Farmácia Popular Program: changes in geographic accessibility of medicines during ten years of a medicine subsidy policy in Brazil

Emmerick, Isabel Cristina Martins; Nascimento, José Miguel do; Pereira, Marco Aurélio; Luiza, Vera Lúcia; Ross‐Degnan, Dennis

doi:10.1186/s40545-015-0030-x

Cited by 27 publications

(37 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Accessibility to FPFP presented differences concerning region, socioeconomic level, and health conditions, indicating the need to promote better geographic distribution of the program, especially in the North, Northeast, and Midwest. Study on accessibility to FPFP found similar result in relation to geographic coverage 9 . Accessibility to Fprivadas showed no regional differences.…”

Section: Discussionsupporting

confidence: 67%

See 1 more Smart Citation

Access to medicines for chronic diseases in Brazil: a multidimensional approach

et al. 2016

Self Cite

View full text Add to dashboard Cite

OBJECTIVE To analyze the access to medicines to treat non-communicable diseases in Brazil according to socioeconomic, demographic, and health-related factors, from a multidimensional perspective.METHODS Analysis of data from the National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM), household survey, sampling plan by conglomerates with representativeness of the Brazilian population and large areas of the country, according to sex and age domains. Data collected in 2013–2014 with sample of adults (≥ 20 years) who reported having non-communicable diseases and medical indication for use of medicines (n = 12,725). We assessed the prevalence of access to medicines for self-reported non-communicable diseases, considering four dimensions: availability, geographic accessibility, acceptability, and affordability. We applied Pearson’s Chi-square test to assess the statistical significance of the differences between strata, considering the level of significance of 5%. We found prevalence of 94.3%, 5.2%, and 0.5% for full, partial, and null access, respectively. Higher prevalence was observed among seniors in the South compared to the Northeast; for those who reported having one non-communicable disease compared to those who reported having two or more; for those who needed one medicine compared to those who needed three or more; and for those who self-assessed their health as good or very good. Geographic accessibility was similar in the Unified Health System and in the private pharmacies (72.0%). Total availability of medicines was 45.2% in the Unified Health System, 67.4% in the Popular Pharmacy Program, and 88.5% in private pharmacies. Acceptability was 92.5% in the Unified Health System, 97.8% in the Popular Pharmacy Program, and 98.7% in private pharmacies. As to affordability, 2.6% of the individuals failed to take the medicines they should in the 30-day period prior to the interview due to financial difficulty. Prevalence of full access to medicines for non-communicable diseases in Brazil is high and presents significant differences for age group, region of the country, number of non-communicable diseases, and for medicines prescribed and self-assessment of health. The major barriers to access to medicines were identified in the dimensions analyzed.

show abstract

Section: Discussionsupporting

confidence: 67%

“…As the number of pharmacies participating in the Popular Pharmacy Program is much higher than that of the public network, it is necessary to establish measures to ensure the quality of service to their users 9 , 24 .…”

Section: Discussionmentioning

confidence: 99%

Access to medicines for chronic diseases in Brazil: a multidimensional approach

et al. 2016

Self Cite

View full text Add to dashboard Cite

show abstract

“…The amount paid to the company was prorated to all medicines, considering the following specific adjustments: (i) monthly consumption of each medicine in PU; (ii) storage and transport space (in m 3 stored and shipped); (iii) labor force employed in separating medicines, considering the number of items per order; and (iv) insurance, considering the average value in stock. This allowed isolating the contribution of each medicine of the common list between municipal public provision and the ATFP Program, enabling the individualization of a price per PU linked to logistics costs.…”

Section: Methodsmentioning

confidence: 99%

“…It has its own rules of operation and includes 41 products to treat the most prevalent diseases in the population, most of which feature in the basic list provided by pharmacies from the SUS network. A list of antihypertensive, antidiabetic and antiasthmatic medicines is exempt from co-financing 3 , 13 , 15 .…”

Section: Introductionmentioning

confidence: 99%

Costs of Public Pharmaceutical Services in Rio de Janeiro Compared to Farmácia Popular Program

