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Applying a health system perspective to the evolving Farmácia Popular medicines access programme in Brazil.
Luiza, Vera L; Chaves, Luisa A; Campos, Monica R; Bertoldi, Andrea D; Silva, Rondineli M; Bigdeli, Maryam; Ross-Degnan, Dennis; Emmerick, Isabel C M.
Afiliação
  • Luiza VL; Department of Medicines and Pharmaceutical Services Policies, Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
  • Chaves LA; Pharmacy Department, Federal University of Rio de Janeiro, Macaé Campus, Rio de Janeiro, Brazil.
  • Campos MR; Department of Social Sciences, Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
  • Bertoldi AD; Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
  • Silva RM; Department of Medicines and Pharmaceutical Services Policies, Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
  • Bigdeli M; Department of Health Systems Governance and Financing, World Health Organization, Geneva, Switzerland.
  • Ross-Degnan D; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
  • Emmerick ICM; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
BMJ Glob Health ; 2(Suppl 3): e000547, 2017.
Article em En | MEDLINE | ID: mdl-29527335
The Farmácia Popular Program (FPP) launched a subsidy system in Brazil, but in coexistence with the ongoing regular governmental access to medicines (Unified Health System (SUS) dispensings) mechanisms, causing overlaps in terms of financing and target population. This characteristic is quite different from most countries with medicines cost-sharing schemes. This paper aims to analyse the FPP under a health systems perspective considering the different health system levels. We analysed the findings from the study 'Impact of consecutive subsidies policies on access to and use of medicines in Brazil - ISAUM-Br', designed with the objective of describing and evaluating the impact of the government medicines subsidy policies implemented between 2004 and 2011. Patient share of copayment increased with the implementation of the intervention, which decreased the reference price and decreased with SNP (Saúde Não Tem Preço; zero copayment for patients). There was an increased number of FPP dispensations over time, but SUS dispensings remained the most important source for medicines, especially for hypertension and diabetes. FPP allowed the establishment of a well-designed pharmaceutical information system in the country. Despite the improvement on control mechanism, fraud remained a problem. There were important effects on the pharmaceutical market and sales of generic medicines. FPP has proven to be a very important policy for promoting access to medicines for hypertension and diabetes in Brazil. Examining this policy with a health system perspective has allowed us to highlight many of its important consequences, including for the first time a broad and consistent information system on access to medicines in the country.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE País/Região como assunto: America do sul / Brasil Idioma: En Revista: BMJ Glob Health Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE País/Região como assunto: America do sul / Brasil Idioma: En Revista: BMJ Glob Health Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido