Venue: The Fuqua School of Business, Duke University, 1 Towerview Drive, Durham, NC 27708-0120

 

Presentation

Access and public expenditure on high cost medicines in the Brazilian health system, 2000-2004

Authors: Francisco de Assis Acúrcio (Federal University of Minas Gerais); Eli Iola Gurgel Andrade (Federal University of Minas Gerais); Mariângela Leal Cherchiglia (Federal University of Minas Gerais); Grazielle Dias da Silva (Federal University of Minas Gerais); Augusto Afonso Guerra Júnior (Federal University of Minas Gerais); Alessandra Maciel Almeida (Federal University of Minas Gerais); Cristina Ruas Brandão (Federal University of Minas Gerais); Odilon Vanni de Queiroz (Federal University of Minas Gerais); Daniele Araújo Campos Szuter (Brazilian Ministry of Health); Daniel Resende Faleiros (Brazilian Ministry of Health); Elias Antonio Jorge (Brazilian Ministry of Health)

Presenter: Francisco Acurcio (Federal University of Minas Gerais (UFMG))

Session: Poster Session

Room: Kirby Winter Garden

When: Monday 2:30 p.m. - 3:15 p.m.

Rationale: The Program of High Cost Medicines (PHCM) of the National Health System (SUS) in Brazil aims to respond to the demand for high unitary cost medicines or for drugs used in chronic diseases that imply in an overall high cost of treatment. Currently, one third of the federal resources invested in pharmaceutical products is aimed at high cost medicines.

Objectives: To evaluate the access and public expenditure of these drugs by the PHCM (2000 to 2004). Methodology: Patients under the PHCM were identified in the Ministry of Health’s database (DATASUS). Socio-demographic characteristics, drug profile use and expenditures were investigated and described. The monthly expenses had been corrected by general index of inflation and brought up to date to values of 2006, December. The adopted monetary unit was the American dollar. For each calendar year, the individual average expenditure with high cost medicines was obtained dividing the total value registered (12 months) by the number of people attended by the PHCM.

Results: There was an increase in the number of people attended by the PHCM. In 2000, 54.723 individuals received drugs for the first time by the PHCM. In 2004 this number was 157.742. Most of them were female (65,3%) and 31.8% of the users were 60-year-old or more. The five most frequent drugs prescribed were: Alendronate (12,0%), recombinant human erythropoietin (9,8%), olanzapine (4,8%), calcitriol (4,7%). The average monthly individual expenditure was growing from USD 516.96 in 2000 to USD 594.39 in 2004.

Conclusions: We observed an increasing of access to high cost medicines in the studied period. The highest average monthly individual expenditure with medicines was observed in 2004. However, no clear tendency of growth of these expenditures was confirmed from 2000 to 2004. The analysis of drug use profile and expenditure with high cost medicines can contribute to a more equitable allocation of resources and to guarantee more rational access to high cost medicines in the country.