NOVOS MEDICAMENTOS APENAS DISPONIBILIZADOS A NÍVEL HOSPITALAR: O PROCESSO DE COMPRA PELOS HOSPITAIS DO SNS E A AVALIAÇÃO ECONÓMICA
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.25756/rpf.v5i2.49 |
Resumo: | Introduction: The access to hospital use drugs (HUD) in the Portuguese National Health Service (NHS) hospitals is a two-stage decision process. The first stage is the reimbursement approval at the national level and the second stage is the purchasing decision by Drug and Therapeutic Committees (DTCs) of each NHS hospital.Objectives: To identify the most important factors considered by DTCs when deciding to buy a new HUD and to understand the utility of economic evaluation studies (EES) in this context.Methods: A postal survey was developed and sent to hospital pharmacy directors and clinical directors of all Portuguese NHS hospitals.Results: A response rate of 25% was obtained. Evidence on cost-effectiveness, safety, effectiveness and the lack of therapeutic alternatives were considered, on average, as more important factors than budget impact analysis or acquisition costs to consider in this decision-making process. The Prior Assessment Reports were chosen as the most important source of information used, with EES publications in sixth place. Among barriers and factors that could simplify the use of EES are the distrust on EES financed by the pharmaceutical industry and local needs as to consider more therapeutic alternatives and a hospital perspective in EES. Ethical objections to applying economic criteria in the decision-making process do not seem a barrier to use EES.Conclusions: This analysis allowed a foremost analysis about the decision-making process of introducing new HUD in Portuguese NHS hospitals, notwithstanding its limitations as the low response rate. Cost-effectiveness analyses were considered of higher importance to the decision-making process, with special reference to Prior Assessment Reports. However, there is a high distrust level on EES financed by the pharmaceutical industry. Some needs of local decision-makers were also identified. Including more therapeutic alternatives and a hospital perspective were stressed as their main specific needs. |
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NOVOS MEDICAMENTOS APENAS DISPONIBILIZADOS A NÍVEL HOSPITALAR: O PROCESSO DE COMPRA PELOS HOSPITAIS DO SNS E A AVALIAÇÃO ECONÓMICANOVOS MEDICAMENTOS APENAS DISPONIBILIZADOS A NÍVEL HOSPITALAR: O PROCESSO DE COMPRA PELOS HOSPITAIS DO SNS E A AVALIAÇÃO ECONÓMICAIntroduction: The access to hospital use drugs (HUD) in the Portuguese National Health Service (NHS) hospitals is a two-stage decision process. The first stage is the reimbursement approval at the national level and the second stage is the purchasing decision by Drug and Therapeutic Committees (DTCs) of each NHS hospital.Objectives: To identify the most important factors considered by DTCs when deciding to buy a new HUD and to understand the utility of economic evaluation studies (EES) in this context.Methods: A postal survey was developed and sent to hospital pharmacy directors and clinical directors of all Portuguese NHS hospitals.Results: A response rate of 25% was obtained. Evidence on cost-effectiveness, safety, effectiveness and the lack of therapeutic alternatives were considered, on average, as more important factors than budget impact analysis or acquisition costs to consider in this decision-making process. The Prior Assessment Reports were chosen as the most important source of information used, with EES publications in sixth place. Among barriers and factors that could simplify the use of EES are the distrust on EES financed by the pharmaceutical industry and local needs as to consider more therapeutic alternatives and a hospital perspective in EES. Ethical objections to applying economic criteria in the decision-making process do not seem a barrier to use EES.Conclusions: This analysis allowed a foremost analysis about the decision-making process of introducing new