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Lima VG, Silva MT, Biase TMMA, Galvão TF. Effect of Deregulation of the Brazilian National Controlled Products Management System on Antidepressants' Sales Data Deregulation of a Brazilian Drug Electronic System. Pharmacoepidemiol Drug Saf 2025; 34:e70136. [PMID: 40107838 DOI: 10.1002/pds.70136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Revised: 03/07/2025] [Accepted: 03/08/2025] [Indexed: 03/22/2025]
Abstract
PURPOSE To assess the effect of deregulating the national sales reporting system on Brazilian pharmacoepidemiologic data on antidepressants. METHODS This was a time series analysis to assess the trends in antidepressant sales in Brazilian drugstores from January 2014 to December 2022 using the Brazilian National Controlled Products Management System (SNGPC) and to predict sales records for 2022 after the deregulation of the mandatory record in December 2021. Antidepressant sales were converted to defined daily doses per 1000 inhabitants per day (DID). The seasonal autoregressive integrated moving average (SARIMA) was used to predict sales records for 2022. All analyses were conducted in Stata v.14.2. RESULTS Sales of patients taking antidepressants increased significantly from 2014 (mean: 14.7 DID/month) to 2020 (mean: 33.5 DID/month; β = 0.231; p < 0.001). After the start of the COVID-19 pandemic, the increasing trend continued, but the change was not significant (β = 0.330; p = 0.130). After the deregulation, a sharp decrease was observed (β = -1.032; p < 0.001). The monthly antidepressant sales forecasted for 2022 were 36.5 DID, while the observed value was 2.5 DID. CONCLUSION Deregulation of SNGPC registration significantly decreased the number of antidepressant sales records. This measure affected the availability of pharmacoepidemiological data and research in Brazil.
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Affiliation(s)
- Vanessa Gomes Lima
- School of Pharmaceutical Sciences, Universidade Estadual de Campinas, São Paulo, Brazil
| | - Marcus Tolentino Silva
- Department of Public Health, School of Health Sciences, University of Brasília, Brasília, Brazil
| | | | - Taís Freire Galvão
- School of Pharmaceutical Sciences, Universidade Estadual de Campinas, São Paulo, Brazil
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Cruz AJS, Martins MAP, Batista VS, Santos JS, Santos TRD, de Castilho LS, Sohn W, Abreu MHNG. Rising trend of dentist-prescribed antibiotics in Brazil: 2011-2021. J Public Health Dent 2024; 84:453-459. [PMID: 39364574 DOI: 10.1111/jphd.12645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 07/28/2024] [Accepted: 09/01/2024] [Indexed: 10/05/2024]
Abstract
OBJECTIVES To describe the trends in antibiotic prescribing by dental practitioners and to investigate the relationship between these trends and some factors of public oral health services in Minas Gerais (MG), Brazil. METHODS This was a time-series analysis of antibiotics prescribed by dental practitioners between January 2011 and December 2021. The outcome variables were number of defined daily doses (DDD) and DDD/1000 population/year in a sample of cities in MG. Covariates were public oral healthcare factors, such as coverage, estimates of dental procedures, and frequency of dental pain. Linear time-series regression models were used to examine trends and the influence of covariates on antibiotic prescribing. RESULTS Overall, the number of prescriptions increased by 334.69% between 2011 and 2021, with amoxicillin being the most commonly prescribed drug (78.53%). The number of DDD for all antibiotics increased from 17,147.13 to 77,346.67 and the average DDD/1000 inhabitants/year was 126.66 (SD: 130.28). The linear time-series regression model showed that for each one-year increase, the average log DDD/1000 inhabitants increased by 0.35 (standard error = 0.07, p < 0.001). No covariates were found to be associated with the outcome. CONCLUSIONS In Minas Gerais, Brazil, a significant upward trend was observed in the number of prescriptions and the number of DDD of antibiotics prescribed by dental practitioners. No influence of factors related to public oral healthcare services on the outcome was observed, thereby emphasizing the need for further research on factors influencing medication use in dental practice.
