Aplicação do processo analítico hierárquico para avaliação da primeira linha do tratamento do câncer de mama metastático HER 2 hiperexpresso na perspectiva do Sistema Único de Saúde.

Abstract

Breast cancer is the most common cancer in women in around the world, and in Brazil. In 2016, an incidence of 57,960 new cases was predicted, according to estimates by the National Cancer Institute (INCA). In 2013, the disease accounted for 14,388 deaths, 181 were men and 14,206 were women. In the Brazilian Health System, there is a diversity of available chemotherapy regimens that can be combined with biological therapies. In order to contribute to the decision making of the technology management process, within the scope of the Brazilian Health System, a methodology for multicriteria decision analysis was performed. The method chosen was the hierarchical analytical process, and consists of the joint trial to evaluate the importance of the established criteria and performance of the alternatives selected for evaluation. A questionnaire was developed and applied to oncologists that work in the care of patients with hyperexpressed HER-2 metastatic breast cancer. We compared the treatment based on pertuzumab in combination with trastuzumab and docetaxel; trastuzumab in combination with docetaxel; and treatment available in professional s healthcare unit. The data obtained served as input parameters to the model. The relevant criteria to the treatment and performance of the alternatives in each criterion were evaluated. As results, it can be observed that the therapeutic scheme considered more appropriate by the model was based on pertuzumab in combination with trastuzumab and docetaxel. In addition to the lower quality criterion, the most sensitive criteria of the model were adverse events, cost-effectiveness and budgetary impact, which suggests that the final classification of the technologies has a close relationship with the oncologists participating in the questionnaire.

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