Access to Oncology Drugs in Brazil: Juggling Innovation and Sustainability in Developing Countries

Abstract

Unfortunately, Brazil's inequalities are also seen in the public's access to health care. The Brazilian public health system (SUS-Sistema Único de Saúde) was created with the new Brazilian constitution of 1988 (4), with the purpose to deliver equal, universal, and integral health care to all Brazilian citizens. The public health system is supposed to be organized in a decentralized manner, to locally adapt to the specific health problems of each region from the tropical diseases of the Amazon forest to the pollution-related diseases of its megalopolis. However, it is underfunded, spending around US$150 per patient per year (5, 6). Table I shows the median health expenditure per capita per year in Brazilian metropolitan regions. It is not yet organized or hierarchized to promote its objective and deal with the reallife health problems of its citizens (7). Nontransmissible chronic diseases in Brazil Currently, worldwide, nontransmissible chronic diseases (NTCD) are the major cause of death, accounting for 36 million deaths per year. This group of diseases is composed of cardiovascular diseases, diabetes, lung diseases, and cancer. It has been estimated that 80% of the deaths by NTCD have occurred in middle-and low-income countries. As a convention, deaths caused by these diseases in people under the age of 60 are considered to be premature, as they may reflect the lack of proper health assistance. When comparing NTCD premature deaths, 13% occurred in developed countries, whereas 29% occurred in developing countries.

Padrões de tratamento, uso de recursos e custo do câncer de pulmão de não pequenas células avançado em instituições brasileiras privadas

“…Apenas em um caso foi identificado o pagamento pelo plano de saúde. As diferenças na taxa de pacientes testados podem ser mais significativas em instituições do sistema público de saúde, geralmente com financiamento escasso (Flores et al, 2015;Silva et al, 2017;Ades, 2017).…”

Strategies leading to drug incorporation by the public health system: the Brazilian Society of Clinical Oncology experience

“…This is a multifaceted discussion, and several stakeholders are involved in the process -from health authorities to pharmaceutical companies, researchers, and civil society. (1) At the beginning of our term at the Board of Directors of the Brazilian Society of Clinical Oncology (SBOC/2015-2017), we have tried to find means to assist the Brazilian Public Health System (Sistema Único de Saúde -SUS) to select drugs regarded, according to scientific evidence available, as beneficial therapies that should be accessible to our population. The process started by compiling and comparing all the available therapeutic agents in Brazil, both in public and private practice (the ones licensed by the Brazilian regulatory health agency -ANVISA).…”