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Affiliation(s)
- Alex Junio Silva Cruz
- Department of Community and Preventive Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Victor Santos Batista
- Department of Community and Preventive Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Jacqueline Silva Santos
- Department of Community and Preventive Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Thiago Rezende Dos Santos
- Department of Statistics, Institute of Exact Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lia Silva de Castilho
- Department of Operative Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Woosung Sohn
- Department of Population Oral Health, School of Medicine, The University of Sydney, Sydney, Australia
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Cruz AJS, Martins MAP, de Aguilar DR, Santos JS, Sohn W, de Castilho LS, Abreu MHNG. High prevalence of potential psychotropic drugs interactions among Brazilian dental patients. Oral Dis 2024; 30:1606-1613. [PMID: 36794905 DOI: 10.1111/odi.14539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 01/11/2023] [Accepted: 02/14/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVE To determine the prevalence of potential drug-drug interactions involving psychotropics prescribed by dentists, and dispensed by the public healthcare system, as well as to describe the severity and level of evidence of those interactions in the state of Minas Gerais, Brazil. MATERIALS AND METHODS We conducted data analysis from pharmaceutical claims in which dental patients received systemic psychotropics in 2017. Data from the Pharmaceutical Management System provided the drug dispensing history of the patients, allowing the identification of those on concomitant medication use. The outcome was the occurrence of potential drug-drug interactions, which were detected according to IBM Micromedex®. Independent variables were the patient's sex, age, and the number of drugs used. Descriptive statistics was performed using SPSS v. 26. RESULTS Overall, 1480 individuals were prescribed psychotropic drugs. The prevalence of potential drug-drug interactions was 24.8% (n = 366). The total of 648 interactions was observed and, most of which were of major severity (n = 438, 67.6%). Most interactions occurred in female individuals (n = 235; 64.2%), with 46.0 (±17.3) years-old, concurrently taking 3.7 (±1.9) drugs. CONCLUSION A substantial proportion of dental patients presented potential drug-drug interactions, mostly of major severity, which might be life-threatening.
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Affiliation(s)
- Alex Junio Silva Cruz
- Graduate Program, School of Dentistry, Universidade Federal de Minas Gerais, Avenida Antonio Carlos, Belo Horizonte, Brazil
| | | | - Diego Rodrigues de Aguilar
- Graduate Program, School of Dentistry, Universidade Federal de Minas Gerais, Avenida Antonio Carlos, Belo Horizonte, Brazil
| | - Jacqueline Silva Santos
- Graduate Program, School of Dentistry, Universidade Federal de Minas Gerais, Avenida Antonio Carlos, Belo Horizonte, Brazil
| | - Woosung Sohn
- Department of Population Oral Health, School of Medicine, The University of Sydney, Sydney, New South Wales, Australia
| | - Lia Silva de Castilho
- Department of Operative Dentistry, Universidade Federal de Minas Gerais, Avenida Antonio Carlos, Belo Horizonte, Brazil
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Birck MG, Ferreira R, Curi M, Krueger WS, Julian GS, Liede A. Real-world treatment patterns of rheumatoid arthritis in Brazil: analysis of DATASUS national administrative claims data for pharmacoepidemiology studies (2010-2020). Sci Rep 2023; 13:17739. [PMID: 37853013 PMCID: PMC10584810 DOI: 10.1038/s41598-023-44389-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 10/07/2023] [Indexed: 10/20/2023] Open
Abstract
Our study assessed DATASUS as a potential source for pharmacoepidemiologic studies in rheumatoid arthritis (RA) in the Brazilian population focusing on treatment patterns and determinants of initiating or switching to a novel therapy. This was a descriptive database study of RA patients with at least one claim of RA and ≥ 2 claims of disease-modifying anti-rheumatic drug (DMARD); conventional synthetic (cs), biologic (b) or targeted synthetic (ts) DMARD with more than 6 months of follow-up from 01-Jan-2010 to 31-Dec-2020. Analyses were stratified for SUS-exclusive and SUS+ private user cohorts. We identified 250,251 patients with RA in DATASUS: mean age of 58.4 years, majority female (83%) and white (58%). 62% were SUS-exclusive and 38% SUS+ private. Most common bDMARDs were adalimumab and etanercept. Age (adjusted odds ratio 1.78 [50+]; 95% CI 1.57-2.01), SUS exclusive status (0.53; 0.47-0.59), distance to clinic [160+ km] (0.57; 0.45-0.72), and pre-index csDMARD claims (1.23; 1.08-1.41) were independent predictors of initiating a novel oral tsDMARD. Switching from bDMARD to tsDMARD, associations were similar, except for the direction of associations for SUS exclusive status (adjusted hazard ratio 1.10; 1.03-1.18), distance to clinic (1.18; 1.03-1.35), and number of previous bDMARD (0.15; 0.14-0.16). DATASUS is a source suitable for treatment-related analyses in RA reflecting the public health system in Brazil.
