1
|
da Silva MRR, Dos Santos JBR, Almeida AM, Alvares-Teodoro J, Kakehasi AM, Acurcio FDA. Access to high-cost medications for psoriatic arthritis in the National Health System in Brazil: the long path up to dispensation. Adv Rheumatol 2019; 59:48. [PMID: 31727164 DOI: 10.1186/s42358-019-0091-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 10/21/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Pharmaceutical Assistance (PA) is a dynamic and multidisciplinary process that aims to supply health systems, programs or services with quality medicines, enabling access and health care, in an efficient and timely manner. The objective of the study was to evaluate the profile of administrative processes for the treatment of PsA, identify the time elapsed in the flow of processes and its associated factors. METHODS A cross-sectional study of medication requests for the treatment of PsA was carried out between November 2014 and December 2016. Linear regression was used to verify the factors associated with time to delivery. RESULTS A total of 218 cases containing 250 drugs were analyzed. The median time between the medical appointment and the first dispensation was 66 days (interquartile range, 44-90). The State proceedings, which includes requesting the drug until the authorization of treatment, was the stage that most contributed to the total time spent. The factors associated with the longer time to delivery of medications were prescriptions coming from clinics and specialty centers, from dermatologists, non-authorized processes and non-persistent patients in the treatment in 12 months. CONCLUSION The median time to receive medicines for the PsA treatment in Belo Horizonte health region after a medical prescription was higher than 2 months. The time between the solicitation of the medicines and the authorization of the treatment in the SUS (State administrative procedure) was the main component of the total time spent.
Collapse
Affiliation(s)
- Michael Ruberson Ribeiro da Silva
- College of Pharmacy, Federal University of Minas Gerais, President Antônio Carlos Avenue, 6627, Campus Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil. .,Department of Pharmacy and Nutrition, Federal University of Espírito Santo, Alto Universitário, s/nº - Guararema, Alegre, Espírito Santo, CEP 29500-000, Brazil.
| | - Jéssica Barreto Ribeiro Dos Santos
- College of Pharmacy, Federal University of Minas Gerais, President Antônio Carlos Avenue, 6627, Campus Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Alessandra Maciel Almeida
- College of Pharmacy, Federal University of Minas Gerais, President Antônio Carlos Avenue, 6627, Campus Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Juliana Alvares-Teodoro
- College of Pharmacy, Federal University of Minas Gerais, President Antônio Carlos Avenue, 6627, Campus Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Adriana Maria Kakehasi
- Medicine School, Federal University of Minas Gerais, Alfredo Balena Avenue, 6627, Health Campus, Belo Horizonte, Minas Gerais, 30130-100, Brazil
| | - Francisco de Assis Acurcio
- College of Pharmacy, Federal University of Minas Gerais, President Antônio Carlos Avenue, 6627, Campus Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil.,Medicine School, Federal University of Minas Gerais, Alfredo Balena Avenue, 6627, Health Campus, Belo Horizonte, Minas Gerais, 30130-100, Brazil
| |
Collapse
|
2
|
Alves JDC, Osorio-de-Castro CGS, Wettermark B, Luz TCB. Immunosuppressants in Brazil: underlying drivers of spending trends, 2010-2015. Expert Rev Pharmacoecon Outcomes Res 2018; 18:565-572. [PMID: 29869896 DOI: 10.1080/14737167.2018.1485098] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND Immunosuppressants are recommended for treatment of autoimmune diseases, and in transplant therapy. The high cost of these drugs has been causing an important impact on global pharmaceutical spending. OBJECTIVE Analyzing immunosuppressant expenditure in Brazil, using data from the Federal Procurement System database (SIASG), between 2010 and 2015. METHODS The pharmaceutical products were classified in accordance with the Anatomical, Therapeutic and Chemical (ATC) classification system recommended by World Health Organization (WHO) and aggregated by volume and by expenditure. The expenditure variation was decomposed into three broad categories: price effects, quantity effects, and drug mix effects. RESULTS During the period, annual expenditure increased by 49%, ranging from USD 494.5 million in 2010 to USD 738.7 million in 2015, while purchased quantities increased by 294%, ranging from 49.8 million in 2010 to 196.5 million in 2015. Two factors drove expenditures: the quantity effect and the drug-mix effect. CONCLUSION These findings may contribute to understand immunosuppressant spending trends and the factors that influence them in order to formulate effective cost containment strategies and design optimum drug policy. Rigorous evaluations are recommended to reduce the drug-mix effect, including systems to monitor price, effectiveness, safety, therapeutic value and budget impact of pharmaceutical innovations.
Collapse
Affiliation(s)
| | - Claudia Garcia Serpa Osorio-de-Castro
- b Department of Pharmaceutical Policies and Pharmaceutical Services (NAF) , Sergio Arouca National School of Public Health/Oswaldo Cruz Foundation , Rio de Janeiro , RJ , Brazil
| | - Bjorn Wettermark
- c Department of Medicine, Clinical Epidemiology , Karolinska Institutet, Solna (MedS), K2 , Stockholm , Sweden
| | | |
Collapse
|
3
|
Almeida-Brasil CC, Costa JDO, Aguiar VCFDS, Moreira DP, Moraes END, Acurcio FDA, Guerra Júnior AA, Álvares J. Acesso aos medicamentos para tratamento da doença de Alzheimer fornecidos pelo Sistema Único de Saúde em Minas Gerais, Brasil. CAD SAUDE PUBLICA 2016; 32:e00060615. [DOI: 10.1590/0102-311x00060615] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 02/18/2016] [Indexed: 01/22/2023] Open
Abstract
Resumo: Avaliou-se as barreiras de acesso ao tratamento da doença de Alzheimer com base nos processos administrativos de medicamentos inibidores da colinesterase (IChE), enviados à Secretaria de Estado de Saúde de Minas Gerais, Brasil, entre 2012 e 2013. Utilizando-se informações de 165 processos selecionados aleatoriamente, abordaram-se as dimensões de acesso: acessibilidade geográfica, acomodação, aceitabilidade, disponibilidade e capacidade aquisitiva. O trâmite administrativo para o fornecimento dos IChE levou em média 39 dias e foi influenciado por características do trajeto percorrido pelo usuário. A maioria dos prescritores cumpriu menos de 80% dos critérios exigidos pelo Protocolo Clínico e Diretrizes Terapêuticas (PCDT) da doença de Alzheimer. Como resultado, 38% dos processos não foram deferidos. A capacidade aquisitiva para o tratamento privado mensal com IChE foi de cerca de 21 dias de salário mínimo. Conclui-se que a burocracia do trâmite administrativo e a dificuldade de seguimento do PCDT pelos prescritores prejudicam o acesso ao tratamento da doença de Alzheimer e constituem uma grande carga para o orçamento dos pacientes.
Collapse
|