Compras de medicamentos pelo Instituto Nacional de Câncer: análise do período 2007-2014.
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UERJ |
Texto Completo: | http://www.bdtd.uerj.br/handle/1/4787 |
Resumo: | The Brazilian National Cancer Institute (INCA) is a national reference center for cancer care in the country and an important purchaser for treatment and paliative care medicines. It possesses a specific separate annual budget for maintenance of the medicine stocks in the institution. Expenses exceeded R$ 650 million between 2007 and 2014. This study examined drug procurement carried out by INCA between January/2007 and December/2014 in order to (1) identify acquired medicines, their therapeutic classification, type of purchase, suppliers, volumes, prices and expenses contracted in these purchases; (2) analyze off-bid procurement modes of purchase and (3) study the antineoplastic drugs of greater impact for procurement in the institution. This was designed as a descriptive, quantitative and retrospective exploratory study, based on INCA drug procurement registers. Data source was a public domain secondary data base extracted from the federal government procurement system. The analyzed variables were purchase mode, justification of the off-bid purchases, acquired total volume, unit purchase price and contracted suppliers. The medicines were categorized by Anatomical Therapeutic Classification (ATC). Unit prices were deflated to December 2014 using the National Consumer Price Index (IPCA/IBGE). For analysis of the historical behavior of prices and volumes, a trend analysis was performed based on the least squares method. A 50% cut-off point of contracted annual spending identified antineoplastics of greater financial impact. In the eight-year period, INCA performed 4,216 medicine purchases, corresponding to 238,284,897 units of 680 different medicines. The expenses were impressive: R$ 922.171.315, 51. There was a tendency towards reduction of number of purchases and of purchase prices over the period. Main ATC groups involved in purchases were Antineoplastic and Immunomodulating Agents (L), Antiinfectives for Systemic Use (J) and Nervous System Drugs (N). These groups are representative the institutional care profile. About 85% of the acquisitions occurred through bidding by manufacturers. A trend of increase in off-bid purchases was observed, strongly influenced by sole supplier acquisitions. Annual data on contracted expenses permitted identification of antineoplastic drugs causing greater impact on drug procurement: trastuzumab, imatinib mesylate, docetaxel, rituximab and capecitabine. The examination of INCA purchases also brought to light important limitations for the success of medicine purchases in the institution, such as: long procurement process duration, budgetary cuts and difficulties in availability of human resources qualified for better understanding the particularities of medicines and their market environment. |
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Caetano, Rosângelahttp://lattes.cnpq.br/0888484011330781Castro, Claudia Garcia Serpa Osorio dehttp://lattes.cnpq.br/5793929244314712Rodrigues, Paulo Henrique de Almeidahttp://lattes.cnpq.br/4031753606677623Steffen, Ricardo Ewbankhttp://lattes.cnpq.br/1858815790172075Santos, Maria Angélica Borges doshttp://lattes.cnpq.br/1679365267765286Silva, Rondineli Mendes dahttp://lattes.cnpq.br/9168471977755273http://lattes.cnpq.br/4048012144501624Moraes, Elaine Lazzaroni2020-08-02T16:55:25Z2018-04-182017-04-24MORAES, Elaine Lazzaroni. Compras de medicamentos pelo Instituto Nacional de Câncer: análise do período 2007-2014.. 2017. 354 f. Tese (Doutorado em Ciências Humanas e Saúde; Epidemiologia; Política, Planejamento e Administração em Saúde; Administra) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2017.http://www.bdtd.uerj.br/handle/1/4787The Brazilian National Cancer Institute (INCA) is a national reference center for cancer care in the country and an important purchaser for treatment and paliative care medicines. It possesses a specific separate annual budget for maintenance of the medicine stocks in the institution. Expenses exceeded R$ 650 million between 2007 and 2014. This study examined drug procurement carried out by INCA between January/2007 and December/2014 in order to (1) identify acquired medicines, their therapeutic classification, type of purchase, suppliers, volumes, prices and expenses contracted in these purchases; (2) analyze off-bid procurement modes of purchase and (3) study the antineoplastic drugs of greater impact for procurement in the institution. This was designed as a descriptive, quantitative and retrospective exploratory study, based on INCA drug procurement registers. Data source was a public domain secondary data base extracted from the federal government procurement system. The