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Affiliation(s)
| | | | - M Curi
- AbbVie, São Paulo, Brazil
| | | | | | - Alexander Liede
- AbbVie Inc., North Chicago, IL, USA.
- Global Epidemiology, AbbVie, 14 Riverwalk, Citywest Business Campus, Dublin 24, D24 XN32, Ireland.
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Cruz AJS, Martins MAP, Batista VS, de Aguilar Penido HP, Santos JS, dos Santos TR, Sohn W, de Castilho LS, Abreu MHNG. Dental Pain Medication Prescriptions in Minas Gerais, Brazil (2011-2021): A Time-Series Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6795. [PMID: 37754654 PMCID: PMC10531368 DOI: 10.3390/ijerph20186795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 09/28/2023]
Abstract
To describe trends of dentist-prescribed non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics, from January 2011 to December 2021, as well as to examine the relationship between these trends and characteristics of public oral health services in Minas Gerais, Brazil. In this time-series analysis, all drugs were classified according to the Anatomical Therapeutic Chemical classification system. Drugs categorized as NSAIDs (M01A), and other analgesics and antipyretics (N02B) were included for analysis. The outcome was the number of Defined Daily Doses (DDDs)/1000 inhabitants/year for NSAIDs and analgesics in each town. Covariates referred to characteristics of public oral health services, such as coverage, estimates of dental procedures, and frequency of toothache. Linear time-series regression models were used to determine the influence of covariates on the outcome. Overall, there were 58,482 prescriptions of NSAIDs recorded in thirty-eight towns, while 47,499 prescriptions of analgesics in forty-three towns. For each year, there was a 0.38 (p < 0.001), and 0.28 (p < 0.001) increase in the average log of DDD/1000 inhabitants/year for NSAIDs and analgesics, respectively. A positive association was detected between toothache (p < 0.001) and the prescription of NSAIDs. Over the eleven years, there was a general rising trend in the prescriptions. Toothache was the only characteristic of public oral health services associated with the prescription rates of NSAIDs, implying that as the frequency of toothaches increase, so do the prescriptions of NSAIDs in the studied towns.
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Affiliation(s)
- Alex Junio Silva Cruz
- Graduate Dental Program, School of Dentistry, Universidade Federal de Minas Gerais, Avenida Antonio Carlos, Belo Horizonte 31270901, Brazil;
| | | | - Victor Santos Batista
- Undergraduate Dental Program, School of Dentistry, Universidade Federal de Minas Gerais, Avenida Antonio Carlos, Belo Horizonte 31270901, Brazil;
| | - Henrique Pereira de Aguilar Penido
- Undergraduate Math Program, Institute of Exact Sciences, Universidade Federal de Minas Gerais, Avenida Antonio Carlos, Belo Horizonte 31270901, Brazil;
| | - Jacqueline Silva Santos
- Oral Health Department for the State of Minas Gerais, Universidade Federal de Minas Gerais, Belo Horizonte 31630-901, Brazil;
| | - Thiago Rezende dos Santos
- Department of Statistics, Institute of Exact Sciences, Universidade Federal de Minas Gerais, Avenida Antonio Carlos, Belo Horizonte 31270901, Brazil;
| | - Woosung Sohn
- Discipline of Population Oral Health, School of Dentistry, The University of Sydney, Sydney, NSW 2006, Australia;
| | - Lia Silva de Castilho
- Department of Operative Dentistry, Universidade Federal de Minas Gerais, Avenida Antonio Carlos, Belo Horizonte 31270901, Brazil;
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Ribeiro AA, Acosta A, Pontes MA, Machado Beltran MA, Peixoto RT, Leite SN. Transparency of data on the value chain of medicines in Argentina, Brazil, and Colombia. Front Pharmacol 2023; 13:1063300. [PMID: 36686702 PMCID: PMC9849945 DOI: 10.3389/fphar.2022.1063300] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/21/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction: The transparency of data on the value chain of medicines is crucial for the study and monitoring of the pharmaceutical system. These data may impact medicine pricing negotiations, contribute to patient access to pharmaceutical products, and strengthen health systems. Objective: This study analyzed the national strategies to ensure the transparency of data from medicine cost development to marketing in Argentina, Brazil, and Colombia. Method: A descriptive study was carried out by searching databases, reports, documents, and scientific articles published between January and August 2022 related to rules on transparency and databases, including 1) marketing authorization; 2) pricing; 3) intellectual property; 4) clinical trials; 5) research and development (R&D); and 6) health technology assessment (HTA) of selected biopharmaceuticals. Results: Transparency data, rules, and information are not uniform. The infostructures (organizational capacity for collecting and distributing information) regarding the pharmaceutical value chain in these three countries face limitations in appropriate measures to publicly share data and evidence, including pre-clinical data, clinical data, and costs. None of the countries require transparency about data on research and development costs. All three countries present similar publicization of data on marketing authorization and intellectual property, with some differences. The significant limitations in Argentina include the absence of formal price regulation and data on the volume of medicine purchased and respective amounts paid. Among the three countries, Brazil showed a higher degree of information transparency, perhaps due to the legal regulation that guarantees citizens access to information of public interest. Brazil also stands out in terms of the public availability of HTA reports and pricing, in addition to the highest volume of information. In contrast, Colombia has in place a decree that allows 5 years of trial data exclusivity for new medicines, an act contrary to data transparency. Despite the different stages of transparency, no country has evidenced a robust use of these data in public policy decision-making. Conclusion: The results reinforce the presence of information asymmetry between stakeholders, data fragmentation, data gaps and overlap, and difficulty in comparing available data across the three countries and the use of these data nationally to produce evidence.
