Resource allocation for pharmaceutical procurement in the Brazilian Unified Health System

• Autor(a) principal: Vieira, Fabiola Sulpino
• Data de Publicação: 2011
• Outros Autores: Zucchi, Paola
• Tipo de documento: Artigo
• Idioma: por; eng
• Título da fonte: Revista de Saúde Pública
• Texto Completo: https://www.revistas.usp.br/rsp/article/view/33034
• topic: Custos de Cuidados de Saúde; Assistência Farmacêutica; economia; Dotação de Recursos para Cuidados de Saúde; Eqüidade na Alocação de Recursos; Gastos em Saúde; Sistema Único de Saúde; Costos de la Atención en Salud; Servicios Farmacéuticos; economía; Asignación de Recursos para la Atención de Salud; Equidad en la Asignación de Recursos; Gastos en Salud; Sistema Único de Salud; Health Care Costs; Pharmaceutical Services; economics; Health Care Rationing; Equity in the Resource Allocation; Health Expenditures; Unified Health System

OBJECTIVE: To analyze resource allocation for pharmaceutical procurement by federative entities in the Brazilian Unified Health System. METHODS: The amounts allocated to purchase pharmaceuticals during 2009 in two information systems were analyzed: Siga Brasil (Follow Brazil) for national data and Sistema de Informações sobre Orçamentos Públicos em Saúde (Information System on Public Health Budgets) for states, the Federal District and municipalities data. Per capita spending and the mean and median spending were calculated by municipalities, according to region and population size. The Spearman correlation coefficient was calculated for some variables. The statistical analysis included tests of normality and multiple comparisons for differences between groups. RESULTS: In 2009 the total amount spent by the three spheres of government for purchase of medicines was approximately R$ 8.9 billion. States and the Federal District were the main players, accounting for 47.1% of the total amount spent in the health system. Some states had per capita spending well above the mean (R$ 22.00 per resident/year) and the median (R$ 17.00 per resident/year). There were differences in municipal spending by region. The mean per capita expenditure of municipalities with less than 5,000 residents was 3.9 times that of municipalities with over 500,000 residents. Municipalities with less than 10,000 residents had higher per capita spending than other municipalities. CONCLUSIONS: Economic aspects such as the scale of procurement and bargaining power may explain differences in per capita spending between federal entities, especially among municipalities. The study indicates inefficiencies in the use of financial resources to procure medicines in the Brazilian Unified Health System.