Blockchain in Health Technology Assessment: A low cost solution in developing and transition countries using Multichain

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  • Tipo de apresentação: Apresentação Oral
  • Eixo temático: 1. Políticas e processos de ATS
  • Palavras chaves: Blockchain; Multichain; HTA; Clinical Trials; Virtualization;
  • 1 Universidade Estadual Paulista “Júlio de Mesquita Filho”

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Introduction: Blockchain is a distributed, decentralized, immutable, transparent and confidential database. Each transaction added on a given node cannot be reversed and is timestamped. Each node carries a copy of the entire chain, which guarantees security and interoperability. Blockchain is disruptive, a emerging solution to many issues involving the field of Public Health, especially Health Technology Assessment (HTA). As an example, Blockchain can link a health supply chain, raw materials, industry, products, medicines, research centers, clinical trials, universities, hospitals, laboratories, doctors, equipments, medical Internet of things (mIoT), governments, insurance, regulatory agencies and patients. It eliminates the possibility of fraud and manipulation in clinical trials, missing data, endpoint switching, P-hacking, selective publication, and has the potential to reduce patient risk and the financial strain on health services. It guarantees to patients the correct use by the health technology, when it was used, who prescribed it, which regulatory agency released, the recommendation, who bought it, who produced it, input raw material, lot, shipping, financing, and more. The WHO estimates that around one million people die each year worldwide from the use of fake drugs. Objectives: To test the feasibility of the Blockchain solution for use in HTA connecting two nodes with small budget. Material and Methods: Multichain solution was chosen because it is publicly available under the GPLv3 open source license, It allows installation in Linux environment on VPS with dedicated IP address, it is easy to operate and maintain. The host contracted (Brazil) price is US$ 3/month. Blockchain configuration is private and permissioned. Results: The open source version of Multichain does not encrypt data in transit on the peer-to-peer connections. It is necessary to increase security levels with VPN, iptables and firewalld. The creation of nodes is simple and each node receives an identifier in the format node_name@ip:port for connection with the other node(s). The connection between two nodes was successful and can serve as a basis for integration with other systems. Conclusions: - The solution is feasible in financial and architectural terms. The technology choice is complex and requires more study depending in needs and there is no standardization, Ex: “Smart Contracts” and “Smart Filters. Which leads to the need to perform proofs of concept for evaluation in different HTA scenarios.

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