ROSELI FERNANDES RODRIGUES
Projetos de Pesquisa
Unidades Organizacionais
LIM/38 - Laboratório de Epidemiologia e Imunobiologia, Hospital das Clínicas, Faculdade de Medicina
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- Health Economic Evaluations of Cancer in Brazil: A Systematic Review(2018) CAMPOLINA, Alessandro G.; YUBA, Tania Y.; DECIMONI, Tassia C.; LEANDRO, Roseli; DIZ, Maria del Pilar Estevez; NOVAES, Hillegonda M. D.; SOAREZ, Patricia C. deBackground: A large number of health economic evaluation (HEE) studies have been published in developed countries. However, Brazilian HEE literature in oncology has not been studied. Objective: To investigate whether the scientific literature has provided a set of HEE in oncology capable of supporting decision making in the Brazilian context. Methods: A systematic review was conducted to identify and characterize studies in this field. We searched multiple databases selecting partial and full HEE studies in oncology (1998-2013). Results: Fifty-five articles were reviewed, of these, 33 (60%) were full health economic evaluations. Type of cancers most frequently studied were: breast (38.2%), cervical (14.6%), lung (10.9%) and colorectal (9.1%). Procedures (47.3%) were the technologies most frequently evaluated. In terms of the intended purposes of the technologies, most (63.6%) were treatments. The majority of the incremental cost-effectiveness ratios (ICERs) reported have been below the cost-effectiveness threshold suggested by the World Health Organization (WHO). Conclusions: There has been an increase in the number of HEEs related to cancer in Brazil. These studies may support decision-making processes regarding the coverage of and reimbursement of healthcare technologies for cancer treatment in Brazil.
- Systematic Review of Health Economic Evaluations of Diagnostic Tests in Brazil: How accurate are the results?(2017) OLIVEIRA, Maria Regina Fernandes; LEANDRO, Roseli; DECIMONI, Tassia Cristina; ROZMAN, Luciana Martins; NOVAES, Hillegonda Maria Dutilh; SOAREZ, Patricia Coelho DeThe aim of this study is to identify and characterize the health economic evaluations (HEEs) of diagnostic tests conducted in Brazil, in terms of their adherence to international guidelines for reporting economic studies and specific questions in test accuracy reports. We systematically searched multiple databases, selecting partial and full HEEs of diagnostic tests, published between 1980 and 2013. Two independent reviewers screened articles for relevance and extracted the data. We performed a qualitative narrative synthesis. Forty-three articles were reviewed. The most frequently studied diagnostic tests were laboratory tests (37.2%) and imaging tests (32.6%). Most were non-invasive tests (51.2%) and were performed in the adult population (48.8%). The intended purposes of the technologies evaluated were mostly diagnostic (69.8%), but diagnosis and treatment and screening, diagnosis, and treatment accounted for 25.6% and 4.7%, respectively. Of the reviewed studies, 12.5% described the methods used to estimate the quantities of resources, 33.3% reported the discount rate applied, and 29.2% listed the type of sensitivity analysis performed. Among the 12 cost-effectiveness analyses, only two studies (17%) referred to the application of formal methods to check the quality of the accuracy studies that provided support for the economic model. The existing Brazilian literature on the HEEs of diagnostic tests exhibited reasonably good performance. However, the following points still require improvement: 1) the methods used to estimate resource quantities and unit costs, 2) the discount rate, 3) descriptions of sensitivity analysis methods, 4) reporting of conflicts of interest, 5) evaluations of the quality of the accuracy studies considered in the cost-effectiveness models, and 6) the incorporation of accuracy measures into sensitivity analyses.
conferenceObject BUDGET IMPACT ANALYSIS OF VACCINES: WHAT ARE THE METHODOLOGICAL ISSUES?(2017) SOAREZ, P. C. De; SARTORI, A. M.; LEANDRO, R. F.; SILVA, D. R.; SOAREZ, D. S.; CAMPOLINA, A. G.; NOVAES, H. M.- Systematic Review of Health Economic Evaluation Studies Developed in Brazil from 1980 to 2013(2018) DECIMONI, Tassia Cristina; LEANDRO, Roseli; ROZMAN, Luciana Martins; CRAIG, Dawn; IGLESIAS, Cynthia P.; NOVAES, Hillegonda Maria Dutilh; SOAREZ, Patricia Coelho DeBackground: Brazil has sought to use economic evaluation to support healthcare decision-making processes. While a number of health economic evaluations (HEEs) have been conducted, no study has systematically reviewed the quality of Brazilian HEE. The objective of this systematic review was to provide an overview regarding the state of HEE research and to evaluate the number, characteristics, and quality of reporting of published HEE studies conducted in a Brazilian setting. Methods: We systematically searched electronic databases (MEDLINE, EMBASE, Latin American, and Caribbean Literature on Health Sciences Database, Scientific Electronic Library Online, NHS Economic Evaluation Database, health technology assessment Database, Bireme, and Biblioteca Virtual em Saude Economia da Saude); citation indexes (SCOPUS, Web of Science), and Sistema de Informacao da Rede Brasileira de Avaliacao de Tecnologia em Saude. Partial and full HEEs published between 1980 and 2013 that referred to a Brazilian setting were considered for inclusion. Results: In total, 535 studies were included in the review, 36.8% of these were considered to be full HEE. The category of healthcare technologies more frequently assessed were procedures (34.8%) and drugs (28.8%) which main objective was treatment (72.1%). Forty-four percent of the studies reported their funding source and 36% reported a conflict of interest. Overall, the full HEE quality of reporting was satisfactory. But some items were generally poorly reported and significant improvement is required: (1) methods used to estimate healthcare resource use quantities and unit costs, (2) methods used to estimate utility values, (3) sources of funding, and (4) conflicts of interest. Conclusion: A steady number of HEE have been published in Brazil since 1980. To improve their contribution to inform national healthcare policy efforts need to be made to enhance the quality of reporting of HEEs and promote improvements in the way HEEs are designed, implemented (i.e.,using sound methods for HEEs) and reported.
