A visão de distintos atores sobre o controle sanitário da importação de substâncias psicotrópicas no Brasil

Sebastião, Patrícia Cristina Antunes; Lucchese, Geraldo

doi:10.1590/s1413-81232010000900014

Cited by 2 publications

(3 citation statements)

References 4 publications

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“…Unpublished data) and unit costs for hearing sequelae were obtained from Garantías Explícitas en Salud [50]. In Brazil, unit costs for health event resources were provided by SIA/SUS and DATASUS [24,51-53] and for hearing sequelae by DATASUS. However, for events requiring hospitalizations in Brazil, final costs were estimated by macro-costing method (DATASUS source) [24].…”

Section: Methodsmentioning

confidence: 99%

A cost-effectiveness analysis of a 10-valent pneumococcal conjugate vaccine in children in six Latin American countries

Martí

Colantonio

Bardach

et al. 2013

Cost Eff Resour Alloc

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BackgroundA recently developed 10-valent pneumococcal non-typeable H influenzae protein D-conjugate vaccine (PHiD-CV) is expected to afford protection against more than two thirds of isolates causing IPD in children in Latin America, and also against acute otitis media caused by both Spn and NTHi. The objective of this study is to assess the cost-effectiveness of PHiD-CV in comparison to non-vaccination in children under 10 years of age in Argentina, Brazil, Chile, Colombia, Mexico and Peru.MethodsWe used a static, deterministic, compartmental simulation model. The dosing regimen considered included three vaccine doses (at 2 months, 4 months and 6 months) and a booster dose (at 13 months) (3 + 1 schedule). Model outcomes included number of cases prevented, deaths averted, quality-adjusted life-years (QALYs) gained and costs. Discount for costs and benefits of long term sequelae was done at 3.5%, and currency reported in 2008-2009 U$S varying between countries.ResultsThe largest effect in case prevention was observed in pneumococcal meningitis (from 27% in Peru to 47% in Colombia), neurologic sequelae after meningitis (from 38% in Peru to 65% in Brazil) and bacteremia (from 42% in Argentina to 49% in Colombia). The proportion of predicted deaths averted annually ranged from 18% in Peru to 33% in Brazil. Overall, the health benefits achieved with PHiD-CV vaccination resulted in a lower QALY loss (from 15% lower in Peru to 26% in Brazil). At a cost of USD 20 per vaccine dose, vaccination was cost-effective in all countries, from being cost saving in Chile to a maximum Incremental Cost-effectiveness Ratio of 7,088 US$ Dollars per QALY gained. Results were robust in the sensitivity analysis, and scenarios with indirect costs affected results more than those with herd immunity.ConclusionsThe incorporation of the 10-valent pneumococcal conjugate vaccine into routine infant immunization programs in Latin American countries could be a cost-effective strategy to improve infant population health in the region.

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Section: Methodsmentioning

confidence: 99%

A cost-effectiveness analysis of a 10-valent pneumococcal conjugate vaccine in children in six Latin American countries

Martí

Colantonio

Bardach

et al. 2013

Cost Eff Resour Alloc

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“…It is prone to considerable inter-observer variation, while requiring continuous training of staff, as well as minimum laboratory infrastructure [28]. Brazil has recently introduced a new career for health workers, that of "microscopy technician", to give professional incentives to health technicians working in malaria [29], decreasing rapid turnover of staff in endemic areas and consequently favoring diagnostic quality.…”

Section: Discussionmentioning

confidence: 99%

“…In Brazil, municipalities are responsible for primary healthcare. Although legislation has been passed stressing the importance of combining efforts between primary health care (PHC) and malaria [36], joint work is absent or lacking in most municipalities. The fact that the PNCM is a vertical programme within the Ministry of Health and centrally managed in regard to procurement is not an excuse for the problems observed in pharmaceutical services.…”

Section: Discussionmentioning

confidence: 99%

Pharmaceutical services for endemic situations in the Brazilian Amazon: organization of services and prescribing practices for Plasmodium vivax and Plasmodium falciparum non-complicated malaria in high-risk municipalities

Suárez-Mútis

Souza

Freitas

et al. 2011

Malar J

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BackgroundIn spite of the fact that pharmaceutical services are an essential component of all malaria programmes, quality of these services has been little explored in the literature. This study presents the first results of the application of an evaluation model of pharmaceutical services in high-risk municipalities of the Amazon region, focusing on indicators regarding organization of services and prescribing according to national guidelines.MethodsA theoretical framework of pharmaceutical services for non-complicated malaria was built based on the Rapid Evaluation Method (WHO). The framework included organization of services and prescribing, among other activities. The study was carried out in 15 primary health facilities in six high-risk municipalities of the Brazilian Amazon. Malaria individuals ≥ 15 years old were approached and data was collected using specific instruments. Data was checked by independent reviewers and fed to a data bank through double-entry. Descriptive variables were analyzed.ResultsA copy of the official treatment guideline was found in 80% of the facilities; 67% presented an environment for receiving and prescribing patients. Re-supply of stocks followed a different timeline; no facilities adhered to forecasting methods for stock management. No shortages or expired anti-malarials were observed, but overstock was a common finding. On 86.7% of facilities, the average of good storage practices was 48%. Time between diagnosis and treatment was zero days. Of 601 patients interviewed, 453 were diagnosed for Plasmodium vivax; of these, 99.3% received indications for the first-line scheme. Different therapeutic schemes were given to Plasmodium falciparum patients. Twenty-eight (4.6%) out of 601 were prescribed regimens not listed in the national guideline. Only 5.7% individuals received a prescription or a written instruction of any kind.ConclusionsThe results show that while diagnostic procedure is well established and functioning in the Brazilian malaria programme, prescribing is still an activity that is actually not performed. The absence of physicians and poor integration between malaria services and primary health services make for the lack of a prescription or written instruction for malaria patients throughout the Brazilian Amazon. This fact may lead to a great number of problems in rational use and in adherence to medication.

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A visão de distintos atores sobre o controle sanitário da importação de substâncias psicotrópicas no Brasil

Abstract: A visão de distintos atores sobre o controle sanitário da importação de substâncias psicotrópicas no BrasilThe different point of view about the sanitary control of importation of psychotropic substances in Brazil

Cited by 2 publications

References 4 publications

A cost-effectiveness analysis of a 10-valent pneumococcal conjugate vaccine in children in six Latin American countries

A cost-effectiveness analysis of a 10-valent pneumococcal conjugate vaccine in children in six Latin American countries

Pharmaceutical services for endemic situations in the Brazilian Amazon: organization of services and prescribing practices for Plasmodium vivax and Plasmodium falciparum non-complicated malaria in high-risk municipalities

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