La incorporación de nuevas tecnologías en el Sistema Nacional de Salud. Coste-efectividad y presiones sobre el gasto sanitario

Resumen

How new technologies are adopted in Spain and what is the role the different institutions and agents play? How can that role be improved? It is neccesary to standarize the cost-effectiveness methodology, and improve the dissemina­ tion of knowledge. There is a complex set of agents involved, at the macro, meso and micro levels, in the incorpora­ tion of new health technologies. Their interests do not always converge. We advocate the creation a state agency to provide independent assessment of health technologies and having the moral authority and legal capacity to set gui­ delines, like the NICE in Britain. Today the most intense pressures on health expenditure are due to investment shock and the new hospital biotech drugs. In this article we analyise these pressures and propose some measures.