Reducing SUS costs through effective healthcare innovation

Discussions about SUS costs are often framed in a simplified way: how to spend less within a public healthcare system that faces chronic underfunding, high care demand, and widely recognized operational constraints. Throughout this text, when we refer to the SUS, we are referring to the Brazilian Unified Health System as it operates in practice, with its achievements, challenges, and inherent complexity.

In this context, reducing SUS costs does not mean merely cutting expenses or restricting access, but rather rethinking how resources are allocated over time, considering patient care trajectories, recurrent use of services, and the systemic impact of these decisions on the sustainability of public healthcare.

It is within this scenario that healthcare innovation plays a strategic role — not as an isolated solution or abstract concept, but as a set of approaches capable of supporting the public system in achieving more consistent, measurable, and sustainable clinical outcomes. This perspective underpins the concept of effective innovation, increasingly present in technical and institutional debates about the future of public health.

SUS costs: why the challenge goes beyond price

When discussing SUS costs, the debate often focuses on the unit price of medicines, procedures, or technologies. However, in the day-to-day functioning of the system, the real cost of a health condition goes far beyond the initial treatment price.

Prolonged hospitalizations, frequent readmissions, recurrent emergency care, therapeutic escalation, and polypharmacy represent a significant share of SUS costs, particularly in complex chronic conditions and mental health. Even when the unit cost of an intervention is relatively low, repeated cycles of care generate a high cumulative burden over time.

For this reason, technical discussions about SUS sustainability have increasingly shifted toward understanding not only how much is paid for a technology, but how it affects the patient’s clinical trajectory after entering the system.

Effective innovation: supporting improved care trajectories

In public healthcare, effective innovation is not defined solely by technological novelty, but by its ability to support improvements in clinical trajectories that currently demand high resource utilization.

Incremental innovations may offer logistical or convenience gains, yet often fail to impact the outcomes that most heavily influence SUS costs. Effective innovation, on the other hand, targets critical points of care such as relapses, disease progression, functional decline, and recurring need for high-complexity interventions.

When an innovation consistently contributes to reducing these events, it becomes an ally of system sustainability — even when its initial cost is higher than traditional alternatives.

How effective innovation contributes to controlling SUS costs

The contribution of effective innovation to reducing SUS costs occurs through complementary mechanisms widely discussed in health economics and public policy forums.

One such mechanism is the reduction of avoidable events, including hospitalizations and readmissions, which consume significant financial and human resources. Another is the reduction in care intensity over time, driven by greater clinical stability and less need for therapeutic escalation.

Additionally, interventions with stronger effectiveness and tolerability profiles tend to improve treatment adherence, reducing interruptions and repeated restarts of care — factors that silently increase SUS costs over time.

Economic evaluation as decision-support

In technical discussions about SUS costs, it is increasingly important to distinguish cost-effectiveness from low cost. Economic evaluations in healthcare aim to assess the relationship between investment and health gains, considering available alternatives and long-term impacts.

An intervention may carry a higher upfront cost and still be cost-effective if it contributes to better clinical outcomes and lower future expenditures. This perspective supports decisions aligned with system sustainability while respecting fiscal constraints.

Budget impact and planning within the SUS

Beyond cost-effectiveness, budget impact analysis is a central planning tool within the SUS. It helps estimate the number of eligible patients, the pace of adoption, and the costs that may be avoided over time.

In real-world system operations, this step is essential to ensure that innovations are incorporated responsibly, contributing to the progressive control of SUS costs without creating short-term budgetary pressure.

Real-world evidence and continuous monitoring

SUS costs are largely driven by what happens in everyday clinical practice. For this reason, real-world evidence has become an increasingly important complement to clinical trial data.

Such evidence supports monitoring performance across diverse settings, enabling adjustments, outcome tracking, and more informed decisions over time.

Governance, regulation, and incorporation criteria

The incorporation of technologies within the SUS follows technical and methodological criteria designed to balance clinical need, scientific evidence, budget impact, and equity. These criteria are part of the system’s institutional framework and guide decision-making at multiple levels.

In practice, their application occurs amid budget constraints, judicial pressures, and monitoring challenges. Even so, regulatory governance remains a key pillar for protecting the system and promoting more efficient use of public resources, with direct implications for SUS costs.

Strategies to support access and cost sustainability

Given the challenges faced by the SUS, various strategies have been discussed internationally to enable sustainable access to innovation, including pilot programs, risk-sharing agreements, and outcome-based payment models.

In Brazil, these approaches are still limited in structured application, but they are part of an evolving technical agenda with potential to align innovation, efficiency, and SUS cost control, particularly in high-complexity care areas.

Implementation as a critical success factor

Even effective interventions depend on sound implementation to deliver results. Adequate training, integration into care pathways, and continuous monitoring are essential for translating clinical gains into systemic benefits.

Experience in public healthcare consistently shows that reductions in SUS costs materialize only when innovation is aligned with the system’s operational reality.

Productive sustainability and system predictability

Supply-chain stability also affects SUS costs. Treatment interruptions and emergency substitutions generate inefficiencies, increase indirect costs, and compromise care continuity.

Sustainable, traceable, and ethically structured production models help reduce systemic risk and improve long-term predictability.

Conclusion: effective innovation as an ally of SUS sustainability

Reducing SUS costs is not a matter of austerity, but of continuous improvement in care delivery. The SUS faces well-recognized structural challenges, and discussions around effective innovation are part of a broader technical agenda aimed at supporting better clinical outcomes and more efficient use of public resources.

When guided by evidence, sound governance, and realistic implementation, innovation becomes not an additional cost, but an ally of system sustainability, contributing to better health outcomes and responsible management of SUS costs.

About Ayamed

Within this context, Ayamed develops prescription medicines grounded in science, regulation, and clinically meaningful outcomes. The company’s work engages with challenges already recognized by the public health system, seeking to contribute technically to solutions that support sustainability, care efficiency, and responsible resource use within the SUS.