No CrossRef data available.
Article contents
Evidence-Informed Update of Argentina’s Health Benefit Package: Application of a Rapid Review Methodology
Part of:
Special Collection - Methods
Published online by Cambridge University Press: 11 March 2022
Abstract
Objectives
Argentina has a fragmented healthcare system with social security covering almost two thirds of the population. Its benefit package—called compulsory medical program (PMO; by its Spanish acronym Programa Médico Obligatorio)—has not been formally and widely updated since 2005. However, laws, clinical practice guidelines (CPGs), and a high-cost technology reimbursement fund complement it. Our objective was to comprehensively review such a PMO and propose an update considering the corresponding complementary sources.
Methods
We followed four steps: (i) identification of health technologies from the current PMO and complementary sources, (ii) prioritization, (iii) assessment through rapid health technology assessment (HTA), and (iv) appraisal and recommendations. We evaluated three value domains: quality of evidence, net benefit, and economics, which were summarized in a five-category recommendation traffic-light scale ranging from a strong recommendation in favor of inclusion to a strong recommendation for exclusion.
Results
Eight hundred fifty technologies were identified; 164 of those, considered as high priority, were assessed through rapid HTAs. Those technologies mentioned in laws and CPGs were mostly outpatient essential medicines, whereas those from the reimbursement system were mostly high-cost drugs; of these 101 technologies, 50 percent were recommended to be kept in the PMO. The other 63 (identified by the Superintendence of Health Services, technology producers, and patients) were mostly medical procedures and high-cost drugs; only 25 percent of those resulted in a favorable recommendation.
Conclusions
A methodology based on four clearly identified steps was used to carry out a comprehensive review of an outdated and fragmented benefit package. The use of rapid HTAs and a traffic-light recommendation framework facilitated the deliberative evidence-based update.
- Type
- Method
- Information
- Copyright
- © The Author(s), 2022. Published by Cambridge University Press
Footnotes
We would like to thank researchers Cecilia Mengarelli, MD, and Silvana Cesaroni, MD, Daniel Comande, and Mónica Soria for their work as documentalists and Miss Gabriela Rodriguez for her administrative support. We would also like to thank Edgardo Von Ew and Eduardo Walter Salewsky (ISALUD University), Constantino Touloupas, MD, and Guadalupe Soulages, PharmD, for their research and technical cooperation during this project.
References
Instituto Nacional de Estadísticas y Censos. República Argentina (INDEC)
. Estadísticas. Available at: https://www.indec.gob.ar/nivel4_default.asp?id_tema_1=2&id_tema_2=24&id_tema_3=84. Accessed 12 May 2021.Google Scholar
Instituto Nacional de Estadísticas y Censos. República Argentina (INDEC). Incidencia de la pobreza y la indigencia en 31 aglomerados urbanos. Segundo semestre de 2020. Informes técnicos. Vol. 5, no. 4. Available at: https://www.indec.gob.ar/uploads/informesdeprensa/eph_pobreza_02_2082FA92E916.pdf. Accessed 21 May 2021.Google Scholar
World Bank Group. Argentina overview. Available at: https://www.worldbank.org/en/country/argentina/overview. Accessed 12 May 2021.Google Scholar
Ministerio de Salud. República Argentina. Resolución 1013/2018. Available at: https://www.argentina.gob.ar/normativa/nacional/resolución-1013-2018-310893/texto. Accessed 9 May 2021.Google Scholar
Rubinstein, A, Zerbino, MC, Cejas, C, Lopez, AS (2018) Making universal health care effective in Argentina: A blueprint for reform. Heal Syst Reform 4(3), 203–213.CrossRefGoogle ScholarPubMed
Rubinstein, A, Barani, M, Lopez, AS (2018) Quality first for effective universal health coverage in low-income and middle-income countries. Lancet Glob Heal 6(11), e1142–e1143.CrossRefGoogle ScholarPubMed