Silva

Caetano

2016

Rev. Saúde Pública

View full text Add to dashboard Cite

OBJECTIVE To analyze the costs of public pharmaceutical services compared to Farmácia Popular Program (Popular Pharmacy Program).METHODS Comparison between prices paid by Aqui Tem Farmácia Popular Program (Farmácia Popular is available here) with the full costs of medicine provision by the Municipal Health Department of Rio de Janeiro. The comparison comprised 25 medicines supplied by both the municipal pharmaceutical service and Aqui Tem Farmácia Popular Program. Calculating the cost per pharmaceutical unit of each medicine included expenditure by Municipal Health Department of Rio de Janeiro with procurement (price), logistics, and local dispensation. The reference price of medicines paid by Aqui Tem Farmácia Popular was taken from the Brazilian Ministry of Health standard in force in 2012. Comparisons included full reference price; reference price minus 10.0% copayment by users; and maximum reference paid by the Ministry of Health (minus copayment and taxes). Simulations were carried out of the differences between the costs of Municipal Health Department of Rio de Janeiro with the common medicines and those potentially incurred based on the reference price of Aqui Tem Farmácia Popular.RESULTS The Municipal Health Department of Rio de Janeiro spent R$28,526,526.57 with 25 medicines of the common list in 2012; 58.7% accounted for direct procurement costs. The estimated costs of the Health Department were generally lower than the reference prices of the Aqui Tem Farmácia Popular Program for 20 medicines, regardless of reference prices. The potential costs incurred by Health Department if expenditure of its consumption pattern were based on the reference prices of Aqui Tem Farmácia Popular would be R$124,170,777.76, considering the best scenario of payment by the Brazilian Ministry of Health (90.0% of the reference price, minus taxes).CONCLUSIONS The difference in costs between public provision by Municipal Health Department of Rio de Janeiro and Farmácia Popular Program indicates that some reference prices could be reviewed aiming at their reduction.

show abstract

“…Subsequently, antihypertensive, antidiabetic (since 2011), and antiasthma medicines (since 2012) began to be dispensed with zero copayment from patients in both government-owned facilities (n = 558) [3] and contracted private pharmacies (n = 25,150, covering 63.4% of the 5570 municipalities [3]). This change was named as "Saúde não tem preço -SNP" (Health has no price).…”

Section: Introductionmentioning

confidence: 99%

Hypertension and diabetes treatment affordability and government expenditures following changes in patient cost sharing in the “Farmácia popular” program in Brazil: an interrupted time series study

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background: Increasing medicines availability and affordability is a key goal of Brazilian health policies. "Farmácia Popular" (FP) Program is one of the government's key strategies to achieve this goal. Under FP, antihypertension (HTN) and antiglycemic (DM) medicines have been provided at subsidized prices in private retail settings since 2006, and free of charge since 2011. We aim to assess the impact of sequential changes in FP benefits on patient affordability and government expenditures for HTN and DM treatment under the FP, and examine their implications for public financing mechanisms and program sustainability. Methods: Longitudinal, retrospective study using interrupted time series to analyze: HTN and DM treatment coverage; total and per capita expenditure; percentage paid by MoH; and patient cost sharing. Analyzes were conducted in the dispensing database of the FP program (from 2006 to 2012). Results: FP has increased its coverage over time; by December 2012 FP covered on average 13% of DM and 11.5% of HTN utilization, a growth of over 600 and 1500%, respectively. The overall cost per treatment to the MoH declined from R$36.43 (R$ = reais, the Brazilian currency) to 18.74 for HTN and from R$33.07to R$15.05 for DM over the period analyzed, representing a reduction in per capita cost greater than 50%. The amount paid by patients for the medicines covered increased over time until 2011, but then declined to zero. We estimate that to treat all patients in need for HTN and DM in 2012 under FP, the Government would need to expend 97% of the total medicines budget. Conclusions: FP rapidly increased its coverage in terms of both program reach and proportion of cost subsidized during the period analyzed. Costs of individual HTN and DM treatments in FP were reduced after 2011 for both patients (free) and government (better negotiated prices). However, overall FP expenditures by MoH increased due to markedly increased utilization. The FP is sustainable as a complementary policy but cannot feasibly substitute for the distribution of medicines by the SUS.

show abstract

Farmácia Popular Program: changes in geographic accessibility of medicines during ten years of a medicine subsidy policy in Brazil

Cited by 27 publications

References 8 publications

Access to medicines for chronic diseases in Brazil: a multidimensional approach

Access to medicines for chronic diseases in Brazil: a multidimensional approach

Costs of Public Pharmaceutical Services in Rio de Janeiro Compared to Farmácia Popular Program

Hypertension and diabetes treatment affordability and government expenditures following changes in patient cost sharing in the “Farmácia popular” program in Brazil: an interrupted time series study

Contact Info

Product

Resources

About