Doença de Alzheimer: uma estimativa dos gastos federais com o tratamento farmacológico no Brasil, de 2010 a 2014.

• Autor(a) principal: Costa, Roberta Dorneles Ferreira da
• Data de Publicação: 2016
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/4349
• topic: Drug Expenditures; Pharmaceutical Services; Unified Health System; Gastos com medicamentos; Doença de Alzheimer; Assistência farmacêutica; Sistema Único de Saúde (Brasil); CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA

The relationship between increased access and spending on medicines is considered a challenge for the Brazilian Health System. The aging population contributes to increased spending with chronic degenerative diseases, such as Alzheimer's disease (AD). Since 2002, AD has a specific treatment guideline (PCDT) and recommended medicines belong to the Specialized Component of Pharmaceutical Services (CEAF) list, financed by the Brazilian Ministry of Health (MoH). This study carried out an estimate of federal expenditure on medicines for first-line treatment of AD, recommended (or not) by the PCDT. We examined the profile of purchase quantities and prices as well as the influence of government strategies aiming at resource efficiency. This study used three data sources. One was the general procurement database of the Brazilian Federal Government, which records the purchases of products by federal agencies. Also used were the Outpatient Information System, in order to extract the transfer of funds for AD medicines present in the CEAF 1B group and information relating to acquisitions agreements generated by Productive Development Partnerships (PDP), obtained through the Access to Information Act. We assessed the period from 2010 to 2014, and the generated values were corrected for December 2014 by the IPCA (Brazilian Pricing Index). The total estimated purchase of medicines for AD was R$ 862,943,367.02, for a volume of 253,390,415 units, with participation of the Ministries of Health, Education (MoE) and Defense (MoD). Expenditures concentrated on medicines present in the PCDT and funded by the MoH. Among MOH expenses, noteworthy are the transfers of resources to the federal entities and a significant share of rivastigmine acquisitions resulting from the PDP. Non-PCDT medicines showed a 0.4% share of expenditures, and were acquired either through litigation by MoH, or directly tendered by MoD. A reduction in corrected average prices occurred for all medicines, regardless of their presence in PCDT. Updates in the PCDT, changes in the financing and purchase of medicines, and the establishment of Productive Development Partnerships contributed to the expansion of AD treatment in Brazil.