Glassman, A, Giedion, U, Smith, PC (2017) What’s In, What’s Out: Designing Benefits for Universal Health Coverage—Key Messages for Donors and Advocates. F1000Research, 6.Google Scholar
World Health Organization. (2014) Making fair choices on the path to universal health coverage: Final report of the WHO Consultative Group on Equity and Universal Health Coverage.Google Scholar
Belló, M, Becerril-Montekio, VM (2011) Sistema de salud de Argentina. Salud Publica Mex 53, s96–s109.Google Scholar
Cetrángolo, O, Goldschmit, A Las obras sociales y otras instituciones de la Seguridad social para la salud en Argentina. Origen y situación actual de un sistema altamente desigual. Available at: http://fcece.org.ar/wp-content/uploads/informes/obras-sociales-argentina.pdf. Accessed 19 May 2021.Google Scholar
Ministerio de Salud-República Argentina Superintendencia de Seguros de Salud. Resolución 1200/2012. Sistema Único de Reintegros. Available at: https://www.argentina.gob.ar/sssalud/transparencia/subsidios/sur. Accessed 9 May 2021.Google Scholar
Ministerio de Salud. República Argentina. Resolución 939/2000. Available at: https://www.sssalud.gob.ar/normativas/consulta/000069.pdf. Accessed 9 May 2021.Google Scholar
Jaimarena, B., Guillermo, Diccionario Enciclopédico de la Legislación Sanitaria Argentina. Programa Médico Obligatorio. Available at: https://salud.gob.ar/dels/entradas/programa-medico-obligatorio. Accessed 9 May 2021.Google Scholar
Youngkong, S (2014) Application of HTA research on policy decision-making. J Med Assoc Thai 97, S119–S126.Google ScholarPubMed
Mohara, A, Youngkong, S, Velasco, RP, et al (2012) Using health technology assessment for informing coverage decisions in Thailand. J Comp Eff Res 1(2), 137–146.CrossRefGoogle ScholarPubMed
World Health Organization (2015) Using health technology assessment for universal health coverage and reimbursement systems. Geneva, Switzerland. Available at: https://www.who.int/health-technology-assessment/HTA_November_meeting_report_Final.pdf. Accessed 9 May 2021.Google Scholar
Glassman, A, Giedion, U, Sakuma, Y, Smith, PC (2016) Defining a health benefits package: What are the necessary processes? Heal Syst Reform 2(1), 39–50.CrossRefGoogle ScholarPubMed
Stolk, EA, de Bont, A, van Halteren, AR, Bijlmer, RJ, Poley, MJ (2009) Role of health technology assessment in shaping the benefits package in the Netherlands. Expert Rev Pharmacoeconomics Outcomes Res 9(1), 85–94.CrossRefGoogle ScholarPubMed
Institute for Clinical Effectiveness and Health Policy. Health technology assessment (HTA) and health economics. Available at: https://www.iecs.org.ar/en/health-technology-assessment-and-economic-evaluations/. Accessed 9 May 2021.Google Scholar
Institute for Clinical Effectiveness and Health Policy. Metodología de elaboración de documentos de ETS. Available at: https://www.iecs.org.ar/metodosets2/. Accessed 9 May 2021.Google Scholar
Alcaraz, A, Hernandez-Vasquez, A, Garcia Marti, S, et al (2017) Developing and piloting a value framework and a tool to inform the “evidence-to-decision making” process. Value Heal 20(9), A854.CrossRefGoogle Scholar
Smith, PC, Chalkidou, K (2017) Should countries set an explicit health benefits package? The case of the English National Health Service. Value Heal 20(1), 60–66.CrossRefGoogle ScholarPubMed
Giedion, U, Bitrán, R, Tristao, I (2014) Health Benefit Plans in Latin America: A Regional Comparison. Washington, DC: Inter-American Development Bank.Google Scholar
Ministerio de Salud de Chile. Subsecretaría de Redes Asistenciales División de Atención Primaria Departamento de Seguimiento de Procesos. Available at: http://www.bibliotecaminsal.cl/wp/wp-content/uploads/2016/03/11.pdf. Accessed 9 May 2021.Google Scholar
World Health Organization. Developing an approach for using health technology assessments in reimbursement systems for medical products: Geneva, Switzerland, July 20–21, 2015.Google Scholar
Alcaraz et al. supplementary material
Alcaraz et al. supplementary material
File
25.4 KB