Análise comparativa das estratégias de abastecimento de medicamentos do componente básico, no Estado de Minas Gerais

• Autor(a) principal: Carolina Andrade Oliveira Dibai
• Data de Publicação: 2020
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFMG
• Texto Completo: http://hdl.handle.net/1843/34758
• topic: Saúde pública; Gestão de medicamentos; Economia da saúde; Assistência Farmacêutica; Descentralização

The supply of medicines must be in accordance with the real needs of the population and in line with the principles of the Sistema Único de Saúde (SUS). Thus, Pharmaceutical Assistance management has been adopting new organizational formats, based, especially, on the principle of decentralization, with the objective of promoting better efficiency of the process. The current situation, of scarcity of financial resources, mainly with regard to federal resources, which have been frozen since 2016, places have a greater participation in financing in Primary Health Care. In addition, the amounts set by doctors to the Basic Component of Pharmaceutical Care they are outdated and are already insufficient to meet the needs of the municipalities. And medication logistics costs are also significant in public spending. Faced with the scenario of limited resources and increased expenses in order to improve access, in 2016, the Secretaria de Estado da Saúde de Minas Gerais (SES/MG) implemented a decentralized strategy of supplying medicines from the Basic Component and extinguished centralized supply. This study aimed to carry out a comparative analysis between a drug supply strategy of the Basic Component of Centralized Pharmaceutical Assistance and a decentralized strategy. In order to achieve the objective, an analysis of the main characteristics of the two types of arrangement should be carried out as regards financing, the way resources are managed, the purchase of medicines and logistics. To this end, a documentary review of the main legal frameworks was carried out to reference the financing and purchase of medicines of the Basic Component in the state of Minas Gerais, as well as Technical Notes, Memoranda, Letters and Reports that describe the history and characteristics of the two strategies. In addition, an economic assessment was carried out between the two strategies from the perspective of state public financing, assessing the costs of medicines and logistical operations. Finally, the prices and quantities of drugs purchased in the State Price Record Minutes in 2015 and 2018 and the prices of drugs purchased in municipal bidding processes were compared with state prices in 2018. The results of this study showed that the decentralized model is positive because it follows the principle of SUS and has the cooperation of the state in the acquisition stage. Decentralization also brought about an increase in the state contribution, an increase in the number of castles and greater autonomy for the municipalities. In addition, savings of 6.5% were observed in 2018 when compared to 2015, economies of scale due to the increase in   quantities purchased and greater efficiency in state acquisitions when compared to municipal ones. It is concluded, therefore, that the process of decentralization of the supply of medicines from the CBAF in Minas Gerais enables savings of resources and favors cooperation with the municipalities regarding the administrative infrastructure for the purchase of medicines and an increase in the state counterpart.