship and 12 thousands medical residency in 49 medical specialities

bull 500 studentship in 93 multi-professional post-graduate programs

bull produced 15 thousands MSc amp PhD in 2010

bull over 3 thousands Research published

Escola de Enfermagem

Instituto de Medicina Legal Instituto de Medicina Tropical

Emiacutelio Ribas

FACULDADE de MEDICINA SECRETARIA DE SAUacuteDE de SP CEFACS ndash Aperfeiccediloam Ciecircncias Sauacutede

The HC-FMUSP

WorkFlow New Technologies Adoption Proposals

Evaluation Proposal reception(Mini Assessment)

Responsible Reviewer amp Group Designation

Independent relevant scientific literature review amp previous local technology utilization

analysis (research(s) or alternative financing) or review utilization in other jurisdictions

1st WG Report

Report Review by peers

Report adjustment public presentation and discussion

Interview Proponent Complete or Defend | ambiguous topics

NATS

SP

EC

IFIC

WG

Economic factibility analysis

Favorable Report

NATS Report with economic file

HC LIST INCORPORATION ADMINISTRACcedilAtildeO

SUPERIOR

Decision Aproval or Non-aproval

Evaluation Proposal reception(Mini Assessment) completed with Executive Direction SignatureAdmInst

Adjust amp Process Aquisition planning for Program

Proponent Requisition ndash Specify Bid

Non-aprovalProponent revision claim

WG Review claim

Proponent Information

Existing HTAs regarding efficacy safety effectiveness

or economic aspects if applicable are used or

updated with independent literature searches

If data published is applicable it is reanalyzed and

adapted for the aspect under assessment

Else primary studies are searched systematically

Local data is used to contextualize adapt and cross-

validate applicability or other aspects

HTA reviewing data on HT utilization and on outcomes

research is being used to analyze consistency across

jurisdictions

Structured searches published when applicable are

reproduced to update or adapt for particular aspects

under assessment

NATS-HCFMUSP Scientific Evidence Working Grouprsquos

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

NATS-HCFMUSP

EXAMPLES HTAs completed

bull Positron Emission TomographyOncology

bull Multi-Slices Tomography Coronary Angiography

bull Tacrolimus in Pediatric Heart Transplantation

bull Technologies in Surgical Arrhythmia Ablation

bull Adult heart transplantation cohort study

bull Biologic Agents in Rheumatoid Arthritis

bull Administrative Public Data Mining OLAP instrument

bull Post-marketing surveillance of infusion sets

bull Cohort study congenital heart deffects surgeries

NATS-HCFMUSP EXAMPLES HTAs ongoing

bull Intravascular Ultrasound with virtual histology

bull Cost-effectiveness of Hepatic transplantation

bull Municipal Investigation Methods Coronary Disease

bull Endobronchial Ultrasound Lung Cancer Biopsies

bull Siphon Valves in Hydrocephalus Control

bull Mofetil mycophenolate in immuno-modulation

bull Implantable Devices for Emphysemas

bull Valve implants for Glaucoma control

bull News and existing drugs protocol for neuropathic pain

bull Surgical sutures postmarketing surveillance assessment

bull Cardiac valves replacement costs and effects

bull Lung transplantation cost-effectiveness

Cochrane Handbook for

Systematic Reviews of

Interventions

copy The Cochrane Collaboration

Above cited references are being used for training

graduate and post-graduation students how to do

structured searches in big medical schools

published when applicable are reproduced to

update or adapt for particular aspects under

assessment

NATS-HCFMUSP Scientific Evidence Working Group

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

the active Scientific Evidence Working Group use

specific management software mentioned previously

to perform systematic update alerts for Medical or

Multi-professional Faculty or students and update

searches at main bibliographic databases or editor

sites

You are the experts

Thank you for your attention

Health Technology Assessment in Latin America

Brazil

National Network of HTA REBRATS

2008 Brazilian Health Technology Assessment Network (Rede Brasileira de Avaliaccedilatildeo de Tecnologias em Sauacutede ndash REBRATS) a network of 24 Sentinel Hospitals and research institutions to congregate HTA stakeholders

