02/27/2026  |  Beth Koike   |  Vlor International

https://valorinternational.globo.com/google/amp/business/news/2026/02/27/santas-casas-join-forces-in-clinical-research.ghtml 

Project led by Dr. Nelson Teich attracts pharmaceutical companies in newly regulated clinical research market

Four months after the regulation of clinical research in Brazil, Santas Casas and public philanthropic hospitals are joining forces to conduct scientific studies on new treatments. The country has 1,800 such healthcare institutions, which together account for 62% of high-complexity surgeries and 50% of medium-complexity procedures performed in the public health system.

Under a moderate scenario with gradual adoption of the new legislation, revenue from clinical research at Santas Casas and philanthropic hospitals is expected to nearly double within four years. In 2026, estimates range from R$1.8 billion to R$2.25 billion, rising to between R$3.8 billion and R$4.7 billion by 2030, according to consultancy Ekantika.

The project is led by oncologist Nelson Teich, who served as Health minister in 2020, in partnership with Ekantika, which is using its data and artificial intelligence platform for analysis.

“It is a way for Santas Casas to receive an injection of new funding amid longstanding difficulties with public transfers. These philanthropic institutions are known for high-complexity care,” Teich said.

A joint effort among Santas Casas is particularly valuable for clinical research because these hospitals treat patients from across the country, which has the world’s greatest genetic diversity, and handle more complex medical cases, which are of interest to the pharmaceutical industry. Drugmakers sponsor between 78% and 86% of clinical trials conducted in Brazil.

According to projections by consultancy Falconi, which advises the National Confederation of Santas Casas (CMB), in a fully regulated environment monthly inflows of R$3 million to R$4 million per hospital are possible. “In addition to bringing in new funding, it is an opportunity to reduce costs because pharmaceutical companies cover the expenses of patients selected for clinical research. It is also beneficial for the SUS [Unified Health System, Brazil's public healthcare option] and for health insurers,” said Vinicius Brum, Falconi’s vice president of operations.

Santas Casas currently carry tax liabilities of around R$15 billion, and bank loans backed by the National Health Fund—the financial manager of the SUS total nearly R$6 billion. This financial burden affects about 850 of the country’s 1,800 Santas Casas.

The SUS reimbursement table covers only 65% of medical procedure costs. The shortfall is offset by services provided to privately insured patients and by donations. However, many of these hospitals serve exclusively public health system patients, generating recurring deficits. In some locations, such as São Paulo, additional transfers from state and municipal governments help balance the accounts.

According to Mario Cesar Homsi Bernardes, superintendent of the Confederation of Santas Casas and Philanthropic Hospitals (CMB), the project is currently in a pilot phase with 35 Santas Casas from the South, Southeast, Northeast and Central-West regions. Negotiations are under way in the North.

“It is a major opportunity that brings benefits to all parties. Leading physicians will be interested, new technologies are introduced, patients benefit and significant funding is generated. We can verify this because some Santas Casas already engage in clinical research,” Bernardes said. There are currently 16 partnerships between hospitals and pharmaceutical companies involving 179 clinical trials, according to Interfarma (the Pharmaceutical Research Industry Association).

The Santa Casa de Porto Alegre reported R$35 million in clinical research revenue in 2025. The institution has conducted clinical research for two decades and participated in studies of Trastuzumab and Pertuzumab, monoclonal antibodies developed by Roche for breast cancer treatment. The company has conducted 14 oncology studies with the Rio Grande do Sul-based institution focused on this type of therapy.

“We treat 500 patients per month. They may be from the SUS, private health plans or other regions of the country, provided they meet the research requirements, which are not simple,” said Katsuki Tiscoski, the oncologist in charge of the research center at Santa Casa de Porto Alegre.

“Having centers in regional hubs such as Santa Casa de Porto Alegre is part of our strategy to decentralize high-complexity research in the country,” said Waleuska Spiess, head of clinical research at Roche Farma Brasil.

Patients participating in the studies have their treatment costs covered by the pharmaceutical company. After treatment, patients are entitled to receive the medication for five additional years. Previously, there was no time limit, which discouraged pharmaceutical companies from investing due to the risk of future liabilities.

“Brazil lost the opportunity to include 700,000 patients in clinical research between 2022 and 2025 due to the lack of regulation,” said Renato Porto, president of Interfarma. Today, Brazil accounts for less than 3% of global studies.

Brazil’s main attraction is its population’s high genetic diversity, according to research by the University of São Paulo published in the scientific journal Science in 2025. With extensive ethnic mixing, pharmaceutical companies can concentrate studies in the country. Currently, most trials are conducted in Europe and the United States, where populations are predominantly white.

Santa Casa de São José dos Campos (São Paulo) began conducting clinical research about six months ago and has signed contracts with two pharmaceutical companies for studies on breast and ovarian cancer and epidermolysis bullosa, a rare genetic disease that mainly affects children. “There is a series of analyses of facilities, procedures and the clinical staff at the research center carried out by pharmaceutical companies. It is very rigorous,” said Danilo Stanzani, director of the clinical research center at Santa Casa de São José dos Campos.

Today, only a small share of the 1,800 Santas Casas and public hospitals meet the requirements for scientific studies. In addition, there remains some reluctance among Brazilians to participate in trials. “With the pandemic and studies around the covid-19 vaccine, there was a reduction in prejudice—the perception that patients are guinea pigs—but we still need to further promote clinical research to eliminate that view,” said oncologist Taiana Marina of Santa Casa de São José dos Campos.

According to Rodrigo Sato, a partner at Ekantika, clinical research in Brazil remains highly concentrated, with 54% of research centers in the Southeast and 25% in the South. The remaining 21% is spread across the North, Northeast and Central-West. The most studied therapeutic areas are oncology (30.6%), infectious diseases (15.3%), metabolic disorders (9.2%), cardiovascular conditions (9.6%) and central nervous system diseases (8%).