[Technology assessment in health care: bone densitometry and alternative therapies in post-menopausal osteoporosis].
This article briefly presents the target factors and methods for summarizing evidence employed in a technological evaluation, as well as the underlying logic in their elaboration and utilization in the field of public health. The example is post-menopausal osteoporosis, analyzing the current timeliness of disseminating bone densitometry and technologies to combat osteoporosis in Brazil Available studies on the effects of the respective technologies were reviewed according to the recommended methodology in order to produce a synthesis of the scientific evidence, updated and applied in Brazil. Preliminary cost-effective analyses of different alternatives for intervention (as compared to traditional care) are presented, considering women in and around menopause and at 65 years of age. Despite the optimistic hypotheses, the incremental cost estimates per averted fracture were high, all above R$ 10,000 for any of the various intervention alternatives, as compared to a mean cost of fractures treated by traditional care estimated at less than R$ 2,000, suggesting that the implementation of any of the target alternatives in the SUS would be questionable according to both efficiency criteria in the use of resources as well as equity.
Silva
Leticia Krauss
LK
Departamento de Administração e Planejamento em Saúde, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, 21041-210, Brasil. leticiak@ensp.fiocruz.br
D000368:Aged; D000465:Algorithms; D015519:Bone Density / Q000187:drug effects; D003362:Cost-Benefit Analysis; D003720:Densitometry; D005260:Female; D050723:Fractures, Bone / Q000191:economics / Q000517:prevention & control; D020249:Hormone Replacement Therapy; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy*; D012307:Risk Factors; D013673:Technology Assessment, Biomedical / Q000191:economics
Avaliação tecnológica em saúde: densitometria óssea e terapêuticas alternativas na osteoporose pós-menopausa.