The HTA REBRATS validated studies are disseminated to the Commission for Technology Incorporation from Ministry of Health

Research database created SISREBRATS

Review

Studies financed by DECIT Health Ministry

bull Near 100

bull Bilingual structured abstracts

bull 10 from NATS-HCFMUSP

NATS-HCFMUSP

Is the HTA Center InCor (Heart Institute) amp Clinics Hospital of the Satildeo Paulo University Medical School the HC-FMUSP

Brief Institutional highlights

2500 active beds 15 million outpatient visits 400 thousands emergency care 500 thousands imaging exams 72 thousands Inpatient care 50 thousands Surgeries 25 thousands High-risk deliveries and 600 organ amp tissue transplantations

bull internship and 12 thousands medical residency in 49 medical specialities

bull 500 studentship in 93 multi-professional post-graduate programs

bull produced 15 thousands MSc amp PhD in 2010

bull over 3 thousands Research published

Escola de Enfermagem

Instituto de Medicina Legal Instituto de Medicina Tropical

Emiacutelio Ribas

FACULDADE de MEDICINA SECRETARIA DE SAUacuteDE de SP CEFACS ndash Aperfeiccediloam Ciecircncias Sauacutede

The HC-FMUSP

WorkFlow New Technologies Adoption Proposals

Evaluation Proposal reception(Mini Assessment)

Responsible Reviewer amp Group Designation

Independent relevant scientific literature review amp previous local technology utilization

analysis (research(s) or alternative financing) or review utilization in other jurisdictions

1st WG Report

Report Review by peers

Report adjustment public presentation and discussion

Interview Proponent Complete or Defend | ambiguous topics

NATS

SP

EC

IFIC

WG

Economic factibility analysis

Favorable Report

NATS Report with economic file

HC LIST INCORPORATION ADMINISTRACcedilAtildeO

SUPERIOR

Decision Aproval or Non-aproval

Evaluation Proposal reception(Mini Assessment) completed with Executive Direction SignatureAdmInst

