SYNCING INFORMATION CHAINS WITH HEALTH SYSTEMS DEVELOPMENT FOR BETTER OUTCOMES Gabriela Tannus Branco de Araújo, MSc BRICS 2015 1
BRICS Some of the world s fastest growing large economies Health-system reforms - Universal health coverage 40% of the world s population China 1.3 Bi India - 1.2 Bi Russia 146 mio Brazil 204 mio South Africa 51.6 mio The Brazilian health reforms resulted from a political movement that made health a constitutional right, whereas those in China, India, the Russian Federation and South Africa were an attempt to improve the performance of the public system and reduce inequities in access Source: Bull World Health Organ 2014;92:429 435 2
BRICS and Health Care delivery Beijing declaration 2011 - BRICS ministers of health discussed their role in providing wider access to quality and affordable drugs around the world. New Delhi 2013 Scope of cooperation expansion and a strong call for strengthened cooperation in applying affordable, equitable and sustainable solutions both for ensuring access to health services and for combating emerging health threats. Source: http://www.who.int/bulletin/volumes/92/6/14-141051/en/ BRICS Health working groups 1. Strategic health technologies for communicable diseases - led by Brazil 1. Medical technologies - led by the Russian Federation 1. Strengthening health surveillance system - led by India 1. Drug discovery and development - led by China 1. Reducing noncommunicable-disease risk factors, prevention, health promotion and universal health coverage - led by South Africa Source: http://www.who.int/bulletin/volumes/92/6/14-141051/en/ 3
Health care top 50 Country* Population in 2015 Life Expectancy % GDP for Health care Health care cost Per capita China 1.3 Bi 75.2 5.3 322 Brazil 204 mio 73.6 9.3 1,056 Russia 146 mio 70.5 6.3 887 Chile 17.9 mio 79.6 7.2 1,103 Mexico 125 mio 77.1 6.3 618 Colombia 49.5 mio 73.8 6.8 530 Come visit us in September! * Not available info from India and South Africa Source: http://www.bloomberg.com/visual-data/best-and-worst/most-efficient-health-care-2014-countries Brazil, beloved homeland we can do much more! 4
The Brazilian health care system Total population: 204.2 mio (IBGE - Brazil population projection in 2015) Sixth largest global economy 247% per capita investment grow in the last 10 years 75% SUS 153,2 mio 25% Supplementary system 51 mio 23,4% of the federal budget destined to MoH MoH drug distribution program US$ 3.8 Billion in 2013 Total population 204.2 mio 100% western medicine Other important health care markets population Japan 126.3 mio Germany 80 mio France 66.7 mio UK 64.8 mio South Africa 51.6 mio Canada 35.6 mio Australia 23.6 mio Source: Axia.Bio Brazilian market report 2015 The Brazilian reimbursement process very brief explanation CONITEC (HTA commission) For any health technology Multiple stakeholders participation (Including ANS) Supplementary health agency is a public agency, part of the process and has a similar requirement level on their own process, including previous CONITEC review. Local guidelines, checklist and rules for incorporation and disincorporation. Technical exigency level is the same as NICE/UK. Changes in the submission format for reimbursement at SUS: PICO establishment Robust clinical results Real word data how the technology feats in SUS reality Local professionals expertise CEA and BIA Logistics issues Solutions/proposals, not only products Source: Axia.Bio Brazilian market report 2015 5
Administrative Claims - DATASUS Consultation Lab tests Image Hospitalization Procedures Drugs Devices Population, not sample 15 years of data Official database ICD 10 Procedure code Units and R$ Info by: Region State City Age Hospital (with identification) No link between the different databases record linkage can be done in some cases No patient follow-up No health results Epidemiological databases - DATASUS Mortality information System (SIM/MoH) Morbidity data system Compulsory reportable diseases system (SINAN/MoH) National immunization program System (PNI/MoH) Health virtual library (BVS/MoH) Sentinel Surveillance System for FLU (Sivepgripe/SVS) Cervical cancer information system (Siscolo/MoH) Breast cancer information system (Sismama/MoH) Hypertension and Diabetes information system (Hiperdia/MoH) National health research (PNS/IBGE) - New And others. 6
Administrative claims - Supplementary Health care Consultation Lab and image tests Procedures, drugs and devices Hospitalization Patient follow-up ICD 10 Units and R$ Procedure code Sample Not representative of all country most of the times No health results Info by: Region State City Age What we need to sync in Brazil? Paper file Electronic/WEB Local Laws 7
What we need to sync in Brazil? Cohort projects investment With partnership with university Review/discussion of patient health status data access law Running together with the clinical trials law discussion Data registry Culture PCO/PRO Culture gabriela.tannus@axia.bio.br www.axiabiobrazil.com 8