HUD in Portuguese NHS hospitals, notwithstanding its limitations as the low response rate. Cost-effectiveness analyses were considered of higher importance to the decision-making process, with special reference to Prior Assessment Reports. However, there is a high distrust level on EES financed by the pharmaceutical industry. Some needs of local decision-makers were also identified. Including more therapeutic alternatives and a hospital perspective were stressed as their main specific needs. Introdução: Após a aprovação pelo INFARMED da comparticipação de novos medicamentos hospitalares (MH) pelo Serviço Nacional de Saúde (SNS), existe um segundo nível de decisão, nos hospitais, a cargo das comissões de farmácia e terapêutica (CFT).Objetivos: Identificar os fatores mais importantes no processo de tomada de decisão de compra de novos medicamentos hospitalares pelas CFT dos hospitais do SNS e compreender a utilidade de estudos de avaliação económica (EAE) neste contexto.Métodos: Desenvolveu-se um questionário postal que se endereçou aos diretores dos serviços farmacêuticos e diretores clínicos dos hospitais do SNS (n=108).Resultados: Obteve-se uma taxa de resposta de 25 por cento. A evidência de custo-efetividade, segurança, efetividade e a falta de alternativas terapêuticas foram avaliadas, em média, como sendo mais importantes no processo de tomada de decisão do que análises de impacto orçamental ou custos de aquisição. Os relatórios de avaliação prévia são referidos como a fonte de informação mais utilizada, com as publicações de EAE em sexto lugar. Entre barreiras e facilitadores de utilização de EAE destacam-se a desconfiança para com EAE financiados pela indústria farmacêutica e necessidades locais, como a consideração de mais alternativas terapêuticas e de análises na perspetiva hospitalar nos EAE. Objeções éticas à consideração de critérios económicos não demonstraram constituir uma barreira relevante.Conclusões: Este estudo permitiu uma primeira análise sobre o processo de decisão de compra de novos MH pelos hospitais do SNS, apesar das suas limitações, como a baixa taxa de resposta. As análises de custo--efetividade foram consideradas de elevada importância neste processo de decisão, com especial recurso aos relatórios de avaliação prévia. Contudo, identificou-se um elevado nível de desconfiança sobre EAE financiados pela indústria farmacêutica. Analisaram-se também as necessidades específicas dos decisores locais na utilização de EAE, destacando-se a necessidade de incluir nos EAE mais alternativas terapêuticas e uma perspetiva hospitalar.Formifarma2013-06-23info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.25756/rpf.v5i2.49https://doi.org/10.25756/rpf.v5i2.49Revista Portuguesa de Farmacoterapia / Portuguese Journal of Pharmacotherapy; Vol 5 No 2 (2013): Abril; 4-20Revista Portuguesa de Farmacoterapia; v. 5 n. 2 (2013): Abril; 4-202183-73411647-354Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttp://revista.farmacoterapia.pt/index.php/rpf/article/view/49http://revista.farmacoterapia.pt/index.php/rpf/article/view/49/38Direitos de Autor (c) 2017 Revista Portuguesa de Farmacoterapiahttp://creativecommons.org/licenses/by-nc-nd/4.0info:eu-repo/semantics/openAccessPaquete, Ana Teresa2023-09-01T04:33:06Zoai:ojs.farmacoterapia.pt:article/49Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:11:31.454051Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
NOVOS MEDICAMENTOS APENAS DISPONIBILIZADOS A NÍVEL HOSPITALAR: O PROCESSO DE COMPRA PELOS HOSPITAIS DO SNS E A AVALIAÇÃO ECONÓMICA NOVOS MEDICAMENTOS APENAS DISPONIBILIZADOS A NÍVEL HOSPITALAR: O PROCESSO DE COMPRA PELOS HOSPITAIS DO SNS E A AVALIAÇÃO ECONÓMICA |
title |
NOVOS MEDICAMENTOS APENAS DISPONIBILIZADOS A NÍVEL HOSPITALAR: O PROCESSO DE COMPRA PELOS HOSPITAIS DO SNS E A AVALIAÇÃO ECONÓMICA |
spellingShingle |
NOVOS MEDICAMENTOS APENAS DISPONIBILIZADOS A NÍVEL HOSPITALAR: O PROCESSO DE COMPRA PELOS HOSPITAIS DO SNS E A AVALIAÇÃO ECONÓMICA Paquete, Ana Teresa |
title_short |