Adjust amp Process Aquisition planning for Program

Proponent Requisition ndash Specify Bid

Non-aprovalProponent revision claim

WG Review claim

Proponent Information

Existing HTAs regarding efficacy safety effectiveness

or economic aspects if applicable are used or

updated with independent literature searches

If data published is applicable it is reanalyzed and

adapted for the aspect under assessment

Else primary studies are searched systematically

Local data is used to contextualize adapt and cross-

validate applicability or other aspects

HTA reviewing data on HT utilization and on outcomes

research is being used to analyze consistency across

jurisdictions

Structured searches published when applicable are

reproduced to update or adapt for particular aspects

under assessment

NATS-HCFMUSP Scientific Evidence Working Grouprsquos

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

NATS-HCFMUSP

EXAMPLES HTAs completed

bull Positron Emission TomographyOncology

bull Multi-Slices Tomography Coronary Angiography

bull Tacrolimus in Pediatric Heart Transplantation

bull Technologies in Surgical Arrhythmia Ablation

bull Adult heart transplantation cohort study

bull Biologic Agents in Rheumatoid Arthritis

bull Administrative Public Data Mining OLAP instrument

bull Post-marketing surveillance of infusion sets

bull Cohort study congenital heart deffects surgeries

NATS-HCFMUSP EXAMPLES HTAs ongoing

bull Intravascular Ultrasound with virtual histology

bull Cost-effectiveness of Hepatic transplantation

bull Municipal Investigation Methods Coronary Disease

bull Endobronchial Ultrasound Lung Cancer Biopsies

bull Siphon Valves in Hydrocephalus Control

bull Mofetil mycophenolate in immuno-modulation

bull Implantable Devices for Emphysemas

bull Valve implants for Glaucoma control

bull News and existing drugs protocol for neuropathic pain

bull Surgical sutures postmarketing surveillance assessment

bull Cardiac valves replacement costs and effects

bull Lung transplantation cost-effectiveness

Cochrane Handbook for

Systematic Reviews of

Interventions

copy The Cochrane Collaboration

Above cited references are being used for training

graduate and post-graduation students how to do

structured searches in big medical schools

published when applicable are reproduced to

update or adapt for particular aspects under

assessment

NATS-HCFMUSP Scientific Evidence Working Group

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

the active Scientific Evidence Working Group use

specific management software mentioned previously

to perform systematic update alerts for Medical or

Multi-professional Faculty or students and update

searches at main bibliographic databases or editor

sites

You are the experts

Thank you for your attention

Review

Studies financed by DECIT Health Ministry

bull Near 100

bull Bilingual structured abstracts

bull 10 from NATS-HCFMUSP

NATS-HCFMUSP

Is the HTA Center InCor (Heart Institute) amp Clinics Hospital of the Satildeo Paulo University Medical School the HC-FMUSP

Brief Institutional highlights

2500 active beds 15 million outpatient visits 400 thousands emergency care 500 thousands imaging exams 72 thousands Inpatient care 50 thousands Surgeries 25 thousands High-risk deliveries and 600 organ amp tissue transplantations

bull internship and 12 thousands medical residency in 49 medical specialities

bull 500 studentship in 93 multi-professional post-graduate programs

bull produced 15 thousands MSc amp PhD in 2010

bull over 3 thousands Research published

Escola de Enfermagem

Instituto de Medicina Legal Instituto de Medicina Tropical

Emiacutelio Ribas

FACULDADE de MEDICINA SECRETARIA DE SAUacuteDE de SP CEFACS ndash Aperfeiccediloam Ciecircncias Sauacutede

The HC-FMUSP

WorkFlow New Technologies Adoption Proposals

Evaluation Proposal reception(Mini Assessment)

Responsible Reviewer amp Group Designation

Independent relevant scientific literature review amp previous local technology utilization

analysis (research(s) or alternative financing) or review utilization in other jurisdictions

1st WG Report

Report Review by peers

Report adjustment public presentation and discussion

Interview Proponent Complete or Defend | ambiguous topics

NATS

SP

EC

IFIC

WG

Economic factibility analysis

Favorable Report

NATS Report with economic file

HC LIST INCORPORATION ADMINISTRACcedilAtildeO

SUPERIOR

Decision Aproval or Non-aproval

Evaluation Proposal reception(Mini Assessment) completed with Executive Direction SignatureAdmInst

