Acesso aos medicamentos para tratamento da doença de Alzheimer fornecidos pelo Sistema Único de Saúde em Minas Gerais, Brasil

Almeida-Brasil, Celline Cardoso; Costa, Juliana de Oliveira; Aguiar, Viviane Celestino Ferreira dos Santos; Moreira, Daniela Pena; Moraes, Edgar Nunes de; Acúrcio, Francisco de Assis; Júnior, Augusto Afonso Guerra; Álvares, Juliana

doi:10.1590/0102-311x00060615

Cited by 18 publications

(30 citation statements)

References 20 publications

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“…In this sense, it is emphasized the importance of correct filling and accomplishment of all legal requisites to obtain the respective process acceptance. The proportion of processes acceptance for PsA was larger than that observed for Alzheimer disease and similar to that observed for renal transplantation [19,20].…”

Section: Main Datessupporting

confidence: 73%

Access to high-cost medications for psoriatic arthritis in the National Health System in Brazil: the long path up to dispensation

et al. 2019

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Background: Pharmaceutical Assistance (PA) is a dynamic and multidisciplinary process that aims to supply health systems, programs or services with quality medicines, enabling access and health care, in an efficient and timely manner. The objective of the study was to evaluate the profile of administrative processes for the treatment of PsA, identify the time elapsed in the flow of processes and its associated factors. Methods: A cross-sectional study of medication requests for the treatment of PsA was carried out between November 2014 and December 2016. Linear regression was used to verify the factors associated with time to delivery. Results: A total of 218 cases containing 250 drugs were analyzed. The median time between the medical appointment and the first dispensation was 66 days (interquartile range, 44-90). The State proceedings, which includes requesting the drug until the authorization of treatment, was the stage that most contributed to the total time spent. The factors associated with the longer time to delivery of medications were prescriptions coming from clinics and specialty centers, from dermatologists, non-authorized processes and non-persistent patients in the treatment in 12 months. Conclusion: The median time to receive medicines for the PsA treatment in Belo Horizonte health region after a medical prescription was higher than 2 months. The time between the solicitation of the medicines and the authorization of the treatment in the SUS (State administrative procedure) was the main component of the total time spent.

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Section: Main Datessupporting

confidence: 73%

Access to high-cost medications for psoriatic arthritis in the National Health System in Brazil: the long path up to dispensation

et al. 2019

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“…AD has no cure, and even though available medications alleviate the symptoms and delay the progression of the disease, current therapy is far from being satisfactory 14 . The drug treatments currently available for AD are acetylcholinesterase inhibitors (AChEIs), such as rivastigmine, galantamine and donepezil, and N-methyl-D-aspartate (NMDA) receptor antagonist, such as memantine 15 .…”

Section: Introductionmentioning

confidence: 99%

“…Medicines are highly relevant inputs to establish policies and priorities adjusted to the population's health needs but are rarely used in prevalence studies 15 . The information resulting from the use of specific drugs is predictably more reliable since drugs used in the treatment of cognitive symptoms follow specific protocols from the Brazilian Ministry of Health and can only be applied in the treatment of AD 18 .…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Alzheimer's disease according to anticholinesterase drug usage from 2012 to 2017 in the state of Paraná, Brazil

et al. 2020

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Introduction: Alzheimer's disease (AD) is a public health problem in Brazil due to the growing number of older adults in this population. Knowing the prevalence of AD in the Paraná state is essential to improve patients’ quality of life. The objective of the study was to estimate AD prevalence in the state of Paraná, based on the prescription of anticholinesterases, from 2012 to 2017. Methods: Patients diagnosed with AD, aged 60 years or over, who used Brazil’s Unified Public Health System (SUS) and received AD medication from the Department of Pharmaceutical Assistance of the state of Paraná, from 2012 to 2017, were the target population of the present study. The medication data were collected from the Computerized system management and Monitoring of Exceptional Drugs (SISMEDEX), and the population’s data were collected from the Brazilian Institute of Geography and Statistics (IBGE). Results: The sample consisted of 52,687 patients, and the median prevalence of AD in the established period for the state was 642.6/100,000 inhabitants (0.64%). In all ages and macro-regions, women showed the highest prevalence rates. The median prevalence for women in the established period was 755.4/100,000 inhabitants (0.75%). Among men, the median prevalence was 510.2/100,000 inhabitants (0.51%). In the temporal analysis of prevalence, between 2012 and 2017, a reduction of 23% was found in the state rate. The prevalence rate of Paraná for AD is nine times lower than the Brazilian average. Conclusions: Paraná’s prevalence rate for AD is lower than the rates of Brazil and the world, suggesting that AD is underdiagnosed in most municipalities of this state.

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“…The objective of this work is to perform an analysis of the cost-effectiveness of donepezil and rivastigmine, the drugs most commonly prescribed for mild and moderate AD,15 from the perspective of the Unified Health System.…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness analysis of the treatment of mild and moderate Alzheimer’s disease in Brazil

Silva

Vianna

Mosegui

et al. 2019

Braz. J. Psychiatry

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Objective:To perform a cost-effectiveness analysis of donepezil and rivastigmine therapy for mild and moderate Alzheimer’s disease (AD) from the perspective of the Brazilian Unified Health System.Method:A hypothetical cohort of 1,000 individuals of both sexes, aged >65 years, and diagnosed with AD was simulated using a Markov model. The time horizon was 10 years, with 1-year cycles. A deterministic and probabilistic sensitivity analysis was performed.Results:For mild AD, the study showed an increase in quality-adjusted life years (QALYs) of 0.61 QALY/21,907.38 Brazilian reais (BRL) for patients treated with donepezil and 0.58 QALY/BRL 24,683.33 for patients treated with rivastigmine. In the moderate AD group, QALY increases of 0.05/BRL 27,414.96 were observed for patients treated with donepezil and 0.06/BRL 34,222.96 for patients treated with rivastigmine.Conclusions:The findings of this study contradict the standard of care for mild and moderate AD in Brazil, which is based on rivastigmine. A pharmacological treatment option based on current Brazilian clinical practice guidelines for AD suggests that rivastigmine is less cost-effective (0.39 QALY/BRL 32,685.77) than donepezil. Probabilistic analysis indicates that donepezil is the most cost-effective treatment for mild and moderate AD.

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Acesso aos medicamentos para tratamento da doença de Alzheimer fornecidos pelo Sistema Único de Saúde em Minas Gerais, Brasil

Cited by 18 publications

References 20 publications

Access to high-cost medications for psoriatic arthritis in the National Health System in Brazil: the long path up to dispensation

Access to high-cost medications for psoriatic arthritis in the National Health System in Brazil: the long path up to dispensation

Prevalence of Alzheimer's disease according to anticholinesterase drug usage from 2012 to 2017 in the state of Paraná, Brazil

Cost-effectiveness analysis of the treatment of mild and moderate Alzheimer’s disease in Brazil

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