analyzed variables were purchase mode, justification of the off-bid purchases, acquired total volume, unit purchase price and contracted suppliers. The medicines were categorized by Anatomical Therapeutic Classification (ATC). Unit prices were deflated to December 2014 using the National Consumer Price Index (IPCA/IBGE). For analysis of the historical behavior of prices and volumes, a trend analysis was performed based on the least squares method. A 50% cut-off point of contracted annual spending identified antineoplastics of greater financial impact. In the eight-year period, INCA performed 4,216 medicine purchases, corresponding to 238,284,897 units of 680 different medicines. The expenses were impressive: R$ 922.171.315, 51. There was a tendency towards reduction of number of purchases and of purchase prices over the period. Main ATC groups involved in purchases were Antineoplastic and Immunomodulating Agents (L), Antiinfectives for Systemic Use (J) and Nervous System Drugs (N). These groups are representative the institutional care profile. About 85% of the acquisitions occurred through bidding by manufacturers. A trend of increase in off-bid purchases was observed, strongly influenced by sole supplier acquisitions. Annual data on contracted expenses permitted identification of antineoplastic drugs causing greater impact on drug procurement: trastuzumab, imatinib mesylate, docetaxel, rituximab and capecitabine. The examination of INCA purchases also brought to light important limitations for the success of medicine purchases in the institution, such as: long procurement process duration, budgetary cuts and difficulties in availability of human resources qualified for better understanding the particularities of medicines and their market environment.O Instituto Nacional de Câncer (INCA) é a instituição pública de referência nacional para a atenção oncológica no País e importante comprador de medicamentos para tratamento e paliação do paciente com câncer, com gastos que ultrapassaram 650 milhões de reais entre 2007 e 2014. Este estudo examinou as compras de medicamentos realizadas pelo INCA entre janeiro de 2007 e dezembro de 2014, a fim de (1) identificar os medicamentos adquiridos, as quantidades compradas, as classes terapêuticas relacionadas, os tipo de compra adotado, os fornecedores e os gastos contratados nestas compras; (2) analisar as compras sem licitação (dispensa e inexigibilidade), e (3) estudar o comportamento das compras dos antineoplásicos de maior impacto financeiro para instituição. Foi conduzido estudo exploratório, descritivo, quantitativo e retrospectivo, com base nos registros das compras do INCA, de domínio público, organizados em banco de dados secundários proveniente do governo federal. As variáveis analisadas foram: modalidade de compra, justificativa das compras realizadas sem licitação, quantidade total adquirida, preço unitário praticado e fornecedor contratado. Os medicamentos foram categorizados pela Classificação Anatômica Terapêutica Química (ATC). Os preços unitários foram corrigidos para dezembro/2014 pelo IPCA/IBGE. Para análise do comportamento histórico de preços e quantidades, utilizou-se análise de tendência pelo método dos mínimos quadrados. Para identificação dos medicamentos de maior impacto financeiro, foi adotado ponto de corte de 50% dos gastos anuais contratados. Nos oito anos analisados, o INCA realizou 4.216 compras de medicamentos, correspondentes a 238.284.897 unidades farmacotécnicas de 680 medicamentos diferentes. O volume de gastos também foi expressivo: R$ 922.171.315,51. Verificou-se tendência de queda no período, tanto no número de compras quanto dos gastos contratados com medicamentos. Os principais grupos ATC envolvidos nas compras foram: Antineoplásicos e Agentes Imunomoduladores (L), Sistema Nervoso (N) e Anti-infecciosos de uso sistêmico (J), representativos do perfil assistencial da instituição. Cerca de 85% das aquisições ocorreram por meio de processos licitatórios, com a contratação de fabricantes na maioria das vezes. Observou-se, contudo, tendência de crescimento nas compras sem licitação na série, fortemente influenciada pela proporção de aquisições por inexigibilidade, mesmo frente à predominância da modalidade de dispensa de licitação por motivos subjacentes aos processos de compra. Os recortes anuais dos gastos contratados permitiram identificar que os medicamentos de maior impacto foram: trastuzumabe, mesilato de imatinibe, docetaxel, rituximabe e capecitabina. O exame das compras do INCA possibilitou destacar alguns fatores limitantes para o sucesso das compras de medicamentos na instituição, como o tempo de tramitação dos processos, cortes orçamentários e a importância da qualificação dos recursos humanos para melhor compreensão das especificidades dos medicamentos e seus ambientes mercadológicos.Submitted by Boris Flegr (boris@uerj.br) on 2020-08-02T16:55:25Z No. of bitstreams: 4 Tese Elaine Lazzaroni Elementos pre textuais e cap 1,2,3e4.pdf: 916820 bytes, checksum: 7cb67c87a85bf6ebfe4a8cbc7ceddc76 (MD5) Tese Elaine Lazzaroni cap 5 a 8.pdf: 2789771 bytes, checksum: 450ab0d75d2adebd742114f261c03a0b (MD5) Tese Elaine Lazzaroni concideracoes finai e referencias.pdf: 157622 bytes, checksum: 0ea86932b15f3544ad7a992a73dddade (MD5) Tese Elaine Lazzaroni anexos e apendices.pdf: 1072915 bytes, checksum: d85bb845b72b0ce61050416b6c1a3da2 (MD5)Made available in DSpace on 2020-08-02T16:55:25Z (GMT). No. of bitstreams: 4 Tese Elaine Lazzaroni Elementos pre textuais e cap 1,2,3e4.pdf: 916820 bytes, checksum: 7cb67c87a85bf6ebfe4a8cbc7ceddc76 (MD5) Tese Elaine Lazzaroni cap 5 a 8.pdf: 2789771 bytes, checksum: 450ab0d75d2adebd742114f261c03a0b (MD5) Tese Elaine Lazzaroni concideracoes finai e referencias.pdf: 157622 bytes, checksum: 0ea86932b15f3544ad7a992a73dddade (MD5) Tese Elaine Lazzaroni anexos e apendices.pdf: 1072915 bytes, checksum: d85bb845b72b0ce61050416b6c1a3da2 (MD5) Previous issue date: 2017-04-24application/pdfporUniversidade do Estado do Rio de JaneiroPrograma de Pós-Graduação em Saúde ColetivaUERJBRCentro Biomédico::Instituto de Medicina SocialPharmaceutical ServicesCancerAntineoplastic DrugsPublic ProcurementDrug PriceAssistência FarmacêuticaCâncerAntineoplásicosCompras PúblicasPreços de MedicamentosCNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVACompras de medicamentos pelo Instituto Nacional de Câncer: análise do período 2007-2014.Drug procurements performed by the Brazilian National Cancer Institute: analysis of the period 2007-2014.info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UERJinstname:Universidade do Estado do Rio de Janeiro (UERJ)instacron:UERJORIGINALTese - Elaine Lazzaroni Moraes - 2017 - Completa.pdfTese - Elaine Lazzaroni Moraes - 2017 - Completa.pdfapplication/pdf4875859http://www.bdtd.uerj.br/bitstream/1/4787/5/Tese+-+Elaine+Lazzaroni+Moraes+-+2017+-+Completa.pdf985f9cf02731bcb370d8a15cd19416b4MD551/47872024-02-26 20:20:45.484oai:www.bdtd.uerj.br:1/4787Biblioteca Digital de Teses e Dissertaçõeshttp://www.bdtd.uerj.br/PUBhttps://www.bdtd.uerj.br:8443/oai/requestbdtd.suporte@uerj.bropendoar:29032024-02-26T23:20:45Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ)false |
dc.title.por.fl_str_mv |
Compras de medicamentos pelo Instituto Nacional de Câncer: análise do período 2007-2014. |
dc.title.alternative.eng.fl_str_mv |
Drug procurements performed by the Brazilian National Cancer Institute: analysis of the period 2007-2014. |
title |
Compras de medicamentos pelo Instituto Nacional de Câncer: análise do período 2007-2014. |
spellingShingle |
Compras de medicamentos pelo Instituto Nacional de Câncer: análise do período 2007-2014. Moraes, Elaine Lazzaroni Pharmaceutical Services Cancer Antineoplastic Drugs Public Procurement Drug Price Assistência Farmacêutica Câncer Antineoplásicos Compras Públicas Preços de Medicamentos CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA |
title_short |
Compras de medicamentos pelo Instituto Nacional de Câncer: análise do período 2007-2014. |
title_full |
Compras de medicamentos pelo Instituto Nacional de Câncer: análise do período 2007-2014. |
title_fullStr |
Compras de medicamentos pelo Instituto Nacional de Câncer: análise do período 2007-2014. |
title_full_unstemmed |
Compras de medicamentos pelo Instituto Nacional de Câncer: análise do período 2007-2014. |
title_sort |
Compras de medicamentos pelo Instituto Nacional de Câncer: análise do período 2007-2014. |
author |
Moraes, Elaine Lazzaroni |
author_facet |
Moraes, Elaine Lazzaroni |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Caetano, Rosângela |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/0888484011330781 |
dc.contributor.advisor-co1.fl_str_mv |
Castro, Claudia Garcia Serpa Osorio de |
dc.contributor.advisor-co1Lattes.fl_str_mv |
http://lattes.cnpq.br/5793929244314712 |
dc.contributor.referee1.fl_str_mv |
Rodrigues, Paulo Henrique de Almeida |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/4031753606677623 |
dc.contributor.referee2.fl_str_mv |
Steffen, Ricardo Ewbank |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/1858815790172075 |
dc.contributor.referee3.fl_str_mv |
Santos, Maria Angélica Borges dos |
dc.contributor.referee3Lattes.fl_str_mv |
http://lattes.cnpq.br/1679365267765286 |
dc.contributor.referee4.fl_str_mv |
Silva, Rondineli Mendes da |
dc.contributor.referee4Lattes.fl_str_mv |
http://lattes.cnpq.br/9168471977755273 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/4048012144501624 |
dc.contributor.author.fl_str_mv |
Moraes, Elaine Lazzaroni |
contributor_str_mv |
Caetano, Rosângela Castro, Claudia Garcia Serpa Osorio de Rodrigues, Paulo Henrique de Almeida Steffen, Ricardo Ewbank Santos, Maria Angélica Borges dos Silva, Rondineli Mendes da |
