Palestra apresentada por Denizar Vianna no dia 19/05/2016, no VI Fórum Nacional de Políticas de Saúde em Oncologia

1. Critérios de escolha do tratamento no
Sistema Único de Saúde
Denizar Vianna
Universidade do Estado do Rio de Janeiro
Faculdade de Ciências Médicas
Departamento de Clínica Médica

3. "Promoting treatment irrespective of
the evidence may garner votes, but will
not create healthier voters."
Steven Woloshin, MD, MS; Lisa M. Schwartz, MD, MS
VA Outcomes Group, White River Junction, Vermont,
and the Dartmouth Institute for Health Policy and Clinical Practice, Hanover, New Hampshire.

4. SEGURANÇA
Ensaios Clínicos
Fases I e II
EFICÁCIA
Ensaios Clínicos
Fase III
EFETIVIDADE
Estudos
Observacionais /
Ensaios Clínicos
Pragmáticos
Etapas da Avaliação de Tecnologias em Saúde

5. EFICIÊNCIA
Análise de
Custo-Efetividade
FACTIBILIDADE
Impacto
Orçamentário
Etapas da Avaliação de Tecnologias em Saúde

8. “The use of explicit, standard metrics such
as cost-per-QALY ratios has the advantage
of transparency and can help direct our
resources toward the greatest health
gains”.

9. “The cost for treating early-stage breast cancer
is $78 per DALY with surgery and radiotherapy
vs $4,986 per DALY with systemic chemotherapy
for metastatic disease”.

10. “These sorts of data allow health and finance
ministers to focus investment on interventions
that provide a cost-effective benefit and to
conclude, for example, that it is rational to
detect and treat early breast cancer”.

11. Summary of Therapy Value Frameworks
Organization Factors Considered
American Society of Clinical Oncology (ASCO) Clinical benefit
•Overall survival
•Progression-free survival
•Response rate
Toxicity
Bonus factors
•Palliation
•Time off all treatment
Cost per month
Memorial Sloan Kettering Cancer Center Efficacy (survival)
Toxicity
Novelty
Research and development cost
Rarity
Population health burden
Source: Neumann PJ, Cohen JT. Measuring the Value of Prescription Drugs. N Engl J Med.
2015;373(27):2595-7.

14. "Price is what you pay,
value is what you get"
Warren Buffett

15. OBRIGADO
denizar@uerj.br
Universidade do Estado do Rio de Janeiro
Faculdade de Ciências Médicas
Departamento de Clínica Médica