Health Systems in Transition

Health systems in transition

Portugal

Health technology assessment

Portugal does not have a tradition of health technology assessment, except

for pharmaceutical products, as detailed below. Since 1988, the Ministry of

Health has authorized the procurement and installation of expensive medical

technologies in the public and private sectors. In 1995, new legislation lifted the

restrictions on computed tomography (CT) scanners and magnetic resonance

imaging (MRI) scanners. There are currently no effective methods for

regulating the distribution of health equipment in the private sector.

INFARMED is responsible for regulating the assessment of any

pharmaceutical and medical devices. Created in 2015 and managed by

INFARMED, the new system SiNATS aims to assess health technology

and its utilization. SiNATS covers all public and private institutions that

produce, commercialize or use health technologies. Also, the assessment

performed by SiNATS covers all health technologies. Economic evaluation

of pharmaceuticals was initially only mandatory for ambulatory care, even

though occasionally other drugs were also the subjects of a health technology

assessment. Since 2006, economic evaluation has also become mandatory

for drugs used or prescribed in hospitals. INFARMED is extending its

responsibility from ambulatory to hospital care. In February 2013, the

Ministry of Health created a National Commission of Pharmaceutical Products

(

Comissão Nacional de Farmácia e Terapêutica

) to define a national list of

pharmaceutical products and guidelines for their use. The national list of

pharmaceutical products (

Formulário Nacional de Medicamentos

) is available at

and is currently being validated

(see section 5.6).

2.4.4 Regulation and governance of pharmaceuticals

In recent years, the government has taken a series of decisions that have

changed the regulation of pharmaceuticals in Portugal (see section 5.6), but

can be summarized as follows: since 2005, the price of over-the-counter

medications is no longer fixed, and over-the-counter medications can be sold

outside pharmacies, and since 2006 retail pharmacies can operate in hospitals;

since 2007, the ownership of pharmacies is no longer restricted to pharmacists;

and also since 2007 there has been no change to the strong regulation of

pharmacy locations and the maximum number of pharmacies that are permitted

in each community. Administrative prices of pharmaceutical products are now

maximum prices, with pharmacies being able to provide discounts on prices

to patients.