dc.subject.eng.fl_str_mv |
Pharmaceutical Services Cancer Antineoplastic Drugs Public Procurement Drug Price |
topic |
Pharmaceutical Services Cancer Antineoplastic Drugs Public Procurement Drug Price Assistência Farmacêutica Câncer Antineoplásicos Compras Públicas Preços de Medicamentos CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA |
dc.subject.por.fl_str_mv |
Assistência Farmacêutica Câncer Antineoplásicos Compras Públicas Preços de Medicamentos |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA |
description |
The Brazilian National Cancer Institute (INCA) is a national reference center for cancer care in the country and an important purchaser for treatment and paliative care medicines. It possesses a specific separate annual budget for maintenance of the medicine stocks in the institution. Expenses exceeded R$ 650 million between 2007 and 2014. This study examined drug procurement carried out by INCA between January/2007 and December/2014 in order to (1) identify acquired medicines, their therapeutic classification, type of purchase, suppliers, volumes, prices and expenses contracted in these purchases; (2) analyze off-bid procurement modes of purchase and (3) study the antineoplastic drugs of greater impact for procurement in the institution. This was designed as a descriptive, quantitative and retrospective exploratory study, based on INCA drug procurement registers. Data source was a public domain secondary data base extracted from the federal government procurement system. The analyzed variables were purchase mode, justification of the off-bid purchases, acquired total volume, unit purchase price and contracted suppliers. The medicines were categorized by Anatomical Therapeutic Classification (ATC). Unit prices were deflated to December 2014 using the National Consumer Price Index (IPCA/IBGE). For analysis of the historical behavior of prices and volumes, a trend analysis was performed based on the least squares method. A 50% cut-off point of contracted annual spending identified antineoplastics of greater financial impact. In the eight-year period, INCA performed 4,216 medicine purchases, corresponding to 238,284,897 units of 680 different medicines. The expenses were impressive: R$ 922.171.315, 51. There was a tendency towards reduction of number of purchases and of purchase prices over the period. Main ATC groups involved in purchases were Antineoplastic and Immunomodulating Agents (L), Antiinfectives for Systemic Use (J) and Nervous System Drugs (N). These groups are representative the institutional care profile. About 85% of the acquisitions occurred through bidding by manufacturers. A trend of increase in off-bid purchases was observed, strongly influenced by sole supplier acquisitions. Annual data on contracted expenses permitted identification of antineoplastic drugs causing greater impact on drug procurement: trastuzumab, imatinib mesylate, docetaxel, rituximab and capecitabine. The examination of INCA purchases also brought to light important limitations for the success of medicine purchases in the institution, such as: long procurement process duration, budgetary cuts and difficulties in availability of human resources qualified for better understanding the particularities of medicines and their market environment. |
publishDate |
2017 |
dc.date.issued.fl_str_mv |
2017-04-24 |
dc.date.available.fl_str_mv |
2018-04-18 |
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2020-08-02T16:55:25Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/doctoralThesis |
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doctoralThesis |
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publishedVersion |
dc.identifier.citation.fl_str_mv |
MORAES, Elaine Lazzaroni. Compras de medicamentos pelo Instituto Nacional de Câncer: análise do período 2007-2014.. 2017. 354 f. Tese (Doutorado em Ciências Humanas e Saúde; Epidemiologia; Política, Planejamento e Administração em Saúde; Administra) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2017. |
dc.identifier.uri.fl_str_mv |
http://www.bdtd.uerj.br/handle/1/4787 |
identifier_str_mv |
MORAES, Elaine Lazzaroni. Compras de medicamentos pelo Instituto Nacional de Câncer: análise do período 2007-2014.. 2017. 354 f. Tese (Doutorado em Ciências Humanas e Saúde; Epidemiologia; Política, Planejamento e Administração em Saúde; Administra) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2017. |
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http://www.bdtd.uerj.br/handle/1/4787 |
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Universidade do Estado do Rio de Janeiro |
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Centro Biomédico::Instituto de Medicina Social |
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Universidade do Estado do Rio de Janeiro |
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