Objective: to analyze the budgetary impact of emicizumab compared to activated prothrombin complex concentrate (aPCC) for the prophylactic treatment of hemophilia A with inhibitors. Material and methods: A budget impact analysis in a hypothetical cohort of 26 Peruvian patients with Hemophilia A with inhibitors. The data comes from scientific articles published in peer-reviewed journals. Three scenarios were considered: the e calculated without bleeding episode costs, the price calculated with bleeding episodes treated with aPCC, and the price calculated with bleeding episodes treated with rFVIIa. Results: The savings for using emicizumab range from S/. 67,531,645 to S/. 120,176,763.84, the most likely being S/. 111,008,056.32. In the most conservative scenario, which assumes that the prophylactic use of emicizumab and aPCC have the same risk of annual bleeding episodes, prophylaxis for t...

An innovative health technology (IHT) should be understood as a new technology that is better in its benefits than the status quo in the local health system. The additional benefit that the IHT means must refer to relevant outcomes for a society based on complete best quality scientific evidence. This proposed definition of IHT then highlights the social value of a health technology, which can be made explicit through that methodological tool, increasingly used globally, called health technology assessment. This approach can help governments, from an ethical and economic perspective, to ensure a more efficient distribution of resources and public budgets for rapid and equitable access of the population to IHT. This article proposes and supports the implementation of this definition of IHT in the decision-making processes in health in the Peruvian context.

Objectives. To describe the prioritization process for developing the clinical practice guidelines (GPC) in the Seguro Social del Peru (EsSalud). Methods. The prioritization process was carried out through a multicriteria analysis in three steps: identify the variables, obtain information from them and assign them a weighting. Finally, an ordered list was obtained that was put to the consideration of the policy makers. Results. The five diseases with the highest number of DALY (disability adjusted life year) were osteoarthritis, glaucoma, schizophrenia, osteoporosis and pathological fractures, and diabetes mellitus. The most spending for drugs were hemophilia, the nephritis group, nephrosis (mainly chronic renal failure), rheumatoid arthritis, breast cancer and AIDS. Priority diseases from the point of view of the services offered were those with high mortality and high disability. Concl...

Se describe el proceso de priorización para el desarrollo de guías de práctica clínica (GPC) en el Seguro Social de Salud del Perú (EsSalud). Se realizó mediante un análisis multicriterio en tres pasos: identificación de las variables, obtención de información de las mismas y asignación de una ponderación. Finalmente, se obtuvo una lista ordenada que fue puesta a consideración de los decisores de política. Se determinó que las cinco enfermedades con mayor número de AVISA (años de vida saludable perdidos) fueron: artrosis, glaucoma, esquizofrenia, osteoporosis y fracturas patológicas, y diabetes mellitus. Las de mayor gasto en medicamentos fueron: hemofilia, el grupo de nefritis, nefrosis (principalmente insuficiencia renal crónica), artritis reumatoide, cáncer de mama y SIDA. Las enfermedades prioritarias desde el punto de vista de la oferta de servicios fueron aquell...

Public health systems have the great challenge of meeting the population's health needs with limited financial resources. Thus, to incorporate new health technologies (HT) in their coverage plans, they use tools that allow them to inform their decisions based on scientific evidence, such as health technology assessments (HTAs). These are developed in a multidisciplinary way, under an explicit methodology, which estimates the value of a technology. With this information, the decision-maker can support his decision, anticipate the impact of its implementation, plan actions, and set goals, all of which promote efficient use of resources, transparency of processes, and facilitate accountability. The Peruvian Social Security healthcare system (EsSalud) implemented, through the Instituto de Evaluación de Tecnologías en Salud e Investigación (IETSI), a decision-making process based on HTAs t...