Supporting evidence-based decisions of the Brazilian Regulatory Agency for Supplementary Healthcare: a case study
Ana Luiza Martimbianco, Hospital Sírio-libanês / Unimes
Rachel Riera, Hospital Sírio-Libanês / Universidade Federal de São Paulo / Cochrane Affiliate Rio de Janeiro
2Hospital Sírio-Libanês / Centro Unversitário São Camilo, Brazil
3Hospital Sírio-Libanês, Brazil
4Hospital Sírio-Libanês / Universidade Federal de São Paulo, Brazil
Background: The Brazilian health system is composed of a public system (Sistema Único de Saúde [SUS]) and a supplementary health sector regulated by the Agência Nacional de Saúde Suplementar (ANS), an autonomous government agency responsible for maintaining a catalogue that informs which medicines, devices, and procedures must be provided by health plans [1,2]. The process of evaluating a technology to be incorporated into the catalogue is continuous and has been qualified by the adoption of health technology assessment (HTA) guides and evidence-based health concepts. To this end, ANS has relied on the impartial support of institutions of excellence in research and HTA.
Objectives: To report the implementation and partial results of the project “Supporting the Brazilian regulatory agency for supplementary healthcare using health technology assessment actions”, an initiative from Hospital Sírio-Libanês, Brazil, conducted from 2020 to 2023, to support the ANS and is funded by the Brazilian Ministry of Health initiative (PROADI-SUS).
Methods: This was a case study  conducted at Health Technology Center, Hospital Sírio-Libanês, São Paulo, Brazil.
Results: From 2020 to July 2022, the following activities and products were completed: 59 technical methodological reports assessing the efficacy, safety, cost-effectiveness, and budget impact of technologies received by the ANS to compose its catalogue of drugs products and services; 50 analyses of society contributions from public consultation; 34 methodological or clinical tutorial sessions to support ANS team; 2 templates to standardise the update process of ANS catalogue; and 1 training course on systematic reviews and meta-analysis for ANS team.
Conclusions: The project has contributed to increasing ANS autonomy in HTA, collaborating to efficiency in technologies offer to the users. By adopting and fostering evidence-based knowledge construction, the project reinforces its bridging role in supporting the consonance between public system and supplementary sector of healthcare in Brazil. Patient, public, and/or healthcare consumer involvement: The actions developed in this project are structuring and contribute to the rational choice of technologies available to the almost 50 million users of the supplementary health sector, improving the efficiency of this system and ensuring robustness and reliability for decision-making.