3rd ISPOR Latin America September 2011 México City, México

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1 Iris Contreras Hernández MsC MD Internal Medicine at the General Hospital Zone No. 1-A Los Venados, IMSS, in Mexico City.) Mexico city, Distrito Federal, Mexico 3rd ISPOR Latin America September 2011 México City, México

2 Mexico, demographic characteristics 2010 Total population: Men-Women relation: 98 men for 100 women Medium Age: 26 Economic Active Population (12 yrs or +): 52.6% Health insurance 64.6% Source: Censo de Población y vivienda(2010) Panorama sociodemográfico de México / Instituto Nacional de Estadística y Geografía- México: INEGI, c2011

3 National Health System Public Social Security Ministry of Health Private SECTOR FUNDS BUYERS SUPPLIERS USER S Goverment Others Pemex ISSSTE IMSS Hospitals Private Healthcare Suppliers Physicians Formal workers Employers Worker s Families Employees Retired Seguro Popular de salud State Goverments Ministry of Health Hospitals, Private healthcare suppliers, Physicians Federal Goverment IMSSoportunidades Hospitals Private healthcare suppliers, Physicians Self-employees, shadow economy, unemployment and subjects out of the labor market Subjects Private Insurance Companies Private Suppliers Population with high income Employers Secretaria de Salud. Programa Nacional de Salud Por un México Sano: construyendo alianzas para una mejor salud.

4 Ministry of health Responsible to elaborate Mexican official norms of the sector Concentrate the sanitary statistics General Health Council Body of Mexican state Character health authority across the country Elaborates, reviews and maintains permanently updated the data of formulary drugs Study and solve the requests for updating the formulary drugs of the providers of health, scientific organizations and suppliers.

5 Need of information General Health Council High authorities and Administrative units of Ministry of health Health public institutions of health system in states HTA Clinical, economic, ethic, societal, and organizational Information provide University and Research centers Academic and medical societies aspects Answers of HTA Evaluation reports Conclusions and recommendations Information to make decision at three levels Macro: Ministry of health Meso: Administrations and third party payer Micro: H Health professionals and patients

6 Based on General law of health 3 each new technology must first obtain a sanitary registry. Made to the Comisión Federal para la Protección contra Riesgos Sanitarios (COFEPRIS) 4, Commission evaluates the security and effectiveness of the product Acceptance allows use in the Public System of Social Security the product must be in the Basic Formulary Medications and medicine catalogue. The private part of the system of national health has freedom to use consumptions that are not in Basic Formulary Medications. 3 Op cit 4 Comisión Federal Para la Protección Contra los Riesgos Sanitarios. accesed: July, 2009

7 Proposal Review Process Specific format to get in basic formulary drugs General Health Council Agency commission 1ª review Efficacy No Accepted Si Security Pharmacoeconomics Notification Agency commission 2ª review No Accepted Publication Si

8 2003 mandate pharmacoeconomics study that exactly says: 2008 Guide for the conduction of studies of economic evaluation for the update of the Basic Formulary Medications of consumptions of the health sector in Mexico 2011 Guideline to evaluation of health inputs Cost-minimization : cost saving Cost effectiveness: Dominated or a life year gain or DALY for less than the percapita nation Cost-benefit: The internal rate of return is at least two points percentage higher than the internal rate of return Annual weighted CETES 28 days

9 Minister of Health agency Main purpose is to produce objective, reliable and timely information related with Health Technologies CENETEC is organized in three main programs: Medical Equipment Planning Health Technology Assessment e-health.

10 The health care system of Mexico, there are need of information that combine assessments of clinical effectiveness, societal values, budget impact and economic efficiency The scientific methods, the assessment and the process have to transparent, credible and consistently applied Training of professionals specializing in evaluating technologies to generate the information necessary and sufficient to support the decision maker