Equity analysis of resource distribution for the Popular Pharmacy Program

Abstract

OBJECTIVE: To analyze the regional allocation of the resources from the Brazilian Popular Pharmacy Program, taking into account the relative availability of the program and the potential needs of the region. METHODS: Data from the National Health Survey of the Annual Report of Social Information and the administrative database of the program were used to create a non-parametric indicator of coverage using multiple data envelopment analysis technique. This indicator considers the relative availability of the program, taking into account equal access to equal needs (equity based on regional needs). The analysis of this indicator shows if the regions that most need pharmaceutical assistance are those that receive more resources from the Brazilian Popular Pharmacy Program. RESULTS: The states belonging to the richest regions of the country, Southeast and South, present wider relative coverage of the Brazilian Popular Pharmacy Program compared to poorer localities. In addition, the inequalities observed between locations are better explained by inefficiency in the transfer of resources to the basic component of pharmaceutical care than by the Brazilian Popular Pharmacy Program itself. According to the model, a 43.76% increase in the transfer to the basic component of pharmaceutical care would be required in order to improve equity, whereas the increase required by the Brazilian Popular Pharmacy Program is equivalent to 22.71%. CONCLUSIONS: Although the Brazilian Popular Pharmacy Program seeks to reduce the socioeconomic inequalities observed in access to pharmaceutical care, which integrates health care services, regional disparities in access to medicine persist. These regional differences are attributed mostly to allocation failures and problems in managing the conventional pharmaceutical care cycle provided through SUS pharmacies.

Evolução da oferta de Fonoaudiólogos no SUS: um estudo sobre a correlação com os indicadores sociais no Brasil na última década

“…Equity is one of the doctrinal principles of the Brazilian public healthcare system. Based on this principle, researchers highlight relations between access to health care and factors that permeate the social dynamics of the country (13)(14)(15)(16) .…”

“…Access is a term with a complex definition that has motivated numerous scientific productions (14)(15)(16)(17) . Some authors state that access can be understood from the viewpoint of entry into healthcare services and is related to characteristics of the provision of services, referring to the possibility of using healthcare services when necessary (17,18) .…”

“…Studies have shown advances made by the Brazilian public healthcare system in ensuring universal access (19,20) . Despite progress with regards to the offer of services, there continue to be reports of disparities in terms of access (14,15) as well as inequalities in the distribution of healthcare providers and services among the different regions of the country (5,6,14,15) , which are recognized as important challenges to overcome (6) .…”

Judicialization of health: lawsuits for access to medicines in Uruguaiana-RS

“…The right to Pharmaceutical Services (PS) is part of this context and should also be understood as such, since it is part of comprehensive health care as described in the Organic Health Law 2 . PS Policy involves a set of actions aimed at health promotion, protection and recovery for individuals and the public at large by considering drugs an essential ingredient and fostering their access and rational use [3][4][5] . Among the approaches to promote rational use and to enable the population to have access to these medicines is the use of the National List of Essential Medicines (NLEM).…”

“…Therefore the judicial route is widely used to achieve adequate treatment 4,5 . The lawsuits for requesting medicines that are already on public lists (such as SLEM) are legitimate.…”