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Novos mecanismos de pagamento e avaliação económica de antibióticos em Portugal
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Abstract(s)
O aparecimento das resistências antimicrobianas (RAM) representa uma ameaça crescente para a sustentabilidade dos sistemas de saúde e para a eficácia dos tratamentos. A indisponibilidade de antibióticos de primeira linha, seja devido a ruturas de stock ou ao desenvolvimento de resistências, pode levar à prescrição de alternativas mais caras, com maior potencial de efeitos colaterais e resistência adicional.
Este estudo tem como objetivo principal analisar e comparar os modelos de avaliação e financiamento de antibióticos em países europeus, nomeadamente a Suécia, o Reino Unido e Portugal, com o intuito de identificar boas práticas e propor melhorias para o contexto português.
No Reino Unido, foram testadas abordagens inovadoras, como o modelo de subscrição-pagamento e uma nova abordagem para as Avaliações de Tecnologias de Saúde (HTA) dos antibióticos. Na Suécia, embora os esforços tenham sido limitados a estudos piloto, práticas semelhantes têm sido exploradas.
Para demonstrar que os modelos implementados na Suécia e no Reino Unido possivelmente estão a ter sucesso podemos analisar dois indicadores principais: a taxa de mortalidade atribuídas às RAM e o número de antibióticos aprovados e comercializados. Em 2019 a Suécia apresentou um taxa de mortalidade atribuida às RAM de 5,7 mortes por cada 100.000 habitantes. Embora o Reino Unido tenha uma taxa de mortalidade atribuída às RAM mais alta que a Suécia (11,3 por cada 100.000 habitantes) este valor continua a ser inferior ao apresentado por Portugal (20,9 por 100 000 habitantes) Em relação ao número de antibióticos comercializados em cada país, dos 12 novos antibióticos aprovados pela EMA entre 2010 e 2019, a Suécia comercializou 8, o Reino Unido 9 e Portugal 4.
Esta revisão identifica mecanismos que possam ser implementados em Portugal de avaliação o financiamento de antibióticos, com base nas boas práticas internacionais, garantindo a sustentabilidade do sistema de saúde e enfrentando o desafio da resistência antimicrobiana.
The emergence of antimicrobial resistance (AMR) poses a growing threat to the sustainability of healthcare systems and the effectiveness of treatments. The unavailability of first-line antibiotics, whether due to stock shortages or resistance development, can lead to the prescription of more expensive alternatives with a higher potential for side effects and further resistance. This study aims to analyse and compare antibiotic evaluation and payment models in European countries, specifically Sweden, the United Kingdom, and Portugal, in order to identify best practices and propose improvements for the Portuguese context. In the United Kingdom, innovative approaches for antibiotics have been tested, such as the subscription-payment model and a new approach to Health Technology Assessments (HTA). In Sweden, although efforts have been limited to pilot studies, similar practices have been explored. To demonstrate the potential success of the models implemented in Sweden and the United Kingdom, we can analyse two main indicators: the mortality rate attributable to AMR and the number of approved and marketed antibiotics. In 2019, Sweden reported an AMR-attributable mortality rate of 5,7 deaths per 100,000 inhabitants. Although the United Kingdom has a higher AMR-attributable mortality rate than Sweden (11,3 per 100,000 inhabitants), this value remains lower than that of Portugal (20,9 per 100,000 inhabitants). Regarding the number of marketed antibiotics in each country, of the 12 new antibiotics approved by the EMA between 2010 and 2019, Sweden marketed 8, the United Kingdom 9, and Portugal 4. This review identifies mechanisms for antibiotic evaluation and financing that could be implemented in Portugal, based on international best practices, ensuring the sustainability of the healthcare system and addressing the challenge of antimicrobial resistance.
The emergence of antimicrobial resistance (AMR) poses a growing threat to the sustainability of healthcare systems and the effectiveness of treatments. The unavailability of first-line antibiotics, whether due to stock shortages or resistance development, can lead to the prescription of more expensive alternatives with a higher potential for side effects and further resistance. This study aims to analyse and compare antibiotic evaluation and payment models in European countries, specifically Sweden, the United Kingdom, and Portugal, in order to identify best practices and propose improvements for the Portuguese context. In the United Kingdom, innovative approaches for antibiotics have been tested, such as the subscription-payment model and a new approach to Health Technology Assessments (HTA). In Sweden, although efforts have been limited to pilot studies, similar practices have been explored. To demonstrate the potential success of the models implemented in Sweden and the United Kingdom, we can analyse two main indicators: the mortality rate attributable to AMR and the number of approved and marketed antibiotics. In 2019, Sweden reported an AMR-attributable mortality rate of 5,7 deaths per 100,000 inhabitants. Although the United Kingdom has a higher AMR-attributable mortality rate than Sweden (11,3 per 100,000 inhabitants), this value remains lower than that of Portugal (20,9 per 100,000 inhabitants). Regarding the number of marketed antibiotics in each country, of the 12 new antibiotics approved by the EMA between 2010 and 2019, Sweden marketed 8, the United Kingdom 9, and Portugal 4. This review identifies mechanisms for antibiotic evaluation and financing that could be implemented in Portugal, based on international best practices, ensuring the sustainability of the healthcare system and addressing the challenge of antimicrobial resistance.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Avaliação de tecnologias de saúde Financiamento Antibióticos Portugal Suécia Reino Unido Subscrição-Pagamento