NOVOS MEDICAMENTOS APENAS DISPONIBILIZADOS A NÍVEL HOSPITALAR: O PROCESSO DE COMPRA PELOS HOSPITAIS DO SNS E A AVALIAÇÃO ECONÓMICA |
title_full |
NOVOS MEDICAMENTOS APENAS DISPONIBILIZADOS A NÍVEL HOSPITALAR: O PROCESSO DE COMPRA PELOS HOSPITAIS DO SNS E A AVALIAÇÃO ECONÓMICA |
title_fullStr |
NOVOS MEDICAMENTOS APENAS DISPONIBILIZADOS A NÍVEL HOSPITALAR: O PROCESSO DE COMPRA PELOS HOSPITAIS DO SNS E A AVALIAÇÃO ECONÓMICA |
title_full_unstemmed |
NOVOS MEDICAMENTOS APENAS DISPONIBILIZADOS A NÍVEL HOSPITALAR: O PROCESSO DE COMPRA PELOS HOSPITAIS DO SNS E A AVALIAÇÃO ECONÓMICA |
title_sort |
NOVOS MEDICAMENTOS APENAS DISPONIBILIZADOS A NÍVEL HOSPITALAR: O PROCESSO DE COMPRA PELOS HOSPITAIS DO SNS E A AVALIAÇÃO ECONÓMICA |
author |
Paquete, Ana Teresa |
author_facet |
Paquete, Ana Teresa |
author_role |
author |
dc.contributor.author.fl_str_mv |
Paquete, Ana Teresa |
description |
Introduction: The access to hospital use drugs (HUD) in the Portuguese National Health Service (NHS) hospitals is a two-stage decision process. The first stage is the reimbursement approval at the national level and the second stage is the purchasing decision by Drug and Therapeutic Committees (DTCs) of each NHS hospital.Objectives: To identify the most important factors considered by DTCs when deciding to buy a new HUD and to understand the utility of economic evaluation studies (EES) in this context.Methods: A postal survey was developed and sent to hospital pharmacy directors and clinical directors of all Portuguese NHS hospitals.Results: A response rate of 25% was obtained. Evidence on cost-effectiveness, safety, effectiveness and the lack of therapeutic alternatives were considered, on average, as more important factors than budget impact analysis or acquisition costs to consider in this decision-making process. The Prior Assessment Reports were chosen as the most important source of information used, with EES publications in sixth place. Among barriers and factors that could simplify the use of EES are the distrust on EES financed by the pharmaceutical industry and local needs as to consider more therapeutic alternatives and a hospital perspective in EES. Ethical objections to applying economic criteria in the decision-making process do not seem a barrier to use EES.Conclusions: This analysis allowed a foremost analysis about the decision-making process of introducing new HUD in Portuguese NHS hospitals, notwithstanding its limitations as the low response rate. Cost-effectiveness analyses were considered of higher importance to the decision-making process, with special reference to Prior Assessment Reports. However, there is a high distrust level on EES financed by the pharmaceutical industry. Some needs of local decision-makers were also identified. Including more therapeutic alternatives and a hospital perspective were stressed as their main specific needs. |
publishDate |
2013 |
dc.date.none.fl_str_mv |
2013-06-23 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.25756/rpf.v5i2.49 https://doi.org/10.25756/rpf.v5i2.49 |
url |
https://doi.org/10.25756/rpf.v5i2.49 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
http://revista.farmacoterapia.pt/index.php/rpf/article/view/49 http://revista.farmacoterapia.pt/index.php/rpf/article/view/49/38 |
dc.rights.driver.fl_str_mv |
Direitos de Autor (c) 2017 Revista Portuguesa de Farmacoterapia http://creativecommons.org/licenses/by-nc-nd/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Direitos de Autor (c) 2017 Revista Portuguesa de Farmacoterapia http://creativecommons.org/licenses/by-nc-nd/4.0 |
eu_rights_str_mv |
openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
Formifarma |
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Formifarma |
dc.source.none.fl_str_mv |
Revista Portuguesa de Farmacoterapia / Portuguese Journal of Pharmacotherapy; Vol 5 No 2 (2013): Abril; 4-20 Revista Portuguesa de Farmacoterapia; v. 5 n. 2 (2013): Abril; 4-20 2183-7341 1647-354X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799129986050818048 |