Abstract
Introduction: Health technology assessment (HTA) is understood as a practice that seeks to guide decision-making on processes of incorporation and use of health technologies in order to promote equitable, efficient and quality health services and systems. In the state of Ceará, as in Brazil, the HTA process developed at a faster pace from the year 2000, culminating in the institutionalization of its practices. Objective: To conduct a historical review of the development of HTA in the state of Ceará, Brazil, seeking to understand the current context and the challenges that lie ahead. Methods: This is an experience report, in which the data came from research in documents, regulations and management reports, and through formal and informal conversations with managers and technicians involved with HTA in the state of Ceará, Brazil. Results: HTA was developed in Ceará mainly through actions of the State Health Department (Sesa), starting in 2000, with the creation of the Health Economics Cell, which began studies in health economics and HTA. Subsequently, a Working Group on HTA (GT-HTA) was created, which aimed to improve the process of incorporation and use of health technologies in the state. The GT-ATS participated in a Spanish consultancy, which culminated in the development of training activities, participation in events and exchange of experiences with national and international institutions, such as a study trip to Spain to observe the ATS system and adapt experiences from Spanish agencies in Ceará. In 2007, the Center for Science, Technology and Innovation in Health (NUCIT) was created within the Sesa structure, which in 2009 drove the creation of the ATS Commission (CATS), as a Center for Health Technology Assessment (NATS-Sesa), which had the purpose of advising managers on the incorporation, dissemination and obsolescence of health technologies. Starting in 2009, NATS were established in three teaching hospitals of the state network and in the University Hospital of the Federal University of Ceará, through public calls for funding and support from the Ministry of Health. Since then, the ATS in Ceará has strengthened, carrying out a series of technical-scientific activities, with the publication of opinions and information and the development of research, training and events. In 2014, the first NATS outside the capital Fortaleza was implemented, at the Regional University of Cariri. In the years that followed, NATS-Sesa had other names, and is currently under the management of the Coordination of Policies for Pharmaceutical Assistance and Health Technologies, under which the ATS Cell was recently established, with the purpose of strengthening the ATS within the state. Discussion and conclusions: Ceará followed the process of development of the ATS nationally, with moments of growth and greater difficulties. Over the years, the six NATS in Ceará have produced scientific evidence and research that support health decision-making in the state and contribute to the strengthening and expansion of Rebrats. The state must seek to follow national and global trends, which are anchored in the formation of collaborative networks and the translation of HTA into effective, efficient and sustainable clinical policies and practices, based on studies based on the real needs of the state of Ceará and Brazil.
