– Mrs. Vania Cristina Canuto Santos, Director
History and Purpose
On April 28, 2011, was published the Federal Law 12,401 which provides for the therapeutic care and the incorporation of health technologies within the Brazilian Public Health System (SUS). This law is a milestone for the SUS as it creates the National Committee for Health Technology Incorporation (Conitec) and defines the criteria and deadlines for technology incorporation in the public health system. The Committee is responsible for advising the Brazilian Ministry of Health in the incorporation or disinvestment of health technologies into the SUS and development of clinical guidelines.
Conitec’s recommendations are issued based on the best available scientific evidence regarding efficacy, effectiveness and safety of medicines, procedures and medical devices, as well as in economic evaluation studies of these technologies, developed from the perspective of the public health system. According to legal provisions and in view of increased agility, transparency and efficiency in the analysis of processes of incorporation of technologies, Conitec has 180 days (extendable for another 90 days) to assess requests to incorporate technologies into the SUS and for making a recommendation.
The operational structure of Conitec consists of two boards: Plenary and Executive Secretariat. The Plenary is responsible for issuing recommendations. It consists of thirteen members, one representative from each secretariat of the Ministry of Health – the Plenary’s president is designated by the Secretariat of Science, Technology and Strategic Inputs (SCTIE) – and one representative from each of the following institutions: Brazilian Health Surveillance Agency (ANVISA), National Regulatory Agency for Private Health Insurance and Plans (ANS), National Health Council (CNS), National Council of State Health Secretaries (CONASS), National Council of Municipal Health Secretaries (CONASEMS) and Federal Council of Medicine (CFM). It is up to the Executive Secretariat, operated by the Department of Management and Incorporation of Technologies and Innovation in Health (DGITIS) managing and coordinating the activities of Conitec as well as the issuance of the final report on the technology, which takes into account the scientific evidence, economic evaluation and budget impact of the introduction of technology in the SUS.
All the reports are submitted to Public Consultations in order to ensure transparency and public participation. The contributions and suggestions of the public consultation are analyzed and entered into Conitec’s final report, which is later forwarded to the Secretary of Science, Technology and Strategic Inputs of the Brazilian Ministry of Health for a final decision. The Secretary can also request a public hearing prior to its decision. To guarantee the availability of the incorporated technologies in the SUS, the decree stipulates a deadline of 180 days for making the technology available to the Brazilian population (after the final decision).
The Committee is responsible for advising the Ministry of Health in the:
- Development and updating of clinical guidelines.
- Incorporation or disinvestment of health technologies into the Brazilian Public Health System (SUS).
How the agency works
Currently, the Executive Secretary of Conitec operated by the Department of Management and Incorporation of Health Technology (DGITS), has 30 professionals with multidisciplinary training, essential condition for the development of health technology assessment.
This team critically examines the studies submitted by the applicants regarding the incorporation or exclusion of health technologies, searches for the best evidence on scientific literature and in some cases consults specialists, medical societies and associations and technical areas of the Brazilian Ministry of Health that may directly or indirectly be involved with that incorporation.
In addition to internal staff, Conitec has a network of partner institutions in universities and teaching hospitals that are hired to develop studies assessing health technologies. Conitec also participates in Brazilian Network for Health Technology Assessment (REBRATS) and Health Technology Assessment Network of the Americas (Redetsa).
The studies are developed and disseminated on the website of Conitec in Portuguese, being translated into English and Spanish as needed. Some studies are published as structured abstracts in proceedings of conferences and other events, for example, ISPOR, HTAi, GIN, etc. The website (www.saude.gov.br/conitec) provides all the final reports, clinical guidelines, social participation and information on evaluated demands or ongoing analysis.
A list of recently completed or milestone HTA reports
Since its creation until October 2021, the committee received 880 demands, 324 technologies incorporated, 177 technologies not incorporated and we have 51 demands in evaluation. These numbers are updated day on Conitec’s website: Conitec in Numbers. Examples of reports are:
- Abatacept for rheumatoid arthritis
- Azatioprin, ciclosporin, prednisone, Metotrexato, Metilprednisolona, Micofenolato de sódio, Micofenolato de mofetila, Tacrolimus, Human Imunoglobulin and basiliximab for Immunosuppression in Cardiac Transplantation
- Everolimus and sirolimus for Immunosuppression in Cardiac Transplantation and hepatic
- Clozapine, quetiapia, risperidone and olansapine for bipolar disorder
- Erythropoietin for Anemia, Sickle Cell
- Lamotrigina for bipolar disorder
- Oxibutin for overactive bladder
- Polyvitaminic for obesity after bariatric surgery
- Horizon scanning activities
- Updating of National List of Essential Drug products
- Patient and Public Engagement activities
A list of (selected) current projects
- Health Technology Assessment for advising the Brazilian Ministry of Health in the incorporation or disinvestment of health technologies into the SUS
- Horizon Scanning activities
- Updating of National List of Essential Drug products
- Development of clinical guidelines
- Improvement of Patient and Public engagement
Description of population served: National
Population served (mil):
Current HTA budget (mil USD)
Permanent staff: 19
Ongoing TA projects: Conitec in Numbers
Director: Mrs. Vania Cristina Canuto Santos
Contact person: Clarice Moreira Portugal
Esplanada dos Ministérios
Bl. G, Ed. Sede, 8º andar.
CEP: 70058-900 – Brasília-DF