Detecting unexpected growths in health technologies expenditures: the case of MIPRES in Colombia

BMC Health Services Research

Research

Sergio Basto¹  Cristian Sanabria¹  Jhonathan Rodríguez²  Oscar Espinosa²  Valeria Bejarano²  Paul Rodríguez-Lesmes³  Adriana Robayo⁴ 

[1] Directorate of Analytical, Economic and Actuarial Studies in Health, Instituto de Evaluación Tecnológica en Salud (IETS), Bogotá, D.C, Colombia;Directorate of Analytical, Economic and Actuarial Studies in Health, Instituto de Evaluación Tecnológica en Salud (IETS), Bogotá, D.C, Colombia;Economic Models and Quantitative Methods Research Group, Centro de Investigaciones para el Desarrollo, Universidad Nacional de Colombia, Bogotá, D.C, Colombia;Directorate of Analytical, Economic and Actuarial Studies in Health, Instituto de Evaluación Tecnológica en Salud (IETS), Bogotá, D.C, Colombia;School of Economics, Universidad del Rosario, Bogotá, D.C, Colombia;Executive Directorate, Instituto de Evaluación Tecnológica en Salud (IETS), Bogotá, D.C, Colombia;

关键词: Health technologies;    Health expenditures;    High-cost technology;    Enteral nutritional;    Statistical data analysis;    Data analytics;   

DOI  :  10.1186/s12913-023-10155-w

 received in 2023-01-29, accepted in 2023-10-16,  发布年份 2023

来源: Springer

【 摘 要 】

We developed an algorithm to explore unexpected growth in the usage and costs of health technologies. We exploit data from the expenditures on technologies funded by the Colombian government under the compulsory insurance system, where all prescriptions for technologies not included in an explicit list must be registered in a centralized information system, covering the period from 2017 to 2022. The algorithm consists of two steps: an outlier detection method based on the density of the expenditures for selecting a first set of technologies to consider (39 technologies out of 106,957), and two anomaly detection models for time series to determine which insurance companies, health providers, and regions have the most notorious increases. We have found that most medicines associated with atypical behavior and significant monetary growth could be linked to the use of recently introduced drugs in the market. These drugs have valid patents and very specific clinical indications, often involving high-cost pharmacological treatments. The most relevant case is the Burosumab, approved in 2018 to treat a rare genetic disorder affecting skeletal growth. Secondly, there is clear evidence of anomalous increasing trend evolutions in the identified enteral nutritional support supplements or Food for Special Medical Purposes. The health system did not purchase these products before July 2021, but in 2022 they represented more than 500,000 USD per month.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

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