These are the conclusions of a study that assessed the effectiveness of SiNATS, created in 2015, and which were presented at the conference "From the Past to the Future: The Revolution in Health Technology Assessment", in Lisbon, promoted by Exigo Consultores, which prepared the analysis.

The director of Exigo, Jorge Félix, told Lusa that the aim of the study was to assess the effectiveness of the system in relation to the seven objectives outlined: Maximising health gains and improving the population's quality of life, contributing to the sustainability of the National Health Service and ensuring the efficient use of public health resources.

Other objectives include monitoring the use and effectiveness of technologies, reducing waste and inefficiencies, promoting and rewarding the development of relevant innovation and promoting equitable access to technologies.

Overall, "the assessment is quite positive", with many of the objectives achieved, but there are aspects that need to be improved, such as the assessment and decision-making times on public funding for medicines, which are generally very long, exceeding 18 months in most cases.

Decision-making

"Unfortunately, the decision-making time of Infarmed and the Ministry of Health is excessively long, although there are some mechanisms that mitigate access, such as early access programmes, but this is still one of the areas that the Ministry of Health needs to improve", he argued.

The study indicates that the median time between marketing authorization and public funding was 30.6 months for innovative drugs and 29.7 months for non-innovative drugs.

It highlights that, despite the advances with the creation of SiNATS, "The number of decisions produced by Infarmed is consistently below the number of authorizations for new drugs by the EMA [European Medicines Agency], which generates a growing misalignment between the drugs approved at European level and those effectively accessible in Portugal".

When it comes to health spending, Jorge Félix said that "it is under control", at around 6.5% of the gross domestic product.

Between 2012 and 2023, SNS expenditure on drugs increased from around 2.2 million euros to around 3.6 million, but the proportion of public spending on drugs remained stable, around 20%.

"This proportional stability, despite nominal growth, suggests sustainable management of public spending on drugs", highlights the study.

Regarding equitable access to technologies, Jorge Félix said that there is "a mixed situation". Some indicators point to progress, particularly in orphan drugs, intended for rare diseases.

However, in certain pharmacotherapeutic groups, such as oncology drugs, "there is a certain lack of access and equity", he highlighted.

On the other hand, he stressed, "there is some evidence" that the system has been effective in reducing waste and inefficiencies.