- Many Miles to Go: A Systematic Review of the State of Cost-Utility Analyses in Brazil(2017) CAMPOLINA, Alessandro G.; ROZMAN, Luciana M.; DECIMONI, Tassia C.; LEANDRO, Roseli; NOVAES, Hillegonda M. D.; SOAREZ, Patricia Coelho DeBackground Little is known about the quality and quantity of cost-utility analyses (CUAs) in Brazil. Objective The objective of this study was to provide a systematic review of published CUAs of healthcare technologies in Brazil. Methods We performed a systematic review of economic evaluations studies published in MEDLINE, EMBASE, LILACS (Latin American and Caribbean Health Sciences Literature), SciELO (Scientific Electronic Library Online), NHS EED (National Health Service Economic Evaluation Database), HTA (Health Technology Assessment) Database, Web of Science, Scopus, Bireme (Biblioteca Regional de Medicina), BVS ECOS (Health Economics database of the Brazilian Virtual Library of Health), and SISREBRATS (Sistema de Informacao da Rede Brasileira de Avaliacao de Tecnologias em Saude [Brazilian Network for the Evaluation of Health Technologies]) from 1980 to 2013. Articles were included if they were CUAs according to the classification devised by Drummond et al. Two independent reviewers screened articles for relevance and carried out data extraction. Disagreements were resolved through discussion or through consultation with a third reviewer. We performed a qualitative narrative synthesis. Results Of the 535 health economic evaluations (HEEs) relating to Brazil, only 40 were CUAs and therefore included in the analysis. Most studies adhered to methodological guidelines for quality of reporting and 77.5% used quality-adjusted life-years (QALYs) as the health outcome. Of these studies, 51.6% did not report the population used to elicit preferences for outcomes and 45.2% used a specific population such as expert opinion. The preference elicitation method was not reported in 58.1% of these studies. The majority (80.6%) of studies did not report the instrument used to derive health state valuations and no publication reported whether tariffs (or preference weights) were national or international. No study mentioned the methodology used to estimate QALYs. Conclusions Many published Brazilian cost-utility studies adhere to key recommended general methods for HEE; however, the use of QALY calculations is far from being the current international standard. Development of health preferences research can contribute to quality improvement of health technology assessment reports in Brazil.
- A systematic review of health economic evaluations of vaccines in Brazil(2017) SARTORI, Ana Marli Christovam; ROZMAN, Luciana Martins; DECIMONI, Tassia Cristina; LEANDRO, Roseli; NOVAES, Hillegonda Maria Dutilh; SOAREZ, Patricia Coelho deBackground: In Brazil, since 2005, the Ministry of Health requires Health Economic Evaluation (HEE) of vaccines for introduction into the National Immunization Program.Objectives: To describe and analyze the full HEE on vaccines conducted in Brazil from 1980 to 2013.Methods: Systematic review of the literature. We searched multiple databases. Two researchers independently selected the studies and extracted the data. The methodological quality of individual studies was evaluated using CHEERS items.Results: Twenty studies were reviewed. The most evaluated vaccines were pneumococcal (25%) and HPV (15%). The most used types of HEE were cost-effectiveness analysis (45%) and cost-utility analysis (20%). The research question and compared strategies were stated in all 20 studies and the target population was clear in 95%. Nevertheless, many studies did not inform the perspective of analysis or data sources.Conclusions: HEE of vaccines in Brazil has increased since 2008. However, the studies still have methodological deficiencies.
conferenceObject SYSTEMATIC REVIEW OF BUDGETARY IMPACT ANALYSIS GUIDELINES(2017) RODRIGUES, R. F.; SOAREZ, P. C. De; SILVA, D. R.; CAMPOLINA, A. G.; SARTORI, A. M.; NOVAES, H. M.