Desigualdades socioeconômicas nos gastos e comprometimento da renda com medicamentos no Sul do Brasil

Abstract

OBJECTIVE:To describe socioeconomic inequalities regarding the use, expenditures and the income committed to the purchase of medicines. METHODS:A cross-sectional population-based study was carried out with 1,720 adults living in the urban area of Florianópolis, Southern Brazil, in 2009. Cluster sampling was adopted and census tracts were the primary sampling units. Use of medicines and the expenditures incurred in their purchase in the past 30 days were investigated through interviews. Use, expenditures and the income committed concerning medicines were analyzed according to per capita family income, self-reported skin color, age and sex, adjusting for the complex sample. RESULTS:The prevalence of medicine use was 76.5% (95%CI: 73.8; 79.3), higher among women and in older individuals. The mean expenditure on medicine was R$ 46.70, with higher values among women, whites, older individuals and among richer people. While 3.1% of the richest committed more than 15% of their income to purchasing medicine, that fi gure reached 9.6% in the poorest group. The proportion of people that had to buy medicines after an unsuccessful attempt to obtain them in the public health system was higher among the poor (11.0%), women (10.2%) and the elderly (11.1%). A large part of the adults bought medicines contained in the National List of Essential Medicines (19.9%) or in the Municipal List of Essential Medicines (28.6%), with signifi cant differences according to gender, age and income. CONCLUSIONS:There is socioeconomic, age and gender inequality in the income committed to the purchase of medicines, with worse conditions for the poor, older individuals and women.

Profile of drug spend among elderly individuals from different socioeconomic groups

“…This data corroborates the study by Boing et al 16 which reports that while high-income populations use drugs prescribed by doctors, preferring those that have been recently made available in the market and are therefore technologically advanced, these costs represent only a small portion of their total income. While the consumption of drugs by the middle-income population is influenced by changes in prices, the low-income population has an inelastic demand in relation to price, as even when there is a significant drop in drug prices, the limited income of class E users limits their consumption capacity.…”

“…15 Another Brazilian cross-sectional population based study, conducted in 2009 with 1,720 adults living in the urban area of Florianópolis, in the state of Santa Catarina in southern Brazil, noted that the average spending on drugs was US $23.70, with higher rates among women, older individuals and among the highest socioeconomic class. 16 To ensure access to medicines for the majority of the population, improve the care provided by the health services and provide specific knowledge of the health profile of the elderly population in Brazil, it is necessary to carry out economic analysis and research in the health sector that can be used to support decisions on the allocation of financial resources.…”

Acesso a medicamentos no setor público: análise de usuários do Sistema Único de Saúde no Brasil

“…Isto pode explicar o fato de que mais da metade das pessoas analisadas no presente estudo tiveram de recorrer a outros meios, fora do setor público, para viabilizar seu tratamento terapêutico. Destaca-se, por fim, que a migração dos usuários do SUS para o setor privado ou de copagamento para garantir o acesso aos medicamentos implica maior comprometimento de renda nos gastos em saúde, extremamente elevados 31 , que penalizam, sobretudo, os mais pobres 32 .…”

Conhecimento e utilização do Programa Farmácia Popular do Brasil: estudo de base populacional no município de Campinas-SP

“…representar, no orçamento familiar dos setores economicamente menos favorecidos da população, a maior parte dos gastos privados em saúde. 12 No presente estudo, a maior prevalência em relação ao conhecimento do Programa, observada no segmento com maior poder aquisitivo e escolaridade, sugere que esses estratos sociais possuam condições mais favoráveis para acessar o PFPB, devido à possibilidade de pagar pelos medicamentos, além de usufruírem, eventualmente, de maior acesso à informação sobre o Programa ou ao estabelecimento fornecedor do medicamento. Estudos sobre o copagamento indicam que os usuários não se importam em pagar por um serviço ou por um medicamento, desde que se garanta o acesso a ele.…”