Política Nacional de Medicamentos em retrospectiva: um balanço de (quase) 20 anos de implementação

Vasconcelos, Daniela Moulin Maciel de; Chaves, Gabriela Costa; Azeredo, Thiago Botelho; Silva, Rondineli Mendes da

doi:10.1590/1413-81232017228.02432017

Cited by 27 publications

(24 citation statements)

References 5 publications

(2 reference statements)

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“…Even though HTA is rightly established as the most important tool for the choice of best technologies, it is a method and not a policy pathway. Essential medicines selection has ceded to innovation and adoption as an organizing principle for medicine availability within the health system [17,21,24].…”

Section: Discussionmentioning

confidence: 99%

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Policy Change and the National Essential Medicines List Development Process in Brazil between 2000 and 2014: Has the Essential Medicine Concept been Abandoned?

Osório-de-Castro

Azeredo

Pepe

et al. 2017

Basic Clin Pharma Tox

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Brazil has had a National Essential Medicines List (EML) since 1964. From 2000 to 2010, five consecutive evidence-based editions were produced, building on the essential medicine concept. In 2012, the government changed course to establish a new paradigm, introducing adoption of new medicines as the main aim within the recommendation process. The objective of the article was to report efforts to develop Brazil's national EML, policy changes from 2000 to 2014, discussing results, challenges and perspectives. Brazilian EML history and development process were collected from legislation, minutes, reports and legal ordinances, from 2000 to 2014. The Brazilian EML and the WHO Model Lists were compared using the Anatomical Therapeutic Chemical system. Overlap between lists was verified, and linear trends were produced. Type of membership, inclusion criteria, procedures, flow and listed medicines varied greatly between the selection committees acting before and after 2012. Paradigm-changing legislation aiming at linking list compliance to public financing in 2012 produced (i) greater importance given to political and administrative stakeholders, (ii) increasing trends in number of medicines over the years, (iii) decrease in use of WHO Model List as a reference and (iv) substitution of an essential medicines list review and update process by an adoption decision output. Other issues remained unchanged. Insufficient efforts for list implementation, such as lack of physician education, presented consequences to the health system. Substantial efforts were made to produce and update the list from 2000 to 2014. However, continuous and intense health litigation disproves process outcome effectiveness.

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Section: Discussionmentioning

confidence: 99%

“…An implementation strategy adopted by the MoH included financing of rational prescribing courses, based on WHO good prescribing practices, in several Brazilian states and municipalities, involving various national. The first course was nation-wide, in 2002 [21].…”

Section: Ad Hoc Committee Membersmentioning

confidence: 99%

Policy Change and the National Essential Medicines List Development Process in Brazil between 2000 and 2014: Has the Essential Medicine Concept been Abandoned?

Osório-de-Castro

Azeredo

Pepe

et al. 2017

Basic Clin Pharma Tox

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“…The reorientation of pharmaceutical services proposed by the NMP was cross-cutting, producing direct impacts in the field of public health 6 . The priorities set forth in the guideline are built around three key elements: decentralization, funding, and logistical actions 7 .…”

Section: Realignment Of Pharmaceutical Services -The Comprehensivenesmentioning

confidence: 99%

Assistência Farmacêutica nos 30 anos do SUS na perspectiva da integralidade

Bermudez

Esher

Osório-de-Castro

et al. 2018

Ciênc. saúde coletiva

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This article examines pharmaceutical services and access to essential medicines in Brazil during the 30 years since the advent of Brazil's Unified Health System from a comprehensiveness perspective. The following topics are addressed: the "realignment" of pharmaceutical services; human resources in pharmaceutical services; the essential medicines concept; the rational use of medicines; technological advances and drug manufacturing; and ethical regulation. With a strong regulatory focus and a structural framework centered on the National Medicines Policy, the past three decades represent a mixture of progress and setbacks, considering the national complexities of the healthcare system and the political, economic and social changes that have influenced policy and access to medicines, which is a key concern even in the world's richest countries, as the forums of discussion on global health have demonstrated. We show that major steps forward have been taken, highlighting that the recent fiscal austerity measures imposed by the government threaten to seriously undermine social progress.

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“…Within the field of action of the SUS is the implementation of comprehensive therapeutic care actions (including pharmaceutical) and the formulation of the National Medicines Policy (NMP) that aims to ensure the safety, effectiveness, and quality of medicines and to promote the rational use of and access to medicines that are considered essential. Medicines and other health technologies are at the heart of the health system as they contribute to disease prevention and health care (Vasconcelos, Chaves, Azeredo, & Silva, 2017).…”

Section: Introductionmentioning

confidence: 99%

“…The reformulation of pharmaceutical care by the NMP allowed for the promotion of access to medicines due to the increased availability of medicines in the SUS. The decentralization of drug management was also implemented, which defined the responsibilities for the financing, procurement, and distribution of medicines and reorganized and divided pharmaceutical assistance into three components: basic, specialized, and strategic (Vasconcelos et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Pharmaceutical Service for Multiple Sclerosis Carriers in Brazil: A State Model

Ferreira¹,

Pereira²,

Oliveira³

et al. 2020

GJHS

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The Specialized Component of Pharmaceutical Care is the Brazilian Unified Health System strategy that aims to ensure comprehensive drug treatment at an outpatient level and improve access to high complexity, high cost treatments, such as multiple sclerosis. Given the diversity of treatments available and the differences in financing and dispensing in different countries, the objective of this study was to present the workings of the model of care for patients with multiple sclerosis through the public health system in Brazil in the state of Mato Grosso do Sul. In Campo Grande, the registration and dispensation of drugs for the treatment of multiple sclerosis is the responsibility of the Pharmacy School Professor Ana Maria Cervantes Baraza of the Federal University of Mato Grosso do Sul. In this center, all patients receive pharmaceutical advice on the administration of injectable drugs and oral medications; the storage, preservation, and transportation of refrigerated drugs; and information on the disease and management of adverse reactions. Clinical pharmacy services are also available to patients in a pharmaceutical office, ensuring patient privacy and comfort and enabling the creation of a bond with the pharmacist. The model of care provided by the Pharmacy School allows for the development of pharmaceutical services, encourages the rational use of medicines, and emphasizes the importance of self-care, adherence to therapy, and the co-responsibility of patients and their families.

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Política Nacional de Medicamentos em retrospectiva: um balanço de (quase) 20 anos de implementação

Cited by 27 publications

References 5 publications

Policy Change and the National Essential Medicines List Development Process in Brazil between 2000 and 2014: Has the Essential Medicine Concept been Abandoned?

Policy Change and the National Essential Medicines List Development Process in Brazil between 2000 and 2014: Has the Essential Medicine Concept been Abandoned?

Assistência Farmacêutica nos 30 anos do SUS na perspectiva da integralidade

Pharmaceutical Service for Multiple Sclerosis Carriers in Brazil: A State Model

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