Abstract
Introduction: The National Supplementary Health Agency (ANS) has made it possible to display economic data, through visual resources (interactive panels, dashboards), that present relevant information on the requests for incorporations evaluated for the supplementary health system in Brazil. Objective: To evaluate the results and methodologies used in the budget impact analyses (AIO) and health economic evaluations (AES) in the proposals for incorporation of technologies for oncological diseases submitted to the Brazilian supplementary health system. Material and Method: We carried out a review of the data publicly available on the ANS dashboard with the AIO and AES results of the proposals for incorporation of technologies for oncological diseases submitted to the Brazilian supplementary health system, between the years 2021 and 2023. The dashboard presents data related to the results of the incorporations, methodologies used and values presented in the analyses, among others. Results: A total of 47 technical analysis units (TAUs) proposed in 2021 (n=14), 2022 (n=15), and 2023 (n=18) were included, 38 for drugs and 9 for procedures, with 34 incorporated (72%) and 13 not incorporated (28%). The incremental budgetary impact on the 47 requests showed a median of R$18,918,490 (minimum -R$26,527,172, maximum R$248,265,355). When evaluating only the 34 incorporated requests, the median was R$16,069,365 (minimum -R$26,527,172, maximum R$94,031,075). In non-incorporated requests, the median was R$23,555,865 (minimum R$2,643,454, maximum R$248,665,355). The most commonly used types of AES were cost-utility – R$/QALY (n=33/47, 67% incorporated and 33% not incorporated), followed by cost-minimization – per patient (n=14/47, 93% incorporated and 7% not incorporated). Conclusions: As observed in the results of this study, technology assessment requests incorporated by ANS presented a range with lower budgetary impact values (minimum to maximum) compared to non-incorporated requests. No incorporation request with a negative incremental budgetary impact was denied in the evaluations with data available in the panel. Although the most commonly used type of AES is cost-utility (R$/QALY), requests with cost-minimization presented a higher incorporation rate (93% vs. 67%). Finally, it was observed that most of the technologies requested for oncological diseases in the Brazilian supplementary health system were incorporated, and these presented a median difference of -R$16 million in relation to non-incorporations.
