Programa Aqui tem Farmácia Popular : expansão entre 2006-2012 e comparação com os custos da assistência farmacêutica na Secretaria Municipal de Saúde do Rio de Janeiro

• Autor(a) principal: Silva, Rondineli Mendes da
• Data de Publicação: 2014
• 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/1/4711
• topic: Pharmaceutical services; Costs and cost analysis; Drug costs; Government programs; Popular Pharmacy Program; Assistência farmacêutica; Custos e análise de custo; Custos de medicamentos; Programas governamentais; Programa Farmácia Popular do Brasil; CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA

In 2004, Brazil's government announced at the federal level a new mechanism to improve the Brazilian population s access to medicines. The policy called Popular Pharmacy Program (PPPB) provides a list of medicines subsided by the government. This is a copayment provision model for medicines, additionally to the previous existent access to medicines mechanisms. The PPPB can be divided in three models: on public sector, called own network, the expansion to the private sector in 2006 (public-private partnership with the retail pharmacy sector called "Aqui Tem Farmácia Popular" (ATFP) and finally the 100% subsidy in 2011 in all pharmacies under the program to medicines and products to hypertension, diabetes and asthma. This study examined the Aqui tem Farmácia Popular Program, analyzing it comparatively towards the public provision on the Municipal Health Secretariat at Rio de Janeiro county (SMS-Rio), considering the financial burden in each model. Secondary datasets were obtained to assess the Federal spending of Ministry of Health (MoH) on payments ATFP Program such as the National Health Fund and Living Support Strategic Management, from 2006 to 2012. Data on total amount medicines expenditures, profile of the patients and pharmaceutical units (PU) dispensed were mapped by direct contact with the Electronic System Information Service Citizen. Information on acquisition, logistics and dispensing of twenty five medicines, restricted to the year 2012 were performed in order to estimate the cost of SMS-Rio. In the period 2006-2012 there was a strong expansion of the ATFP program, both accredited units such as municipalities covered with a growth of 750 % and 528 %, respectively. Federal spending on medicines in ATFP during this period were approximately R$ 3.4 billion, with reversal of flow of payments to entities outside the capital, an increase of capillary Program, and relative concentration of payments in large retailers matrix. In the city of Rio de Janeiro, these expenses were higher than R$ 260 million. Since 2008, the amount invested in the public-private partnership by the Federal level is superior on the investments on the acquisition of basic medicines on the traditional procurement process. Comparative costs between the lowest reference value (RV) ATFP program, corresponding to the maximum paid by MoH less taxes, and the estimated cost for PU in SMS-Rio of medicines showed up on the average, under the program the cost is around 255% greater than the municipal cost. The relation on cost was favorable to the the SMS-Rio in 20 of 25 common items. Simulation considering the demand of each drug consumed by SMS-Rio in 2012 showed that if the municipality acquired by the lowest RV, increased more than R$ 95 million in total cost for the same 25 products. The Ministerial Programme has improved access to medicines, but spending significant repercussions in its interface with the decentralized system of financing of pharmaceutical services. Reference Value could be objects of study and assessment review, compared to systematically better cost values raised to SMS-Rio.