Adjust amp Process Aquisition planning for Program

Proponent Requisition ndash Specify Bid

Non-aprovalProponent revision claim

WG Review claim

Proponent Information

Existing HTAs regarding efficacy safety effectiveness

or economic aspects if applicable are used or

updated with independent literature searches

If data published is applicable it is reanalyzed and

adapted for the aspect under assessment

Else primary studies are searched systematically

Local data is used to contextualize adapt and cross-

validate applicability or other aspects

HTA reviewing data on HT utilization and on outcomes

research is being used to analyze consistency across

jurisdictions

Structured searches published when applicable are

reproduced to update or adapt for particular aspects

under assessment

NATS-HCFMUSP Scientific Evidence Working Grouprsquos

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

NATS-HCFMUSP

EXAMPLES HTAs completed

bull Positron Emission TomographyOncology

bull Multi-Slices Tomography Coronary Angiography

bull Tacrolimus in Pediatric Heart Transplantation

bull Technologies in Surgical Arrhythmia Ablation

bull Adult heart transplantation cohort study

bull Biologic Agents in Rheumatoid Arthritis

bull Administrative Public Data Mining OLAP instrument

bull Post-marketing surveillance of infusion sets

bull Cohort study congenital heart deffects surgeries

NATS-HCFMUSP EXAMPLES HTAs ongoing

bull Intravascular Ultrasound with virtual histology

bull Cost-effectiveness of Hepatic transplantation

bull Municipal Investigation Methods Coronary Disease

bull Endobronchial Ultrasound Lung Cancer Biopsies

bull Siphon Valves in Hydrocephalus Control

bull Mofetil mycophenolate in immuno-modulation

bull Implantable Devices for Emphysemas

bull Valve implants for Glaucoma control

bull News and existing drugs protocol for neuropathic pain

bull Surgical sutures postmarketing surveillance assessment

bull Cardiac valves replacement costs and effects

bull Lung transplantation cost-effectiveness

Cochrane Handbook for

Systematic Reviews of

Interventions

copy The Cochrane Collaboration

Above cited references are being used for training

graduate and post-graduation students how to do

structured searches in big medical schools

published when applicable are reproduced to

update or adapt for particular aspects under

assessment

NATS-HCFMUSP Scientific Evidence Working Group

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

the active Scientific Evidence Working Group use

specific management software mentioned previously

to perform systematic update alerts for Medical or

Multi-professional Faculty or students and update

searches at main bibliographic databases or editor

sites

You are the experts

Thank you for your attention

NATS-HCFMUSP

Is the HTA Center InCor (Heart Institute) amp Clinics Hospital of the Satildeo Paulo University Medical School the HC-FMUSP

Brief Institutional highlights

2500 active beds 15 million outpatient visits 400 thousands emergency care 500 thousands imaging exams 72 thousands Inpatient care 50 thousands Surgeries 25 thousands High-risk deliveries and 600 organ amp tissue transplantations

bull internship and 12 thousands medical residency in 49 medical specialities

bull 500 studentship in 93 multi-professional post-graduate programs

bull produced 15 thousands MSc amp PhD in 2010

bull over 3 thousands Research published

Escola de Enfermagem

Instituto de Medicina Legal Instituto de Medicina Tropical

Emiacutelio Ribas

FACULDADE de MEDICINA SECRETARIA DE SAUacuteDE de SP CEFACS ndash Aperfeiccediloam Ciecircncias Sauacutede

The HC-FMUSP

WorkFlow New Technologies Adoption Proposals

Evaluation Proposal reception(Mini Assessment)

Responsible Reviewer amp Group Designation

Independent relevant scientific literature review amp previous local technology utilization

analysis (research(s) or alternative financing) or review utilization in other jurisdictions

1st WG Report

Report Review by peers

Report adjustment public presentation and discussion

Interview Proponent Complete or Defend | ambiguous topics

NATS

SP

EC

IFIC

WG

Economic factibility analysis

Favorable Report

NATS Report with economic file

HC LIST INCORPORATION ADMINISTRACcedilAtildeO

SUPERIOR

Decision Aproval or Non-aproval

Evaluation Proposal reception(Mini Assessment) completed with Executive Direction SignatureAdmInst

