Free access to hypertension and diabetes medicines among the elderly: a reality yet to be constructed

Abstract

The study evaluated free access to hypertension and diabetes medicines and the reasons reported for lack of access. The sample included 4,003 elderly people living in Primary Care Unit coverage areas from 41 Southern and Northeastern Brazilian cities. Free access was higher in the Northeast (62.4%). The strategy of the Family Health Program (Programa Saúde da Família - PSF) was more effective in providing access than the traditional model, with higher results in the Northeast (61.2%) than in the South (39.6%). Around 20% of medicines included in the Hypertension and Diabetes Program and 26% of those included in the National Essential Medicines List (RENAME) were paid out of pocket. In the Northeast, 25% of insulin and 32% of oral antidiabetics were paid out of pocket. Unavailability in the public sector and a lack of money determined the lack of access. Although the PSF, Hypertension and Diabetes Program and RENAME expanded free access, supplies were insufficient. A greater connection between programs and a clear definition of responsibilities can improve medicine acquisition process, increasing the effectiveness of pharmaceutical assistance.

Fontes de obtenção de medicamentos para tratamento de hipertensão arterial no Brasil: análise da Pesquisa Nacional de Saúde, 2013

“…Such differences may result from differences in the organization of services, which impacts on pharmaceutical care in primary health care provided to SUS users, where drugs to treat hypertension are offered in different regions 16 . The findings of the previous studies that assessed access to medicines to treat hypertension in Brazilian macroregions, such regional differences, were found to be in line with those of this study 17,18 . Broadly speaking, the regional differences can be analyzed from the perspective of Hart, who studied in 1971, the law of inverse funds.…”

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

“…Segundo os dados da pesquisa, os principais motivos para que 13% das pessoas não adquirissem os remédios de que precisavam foram a impossibilidade de pagamento e a ausência do produto na farmácia. A falta de dinheiro foi determinante para a falta de acesso em estudo conduzido com 4.003 idosos, residentes em áreas cobertas por unidades básicas de saúde em 41 municípios do Sul e do Nordeste do país 33 .…”

Epidemiological and ophthalmological findings in diabetic patients examined in a general hospital

“…An exception to this is found in Peto and Tadros (4) , where 78% of diabetic patients over 15 years of age in the UK underwent retinal assessment with nonmydriatic cameras. Greater access to health care does not imply that all forms of treatment are available (37) , which can affect outcomes related to disease control (30)(31)(32)(33) . In our environment, Guedes et al (38) studied a Family Health Programme and stressed the need to provide better treatment and education to diabetic patients, even though the authors used a small sample and had a high number of study drop-outs.…”