News from members - ANS and INCa

• National Agency for Supplementary Health (ANS)
• French National Cancer Institute (INCa)

National Agency of Supplementary Health, Brazil

The National Agency of Supplementary Health (Agência Nacional de Saúde Suplementar – ANS) is a regulatory agency linked to the Ministry of Health whose mission is to promote the institutional protection of public interest in supplementary health assistance. It is responsible for the regulation of this sector - including their relations with providers and consumers - and contributes to the development of health actions in Brazil.

Our aims:

1. Ensure integral health care coverage and regulate the conditions of access for consumers of private plans;
2. Set and monitor the conditions of entry, operation and exit of companies and entities in the sector;
3. Define and implement mechanisms to ensure assistance and financial-guarantee, to ensure continuity of services for consumers;
4. Provide transparency and ensure the integration of supplementary health sector and the Public Health System (Sistema Único de Saúde – SUS), as well as the reimbursement of expenses generated by users of private plans for assistance in the public health system;
5. Establish mechanisms to control the abuse of prices;
6. Define the system of rules, regulations and supervision of supplementary health system.

We aim to improve health care regulation, to ensure quality and integrality of care. ANS also works inducing and stimulating the creation of projects in health promotion and prevention. Other actions are the definition of clinical protocols, the solution of disputes regarding indication and coverage of procedures, materials and medicines, and the setup of a technical group with representatives of HMOs, beneficiaries and the scientific community, for discussion of health technology issues. The use of health technology assessment tools is of the foremost importance for all these actions.
The new process improves transparency on the development and implementation of the guidelines and seeks to improve the quality of health care by promoting systematic development of clinical practice guidelines and their application into practice.

Institut National du Cancer, France

The French National Cancer Institute was created through the Public Health Act of 9 August 2004, under the Cancer Plan, and implemented in July 2005 to enable a long-lasting, coordinated national policy against cancer. Placed under the aegis of the Ministry of Health and the Ministry of Research, it brings together all of the players involved in the fight against cancer in France. The Institute is a health and science agency dedicated to oncology.

Its missions are as follows:

• To observe and assess the system in place to fight cancer;

• To define benchmarks for good practices and care in the field of oncology and the criteria for certifying institutions and professionals in the field of oncology;

• To inform professionals and the public;

• To participate in the implementation and validation of continuing education for doctors and paramedical personnel;

• To implement, finance and coordinate research projects in collaboration with the relevant public research organisations and charitable associations;

• To develop and monitor public/private actions in the areas of prevention, epidemiology, screening, research, education, care and evaluation;

• To participate in developing European and worldwide actions;

• To prepare expert reports in oncology and cancer issues at the request of the relevant ministries.

The Institute is a public expertise agency (produces or co produces regulatory documents) whose means of actions are the implementation of partnerships with and through the existing public and/or private structures of Care, Public Health and Research, and calls for proposals.

The Institute covers the whole spectrum of the fight against cancer and has four main areas of interventions; the Institute’s budget in 2007 was about 100 millions €uros dedicated to actions related to health, research, treatment and information:

• Public Health: Implement a better cancer prevention strategy and diagnose cancer earlier;
• Care: Guarantee access to top-quality care for all, clinical guidelines being part of the tools;
• Research: Make innovation and progress more accessible;
• Information: population, patients and physicians.

The governance of the National Cancer Institute is based on a board of directors, which defines the overall strategy, and is made of public, private and associative stakeholders in the fight against cancer. An independent international scientific advisory board ensures the cohesion of scientific and medical policies. A committee of patients and a committee of health professionals are consulted on a regular basis, they advise on all actions of the Institute and actively participate to working groups on specific issues.