Adjust amp Process Aquisition planning for Program

Proponent Requisition ndash Specify Bid

Non-aprovalProponent revision claim

WG Review claim

Proponent Information

Existing HTAs regarding efficacy safety effectiveness

or economic aspects if applicable are used or

updated with independent literature searches

If data published is applicable it is reanalyzed and

adapted for the aspect under assessment

Else primary studies are searched systematically

Local data is used to contextualize adapt and cross-

validate applicability or other aspects

HTA reviewing data on HT utilization and on outcomes

research is being used to analyze consistency across

jurisdictions

Structured searches published when applicable are

reproduced to update or adapt for particular aspects

under assessment

NATS-HCFMUSP Scientific Evidence Working Grouprsquos

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

NATS-HCFMUSP

EXAMPLES HTAs completed

bull Positron Emission TomographyOncology

bull Multi-Slices Tomography Coronary Angiography

bull Tacrolimus in Pediatric Heart Transplantation

bull Technologies in Surgical Arrhythmia Ablation

bull Adult heart transplantation cohort study

bull Biologic Agents in Rheumatoid Arthritis

bull Administrative Public Data Mining OLAP instrument

bull Post-marketing surveillance of infusion sets

bull Cohort study congenital heart deffects surgeries

NATS-HCFMUSP EXAMPLES HTAs ongoing

bull Intravascular Ultrasound with virtual histology

bull Cost-effectiveness of Hepatic transplantation

bull Municipal Investigation Methods Coronary Disease

bull Endobronchial Ultrasound Lung Cancer Biopsies

bull Siphon Valves in Hydrocephalus Control

bull Mofetil mycophenolate in immuno-modulation

bull Implantable Devices for Emphysemas

bull Valve implants for Glaucoma control

bull News and existing drugs protocol for neuropathic pain

bull Surgical sutures postmarketing surveillance assessment

bull Cardiac valves replacement costs and effects

bull Lung transplantation cost-effectiveness

Cochrane Handbook for

Systematic Reviews of

Interventions

copy The Cochrane Collaboration

Above cited references are being used for training

graduate and post-graduation students how to do

structured searches in big medical schools

published when applicable are reproduced to

update or adapt for particular aspects under

assessment

NATS-HCFMUSP Scientific Evidence Working Group

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

the active Scientific Evidence Working Group use

specific management software mentioned previously

to perform systematic update alerts for Medical or

Multi-professional Faculty or students and update

searches at main bibliographic databases or editor

sites

You are the experts

Thank you for your attention

Escola de Enfermagem

Instituto de Medicina Legal Instituto de Medicina Tropical

Emiacutelio Ribas

FACULDADE de MEDICINA SECRETARIA DE SAUacuteDE de SP CEFACS ndash Aperfeiccediloam Ciecircncias Sauacutede

The HC-FMUSP

WorkFlow New Technologies Adoption Proposals

Evaluation Proposal reception(Mini Assessment)

Responsible Reviewer amp Group Designation

Independent relevant scientific literature review amp previous local technology utilization

analysis (research(s) or alternative financing) or review utilization in other jurisdictions

1st WG Report

Report Review by peers

Report adjustment public presentation and discussion

Interview Proponent Complete or Defend | ambiguous topics

NATS

SP

EC

IFIC

WG

Economic factibility analysis

Favorable Report

NATS Report with economic file

HC LIST INCORPORATION ADMINISTRACcedilAtildeO

SUPERIOR

Decision Aproval or Non-aproval

Evaluation Proposal reception(Mini Assessment) completed with Executive Direction SignatureAdmInst

Adjust amp Process Aquisition planning for Program

Proponent Requisition ndash Specify Bid

Non-aprovalProponent revision claim

WG Review claim

Proponent Information

Existing HTAs regarding efficacy safety effectiveness

or economic aspects if applicable are used or

updated with independent literature searches

If data published is applicable it is reanalyzed and

adapted for the aspect under assessment

Else primary studies are searched systematically

Local data is used to contextualize adapt and cross-

validate applicability or other aspects

HTA reviewing data on HT utilization and on outcomes

research is being used to analyze consistency across

jurisdictions

Structured searches published when applicable are

reproduced to update or adapt for particular aspects

under assessment

NATS-HCFMUSP Scientific Evidence Working Grouprsquos

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

NATS-HCFMUSP

EXAMPLES HTAs completed

bull Positron Emission TomographyOncology

bull Multi-Slices Tomography Coronary Angiography

bull Tacrolimus in Pediatric Heart Transplantation

bull Technologies in Surgical Arrhythmia Ablation

bull Adult heart transplantation cohort study

bull Biologic Agents in Rheumatoid Arthritis

bull Administrative Public Data Mining OLAP instrument

bull Post-marketing surveillance of infusion sets

bull Cohort study congenital heart deffects surgeries

NATS-HCFMUSP EXAMPLES HTAs ongoing

bull Intravascular Ultrasound with virtual histology

bull Cost-effectiveness of Hepatic transplantation

bull Municipal Investigation Methods Coronary Disease

bull Endobronchial Ultrasound Lung Cancer Biopsies

bull Siphon Valves in Hydrocephalus Control

bull Mofetil mycophenolate in immuno-modulation

bull Implantable Devices for Emphysemas

bull Valve implants for Glaucoma control

bull News and existing drugs protocol for neuropathic pain

bull Surgical sutures postmarketing surveillance assessment

bull Cardiac valves replacement costs and effects

bull Lung transplantation cost-effectiveness

Cochrane Handbook for

Systematic Reviews of

Interventions

copy The Cochrane Collaboration

Above cited references are being used for training

graduate and post-graduation students how to do

structured searches in big medical schools

published when applicable are reproduced to

update or adapt for particular aspects under

assessment

NATS-HCFMUSP Scientific Evidence Working Group

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

the active Scientific Evidence Working Group use

specific management software mentioned previously

to perform systematic update alerts for Medical or

Multi-professional Faculty or students and update

searches at main bibliographic databases or editor

sites

You are the experts

Thank you for your attention

WorkFlow New Technologies Adoption Proposals

Evaluation Proposal reception(Mini Assessment)

