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Challenges to decision-making processes in the national HTA agency in Brazil: operational procedures, evidence use and recommendations

Overview of attention for article published in Health Research Policy and Systems, May 2018
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  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (78th percentile)

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Title
Challenges to decision-making processes in the national HTA agency in Brazil: operational procedures, evidence use and recommendations
Published in
Health Research Policy and Systems, May 2018
DOI 10.1186/s12961-018-0319-8
Pubmed ID
Authors

Tania Yuka Yuba, Hillegonda Maria Dutilh Novaes, Patrícia Coelho de Soárez

Abstract

The quality of the evidence used in health technology assessment (HTA) agency reports has been considered essential for decision-making processes and their legitimacy. In Brazil, CONITEC is the agency responsible for defining data mandatory for the submission of proposals for the incorporation of new technologies. The objective of this study was to analyse CONITEC recommendation reports, the type of scientific evidence used in them and their compliance with operational procedures. This is a descriptive study based on CONITEC official reports from July 2012 through December 2016. Data were collected with a specific extraction form and analysed using descriptive statistics. We evaluated 199 CONITEC recommendation reports. The annual number of reports increased during the study period. The absolute annual number of new technologies incorporated in 2013 (n = 24) was similar to that observed for 2014 (n = 24) and 2015 (n = 22), decreasing in 2016 (n = 13). The type of technology most frequently evaluated was 'drugs' (68.3%), followed by 'procedures' (20.1%). Overall, 117 (58.8%) reports were internal demands, 75 (37.7%) were external demands and 7 (3.5%) were mixed demands. There were differences between internal and external demands in terms of the evidence used in the reports and the decision regarding the recommendation to incorporate the technologies. Among the internal demands, the recommendation to incorporate the new technology was made for 70.9% of the reports, only 9.6% of which included full HTAs. Among the external demands, the incorporation of the new technology was recommended for 17.3% of the reports, 76.9% of which included full HTAs. Of the 101 reports in which incorporation of the new technology was recommended, 88 (87.1%) did not include a full health economic evaluation and ICER calculation. There are compliance difficulties with the recommendations in the CONITEC internal regulations regarding the type and quality of evidence considered in the analysis of recommendation reports. The characteristics of the evidence used in recommendation reports and those considered to be mandatory were very different, indicating problems in decision-making processes. There is a need to study, with a broader perspective, the factors that influence the type of evidence used in decision-making processes in order to contribute to the development of better practices and policies.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 91 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 91 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 12 13%
Student > Doctoral Student 9 10%
Researcher 7 8%
Student > Ph. D. Student 7 8%
Professor 6 7%
Other 15 16%
Unknown 35 38%
Readers by discipline Count As %
Medicine and Dentistry 17 19%
Nursing and Health Professions 10 11%
Social Sciences 7 8%
Business, Management and Accounting 5 5%
Biochemistry, Genetics and Molecular Biology 4 4%
Other 13 14%
Unknown 35 38%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 9. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 May 2018.
All research outputs
#4,082,517
of 25,311,095 outputs
Outputs from Health Research Policy and Systems
#552
of 1,378 outputs
Outputs of similar age
#72,215
of 332,557 outputs
Outputs of similar age from Health Research Policy and Systems
#23
of 25 outputs
Altmetric has tracked 25,311,095 research outputs across all sources so far. Compared to these this one has done well and is in the 83rd percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,378 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 12.7. This one has gotten more attention than average, scoring higher than 59% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 332,557 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 78% of its contemporaries.
We're also able to compare this research output to 25 others from the same source and published within six weeks on either side of this one. This one is in the 8th percentile – i.e., 8% of its contemporaries scored the same or lower than it.