Key Takeaways
- The SiNATS system has largely met its objectives, improving health outcomes, sustainability, and resource efficiency in Portugal.
- Decision-making times for public funding of medicines are excessively long, averaging over 30 months.
- While overall health spending is stable, access to oncology drugs remains a concern, with disparities in availability across treatment categories.
Study Findings on SiNATS Effectiveness
A recent study presented at the conference “From the Past to the Future: The Revolution in Health Technology Assessment” in Lisbon assessed the effectiveness of the SiNATS system, established in 2015. Jorge Félix, the director of Exigo Consultores, explained that the study aimed to evaluate how well SiNATS achieved its seven key objectives: maximizing health gains, improving quality of life, ensuring sustainable use of resources in the National Health Service (SNS), and promoting equitable access to health technologies.
The assessment overall yielded positive results, but highlighted areas needing improvement. One major concern is the lengthy decision-making process regarding public funding for new medicines, often exceeding 18 months. The study pointed out that the median time between marketing authorization and the availability of innovative and non-innovative drugs is around 30 months, indicating a significant lag in making therapies accessible to patients.
Félix remarked on the inadequacies within the decision-making timelines of Infarmed and the Ministry of Health, despite the existence of early access programs that help mitigate delays. He noted that the number of decisions made by Infarmed often lags behind the number of new drug approvals by the European Medicines Agency (EMA). This gap contributes to a mismatch between the drugs authorized in Europe and those accessible within Portugal.
Health spending in Portugal has been managed sustainably, remaining around 6.5% of the gross domestic product. Between 2012 and 2023, SNS spending on medications rose from approximately 2.2 to 3.6 million euros, though the public spending proportion has remained stable at about 20%. This stability coupled with growth was interpreted as a sign of sustainable financial management.
When discussing equitable access to medical technologies, Félix described a “mixed situation.” Progress has been noted in access to orphan drugs for rare diseases, though oncology drugs reflect an inequity in availability. Nonetheless, there is evidence that SiNATS has successfully reduced waste and inefficiencies within the health system.
In summary, while SiNATS has predominantly achieved its goals and improved efficiencies within the Portuguese health system, challenges in decision-making speed and inequities in drug access remain critical areas for ongoing improvement.
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