Responsible Reviewer amp Group Designation

Independent relevant scientific literature review amp previous local technology utilization

analysis (research(s) or alternative financing) or review utilization in other jurisdictions

1st WG Report

Report Review by peers

Report adjustment public presentation and discussion

Interview Proponent Complete or Defend | ambiguous topics

NATS

SP

EC

IFIC

WG

Economic factibility analysis

Favorable Report

NATS Report with economic file

HC LIST INCORPORATION ADMINISTRACcedilAtildeO

SUPERIOR

Decision Aproval or Non-aproval

Evaluation Proposal reception(Mini Assessment) completed with Executive Direction SignatureAdmInst

Adjust amp Process Aquisition planning for Program

Proponent Requisition ndash Specify Bid

Non-aprovalProponent revision claim

WG Review claim

Proponent Information

Existing HTAs regarding efficacy safety effectiveness

or economic aspects if applicable are used or

updated with independent literature searches

If data published is applicable it is reanalyzed and

adapted for the aspect under assessment

Else primary studies are searched systematically

Local data is used to contextualize adapt and cross-

validate applicability or other aspects

HTA reviewing data on HT utilization and on outcomes

research is being used to analyze consistency across

jurisdictions

Structured searches published when applicable are

reproduced to update or adapt for particular aspects

under assessment

NATS-HCFMUSP Scientific Evidence Working Grouprsquos

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

NATS-HCFMUSP

EXAMPLES HTAs completed

bull Positron Emission TomographyOncology

bull Multi-Slices Tomography Coronary Angiography

bull Tacrolimus in Pediatric Heart Transplantation

bull Technologies in Surgical Arrhythmia Ablation

bull Adult heart transplantation cohort study

bull Biologic Agents in Rheumatoid Arthritis

bull Administrative Public Data Mining OLAP instrument

bull Post-marketing surveillance of infusion sets

bull Cohort study congenital heart deffects surgeries

NATS-HCFMUSP EXAMPLES HTAs ongoing

bull Intravascular Ultrasound with virtual histology

bull Cost-effectiveness of Hepatic transplantation

bull Municipal Investigation Methods Coronary Disease

bull Endobronchial Ultrasound Lung Cancer Biopsies

bull Siphon Valves in Hydrocephalus Control

bull Mofetil mycophenolate in immuno-modulation

bull Implantable Devices for Emphysemas

bull Valve implants for Glaucoma control

bull News and existing drugs protocol for neuropathic pain

bull Surgical sutures postmarketing surveillance assessment

bull Cardiac valves replacement costs and effects

bull Lung transplantation cost-effectiveness

Cochrane Handbook for

Systematic Reviews of

Interventions

copy The Cochrane Collaboration

Above cited references are being used for training

graduate and post-graduation students how to do

structured searches in big medical schools

published when applicable are reproduced to

update or adapt for particular aspects under

assessment

NATS-HCFMUSP Scientific Evidence Working Group

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

the active Scientific Evidence Working Group use

specific management software mentioned previously

to perform systematic update alerts for Medical or

Multi-professional Faculty or students and update

searches at main bibliographic databases or editor

sites

You are the experts

Thank you for your attention

Existing HTAs regarding efficacy safety effectiveness

or economic aspects if applicable are used or

updated with independent literature searches

If data published is applicable it is reanalyzed and

adapted for the aspect under assessment

Else primary studies are searched systematically

Local data is used to contextualize adapt and cross-

validate applicability or other aspects

HTA reviewing data on HT utilization and on outcomes

research is being used to analyze consistency across

jurisdictions

Structured searches published when applicable are

reproduced to update or adapt for particular aspects

under assessment

NATS-HCFMUSP Scientific Evidence Working Grouprsquos

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

NATS-HCFMUSP

EXAMPLES HTAs completed

bull Positron Emission TomographyOncology

bull Multi-Slices Tomography Coronary Angiography

bull Tacrolimus in Pediatric Heart Transplantation

bull Technologies in Surgical Arrhythmia Ablation

bull Adult heart transplantation cohort study

