Registro e incorporação de tecnologias no SUS: barreiras de acesso a medicamentos para doenças da pobreza?

Santana, Rafael Santos; Lupatini, Evandro de Oliveira; Leite, Silvana Nair

doi:10.1590/1413-81232017225.32762016

Cited by 16 publications

(20 citation statements)

References 15 publications

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“…The authors highlight that an equitable alternative for analysis of technologies can be centered on the development by the SUS of activities known as Horizon Scanning (Monitoramento do Horizonte Tecnológico [MHT]) for poverty-related diseases. This strategy would contribute to forming a definition of priority technologies for the SUS and the orientation of investment in research and development of medicines that meet national needs [79].…”

Section: Discussionmentioning

confidence: 99%

The organization, weaknesses, and challenges of the control of thalidomide in Brazil: A review

2020

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The drug thalidomide has resurged in the world market under restrictive conditions for marketing and use. In Brazil, there are still cases of pregnant women using thalidomide even after the implementation of laws that regulate the control of use (Law No. 10.651/2003 and Collegiate Board Resolution No. 11/2011). The objective of this study was to discuss the control of thalidomide use in Brazil, based on a scoping review of the scientific literature, documents, and data from the Ministry of Health. A total of 51 studies and documents related to the following subthemes were selected: (1) organization of access and use of thalidomide in the health system; (2) epidemiological and population characteristics of people affected by leprosy; and (3) occurrence of pregnancy and cases of embryopathy with the use of thalidomide. The results showed that Brazil has no unified information database about thalidomide patients. Furthermore, there is inconsistency in the accreditation of public health centers that dispense this medicine, in a country that has a high consumption of thalidomide in the Unified Health System. A large part of this amount of dispensed medicine is intended for the treatment of erythema nodosum leprosum, mainly in the North, Northeast, and Central-West regions of the country, which are endemic for leprosy. This disease is the only one among the clinical indications of the medicine approved in Brazil that does not have a Clinical Protocol and Therapeutic Guidelines. The control of thalidomide use in Brazil presents historical regulatory failures. These are currently linked to the organization and structure of primary healthcare in the country, as well as to the lack of leadership of the Ministry of Health and National Health Surveillance Agency when it comes to managing the process of control of this use.

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Section: Discussionmentioning

confidence: 99%

The organization, weaknesses, and challenges of the control of thalidomide in Brazil: A review

2020

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“…This committee considers, before make a decision, effective aspects such as safety and cost/benefit by comparing medicines, and other technologies that already exist in the system. 8 , 9…”

Section: Introductionmentioning

confidence: 99%

Legal demands of the tiotropium bromide for treatment of chronic obstructive pulmonary disease and their financial impact for the State of Paraná, Brazil

Szpak¹,

Strapasson²,

Böger³

et al. 2019

Einstein (São Paulo)

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Objective To analyze the legal demands of tiotropium bromide to treat chronic obstructive pulmonary disease.Methods We included secondary data from the pharmaceutical care management systems made available by the Paraná State Drug Center.Results Public interest civil action and ordinary procedures, among others, were the most common used by the patients to obtain the medicine. Two Health Centers in Paraná (Londrina and Umuarama) concentrated more than 50% of the actions. The most common specialty of physicians who prescribed (33.8%) was pulmonology. There is a small financial impact of tiotropium bromide on general costs with medicines of the Paraná State Drug Center. However, a significant individual financial impact was observed because one unit of the medicine represents 38% of the Brazilian minimum wage.Conclusion Our study highlights the need of incorporating this medicine in the class of long-acting anticholinergic bronchodilator in the Brazilian public health system.

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“…It is characterized generally by a greater interest of the pharmaceutical industry and consequently more number of launches / innovations and patents. These medicines are particularly applied for the so called “global diseases”, those that did not have the socioeconomic vulnerability bias as a fundamental determinant [ 5 , 6 , 7 , 8 ]. In Brazil, those diseases are covered by a program called Specialized Component of Pharmaceutical Assistance [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…They are often characterized by requesting older and less expensive drugs for the health system. In Brazil, these drugs are mostly produced by public laboratories and covered by the public program called Strategic Conditions Component of the Pharmaceutical Assistance [ 5 , 6 ]. In this country, poverty-related diseases are particularly important health issues.…”

Section: Introductionmentioning

confidence: 99%

“…In this country, poverty-related diseases are particularly important health issues. They are the result of poor living conditions, insufficient access to adequate and healthy food, clean drinking water, medical care and education [ 5 , 6 , 7 , 8 ]. Some infectious diseases such HIV, considered related to poverty globally, in Brazil is not classified as neglected or poverty related.…”

Section: Introductionmentioning

confidence: 99%

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The different clinical guideline standards in Brazil: High cost treatment diseases versus poverty-related diseases

et al. 2018

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Each year, evidence-based clinical guidelines gain more space in the health professionals’ practice and in services organization. Due to the scarcity of scientific publications focused on diseases of poverty, the development of well-founded clinical guidelines becomes more and more important. In view of that, this paper aims to evaluate the quality of Brazilian guidelines for those diseases. The AGREE II method was used to evaluate 16 guidelines for poverty-related diseases (PRD) and 16 guidelines for global diseases whose treatment require high-cost technologies (HCD), with the ultimate aim of comparing the results. It was found that, in general, the guideline development quality standard is higher for the HCD guidelines than for the PRD guidelines, with emphasis on the "rigour of development" (48% and 7%) and "editorial independence" (43% and 1%) domains, respectively, which had the greatest discrepancies. The HCD guidelines showed results close to or above international averages, whereas the PRD guidelines showed lower results in the 6 domains evaluated. It can be concluded that clinical protocol development priorities need some redirecting in order to qualify the guidelines that define the healthcare organization and the care of vulnerable populations.

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Registro e incorporação de tecnologias no SUS: barreiras de acesso a medicamentos para doenças da pobreza?

Cited by 16 publications

References 15 publications

The organization, weaknesses, and challenges of the control of thalidomide in Brazil: A review

The organization, weaknesses, and challenges of the control of thalidomide in Brazil: A review

Legal demands of the tiotropium bromide for treatment of chronic obstructive pulmonary disease and their financial impact for the State of Paraná, Brazil

The different clinical guideline standards in Brazil: High cost treatment diseases versus poverty-related diseases

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