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STATUS OF DISINVESTMENT INITIATIVES IN LATIN AMERICA: RESULTS FROM A SYSTEMATIC LITERATURE REVIEW AND A QUESTIONNAIRE

Published online by Cambridge University Press:  28 September 2017

Ion Agirrezabal ,
Joseph Burgon ,
Gavin Stewart  and
Iñaki Gutierrez-Ibarluzea
Ion Agirrezabal
Affiliation:
Costello Medical Consultingion.agirrezabal@gmail.com
Joseph Burgon
Affiliation:
Costello Medical Consulting
Gavin Stewart
Affiliation:
Costello Medical Consulting
Iñaki Gutierrez-Ibarluzea
Affiliation:
Basque Office for HTA (OSTEBA)
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Abstract

Objectives: Disinvestment of existing healthcare technologies that deliver low or no health benefit for their cost can be used as a tool to improve access to effective technologies, while ensuring the long-term sustainability of healthcare systems. The objective of this research was to identify disinvestment initiatives in Latin American countries (LAC).

Methods: First, a systematic literature review (SLR) was conducted. In February 2015, MEDLINE, MEDLINE In-Process, EMBASE, The Cochrane Library, and LILACS were searched for relevant journal articles, including terms related to “disinvestment,” “reallocation,” “obsolete technologies,” and “Latin America.” Additionally, a manual search of documents from Latin American health technology assessment agencies was performed. Second, an online questionnaire was sent to experts in LAC to assess whether unpublished real-life disinvestment initiatives exist. Questionnaire results were collected in September 2015.

Results: From the SLR, 350 records were selected for screening following de-duplication and eleven articles fulfilled inclusion criteria. Only two of these reported information on initiatives potentially identifiable as disinvestment-investment activities in Brazil and Peru. Nine respondents completed the questionnaire, and four reported that disinvestment initiatives had been conducted in their respective organizations in Argentina, Brazil, and Mexico. This lack of agreement between the SLR and the questionnaire responses shows that disinvestment initiatives are ongoing, despite being under reported.

Conclusions: Many challenges need to be overcome for a disinvestment initiative to be successful, and sharing particular experiences with the international community would increase the chances of positive outcomes. The present study highlights the need for publication of such experiences in LAC.

Keywords

DisinvestmentHealth technology assessmentReassessmentReviewLatin America
Type
Assessments
Information
International Journal of Technology Assessment in Health Care , Volume 33 , Issue 6 , 2017 , pp. 674 - 680
Copyright
Copyright © Cambridge University Press 2017 

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