bull Biologic Agents in Rheumatoid Arthritis

bull Administrative Public Data Mining OLAP instrument

bull Post-marketing surveillance of infusion sets

bull Cohort study congenital heart deffects surgeries

NATS-HCFMUSP EXAMPLES HTAs ongoing

bull Intravascular Ultrasound with virtual histology

bull Cost-effectiveness of Hepatic transplantation

bull Municipal Investigation Methods Coronary Disease

bull Endobronchial Ultrasound Lung Cancer Biopsies

bull Siphon Valves in Hydrocephalus Control

bull Mofetil mycophenolate in immuno-modulation

bull Implantable Devices for Emphysemas

bull Valve implants for Glaucoma control

bull News and existing drugs protocol for neuropathic pain

bull Surgical sutures postmarketing surveillance assessment

bull Cardiac valves replacement costs and effects

bull Lung transplantation cost-effectiveness

Cochrane Handbook for

Systematic Reviews of

Interventions

copy The Cochrane Collaboration

Above cited references are being used for training

graduate and post-graduation students how to do

structured searches in big medical schools

published when applicable are reproduced to

update or adapt for particular aspects under

assessment

NATS-HCFMUSP Scientific Evidence Working Group

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

the active Scientific Evidence Working Group use

specific management software mentioned previously

to perform systematic update alerts for Medical or

Multi-professional Faculty or students and update

searches at main bibliographic databases or editor

sites

You are the experts

Thank you for your attention

HTA reviewing data on HT utilization and on outcomes

research is being used to analyze consistency across

jurisdictions

Structured searches published when applicable are

reproduced to update or adapt for particular aspects

under assessment

NATS-HCFMUSP Scientific Evidence Working Grouprsquos

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

NATS-HCFMUSP

EXAMPLES HTAs completed

bull Positron Emission TomographyOncology

bull Multi-Slices Tomography Coronary Angiography

bull Tacrolimus in Pediatric Heart Transplantation

bull Technologies in Surgical Arrhythmia Ablation

bull Adult heart transplantation cohort study

bull Biologic Agents in Rheumatoid Arthritis

bull Administrative Public Data Mining OLAP instrument

bull Post-marketing surveillance of infusion sets

bull Cohort study congenital heart deffects surgeries

NATS-HCFMUSP EXAMPLES HTAs ongoing

bull Intravascular Ultrasound with virtual histology

bull Cost-effectiveness of Hepatic transplantation

bull Municipal Investigation Methods Coronary Disease

bull Endobronchial Ultrasound Lung Cancer Biopsies

bull Siphon Valves in Hydrocephalus Control

bull Mofetil mycophenolate in immuno-modulation

bull Implantable Devices for Emphysemas

bull Valve implants for Glaucoma control

bull News and existing drugs protocol for neuropathic pain

bull Surgical sutures postmarketing surveillance assessment

bull Cardiac valves replacement costs and effects

bull Lung transplantation cost-effectiveness

Cochrane Handbook for

Systematic Reviews of

Interventions

copy The Cochrane Collaboration

Above cited references are being used for training

graduate and post-graduation students how to do

structured searches in big medical schools

published when applicable are reproduced to

update or adapt for particular aspects under

assessment

NATS-HCFMUSP Scientific Evidence Working Group

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

the active Scientific Evidence Working Group use

specific management software mentioned previously

to perform systematic update alerts for Medical or

Multi-professional Faculty or students and update

searches at main bibliographic databases or editor

sites

You are the experts

Thank you for your attention

NATS-HCFMUSP

EXAMPLES HTAs completed

bull Positron Emission TomographyOncology

bull Multi-Slices Tomography Coronary Angiography

bull Tacrolimus in Pediatric Heart Transplantation

bull Technologies in Surgical Arrhythmia Ablation

bull Adult heart transplantation cohort study

bull Biologic Agents in Rheumatoid Arthritis

bull Administrative Public Data Mining OLAP instrument

bull Post-marketing surveillance of infusion sets

bull Cohort study congenital heart deffects surgeries

NATS-HCFMUSP EXAMPLES HTAs ongoing

bull Intravascular Ultrasound with virtual histology

bull Cost-effectiveness of Hepatic transplantation

