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Health Technology Assessment and private health insurance in Brazil: a scoping review and document analysis

Health Technology Assessment (HTA) supports public policies on technology management in several countries. In Brazil, the institutionalization of HTA began in 2000 at the Ministry of Health, and had the participation of the National Regulatory Agency for Private Health Insurance (ANS). However, the public and the private systems have taken different paths. Different HTA processes can generate rework, inefficiency and increase inequities between the public and the private sectors. The objective of this research was to identify the duality between those two sectors regarding the current models of HTA implemented in the country. A scoping review of the literature was carried out from 2000 to 2019, in the Medline, Scopus, Web of Science and Lilacs databases. ANS documents were also analyzed, relating to the HTA process in private health insurance sector. The literature review found a shortage of articles on the topic, while the document analysis allowed to draw a timeline with the main milestones related to the Agency’s HTA process. It was concluded that the national coordination of an HTA model is desired, aiming at increasing the transparency of the institutions, the greater credibility of their decisions, greater efficiency of the process, and providing greater equity.