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Affiliation(s)
| | - Angela Acosta
- Departamento de Ciencias Farmacéuticas, Facultad de Ciencias Naturales, Universidad ICESI, Cali, Colombia
| | | | | | - Rafaela Tavares Peixoto
- Department of Pharmaceutical Sciences, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Silvana Nair Leite
- Department of Pharmaceutical Sciences, Federal University of Santa Catarina, Florianopolis, Brazil
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Faria RJ, Cordeiro FJR, dos Santos JBR, Alvares-Teodoro J, Guerra Júnior AA, Acurcio FDA, da Silva MRR. Conventional Synthetic Disease-Modifying Anti-rheumatic Drugs for Psoriatic Arthritis: Findings and Implications From a Patient Centered Longitudinal Study in Brazil. Front Pharmacol 2022; 13:878972. [PMID: 35559237 PMCID: PMC9086188 DOI: 10.3389/fphar.2022.878972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 03/24/2022] [Indexed: 12/04/2022] Open
Abstract
Background: Conventional synthetic disease-modifying antirheumatic drugs are the first-line treatment to inhibit the progression of psoriatic arthritis. Despite their widespread clinical use, few studies have been conducted to compare these drugs for psoriatic arthritis. Methods: a longitudinal study was carried out based on a centered patient national database in Brazil. Market share of drugs, medication persistence, drug costs, and cost per response were evaluated. Results: a total of 1,999 individuals with psoriatic arthritis were included. Methotrexate was the most used drug (44.4%), followed by leflunomide (40.6%), ciclosporin (8.2%), and sulfasalazine (6.8%). Methotrexate and leflunomide had a greater market share than ciclosporin and sulfasalazine over years. Medication persistence was higher for leflunomide (58.9 and 28.2%), followed by methotrexate (51.6 and 25.4%) at six and 12 months, respectively. Leflunomide was deemed the most expensive drug, with an average annual cost of $317.25, followed by sulfasalazine ($106.47), ciclosporin ($97.64), and methotrexate ($40.23). Methotrexate was the drug being the lowest cost per response. Conclusion: Methotrexate had the best cost per response ratio, owing to its lower cost and a slightly lower proportion of persistent patients when compared to leflunomide. Leflunomide had a slightly higher medication persistence than methotrexate, but it was the most expensive drug.
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Affiliation(s)
- Ronaldo José Faria
- Pharmaceutical Services Graduate Program, Federal University of Espírito Santo, Alegre, Brazil
- Health Assessment, Technology, and Economy Group, Federal University of Espírito Santo, Alegre, Brazil
| | | | - Jéssica Barreto Ribeiro dos Santos
- Pharmaceutical Services Graduate Program, Federal University of Espírito Santo, Alegre, Brazil
- Health Assessment, Technology, and Economy Group, Federal University of Espírito Santo, Alegre, Brazil
| | | | | | | | - Michael Ruberson Ribeiro da Silva
- Pharmaceutical Services Graduate Program, Federal University of Espírito Santo, Alegre, Brazil
- Health Assessment, Technology, and Economy Group, Federal University of Espírito Santo, Alegre, Brazil
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