bull Municipal Investigation Methods Coronary Disease

bull Endobronchial Ultrasound Lung Cancer Biopsies

bull Siphon Valves in Hydrocephalus Control

bull Mofetil mycophenolate in immuno-modulation

bull Implantable Devices for Emphysemas

bull Valve implants for Glaucoma control

bull News and existing drugs protocol for neuropathic pain

bull Surgical sutures postmarketing surveillance assessment

bull Cardiac valves replacement costs and effects

bull Lung transplantation cost-effectiveness

Cochrane Handbook for

Systematic Reviews of

Interventions

copy The Cochrane Collaboration

Above cited references are being used for training

graduate and post-graduation students how to do

structured searches in big medical schools

published when applicable are reproduced to

update or adapt for particular aspects under

assessment

NATS-HCFMUSP Scientific Evidence Working Group

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

the active Scientific Evidence Working Group use

specific management software mentioned previously

to perform systematic update alerts for Medical or

Multi-professional Faculty or students and update

searches at main bibliographic databases or editor

sites

You are the experts

Thank you for your attention

NATS-HCFMUSP EXAMPLES HTAs ongoing

bull Intravascular Ultrasound with virtual histology

bull Cost-effectiveness of Hepatic transplantation

bull Municipal Investigation Methods Coronary Disease

bull Endobronchial Ultrasound Lung Cancer Biopsies

bull Siphon Valves in Hydrocephalus Control

bull Mofetil mycophenolate in immuno-modulation

bull Implantable Devices for Emphysemas

bull Valve implants for Glaucoma control

bull News and existing drugs protocol for neuropathic pain

bull Surgical sutures postmarketing surveillance assessment

bull Cardiac valves replacement costs and effects

bull Lung transplantation cost-effectiveness

Cochrane Handbook for

Systematic Reviews of

Interventions

copy The Cochrane Collaboration

Above cited references are being used for training

graduate and post-graduation students how to do

structured searches in big medical schools

published when applicable are reproduced to

update or adapt for particular aspects under

assessment

NATS-HCFMUSP Scientific Evidence Working Group

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

the active Scientific Evidence Working Group use

specific management software mentioned previously

to perform systematic update alerts for Medical or

Multi-professional Faculty or students and update

searches at main bibliographic databases or editor

sites

You are the experts

Thank you for your attention

Cochrane Handbook for

Systematic Reviews of

Interventions

copy The Cochrane Collaboration

Above cited references are being used for training

graduate and post-graduation students how to do

structured searches in big medical schools

published when applicable are reproduced to

update or adapt for particular aspects under

assessment

NATS-HCFMUSP Scientific Evidence Working Group

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

the active Scientific Evidence Working Group use

specific management software mentioned previously

to perform systematic update alerts for Medical or

Multi-professional Faculty or students and update

searches at main bibliographic databases or editor

sites

You are the experts

Thank you for your attention

Above cited references are being used for training

graduate and post-graduation students how to do

structured searches in big medical schools

published when applicable are reproduced to

update or adapt for particular aspects under

assessment

NATS-HCFMUSP Scientific Evidence Working Group

members are active in specific Medical or Multi-

professional disciplines at each Institute and perform

searches systematically

the active Scientific Evidence Working Group use

specific management software mentioned previously

to perform systematic update alerts for Medical or

Multi-professional Faculty or students and update

searches at main bibliographic databases or editor

sites

You are the experts

Thank you for your attention

the active Scientific Evidence Working Group use

specific management software mentioned previously

to perform systematic update alerts for Medical or

Multi-professional Faculty or students and update

searches at main bibliographic databases or editor

sites

You are the experts

Thank you for your attention