Relação entre acesso a medicamentos no Sistema Único de Saúde e a gestão do ciclo da assistência farmacêutica no contexto da pesquisa nacional sobre acesso, utilização e promoção do uso racional de medicamentos.

Abstract

Continuous assessment of access to medication indicators and associated factors is important for monitoring and analyzing public policies with a view to equity and expanding access. The work seeks to measure, through a single indicator, the access to medicines in a sample of the Brazilian population, its association with the different actors that participate in the pharmaceutical assistance cycle (PA) and the relationship with health measures of patients in the SUS . Cross-sectional, exploratory, evaluative study, part of the National Survey on Access, Use and Promotion of Rational Use of Medicines - Services, 2015. The evaluation of access to medicines used concepts proposed by Penshansky and Thomas (1981), according to the dimensions: availability, treated here by obtainment, geographic accessibility, suitability, acceptability and affordability. The single indicator was considered the response variable and was calculated using the weighted averages of each dimension. Categorical variables were presented as absolute and relative frequencies and chi-square tests were performed for categorical variables. The sample consisted of 2,430 users. The average found for the single indicator was 0.64, with 26.9% of users showing that they have no access to medication while 28.5% have full access. Hospitalizations, searches for emergency services and self-perception of health showed worse results in the group that did not have access to medication (p<0.001). For the stages of selection, programming and purchase of medicines, it is possible to say that there is p<0.001, which may indicate some association. Those who report having a standardized list, CFT and purchase schedule generate better access results. The results of availability and shortage periods in pharmacies show a possible relationship with access, with greater availability for the partial and full access groups. Brazil has invested in public policies aimed at improving access to medication and quality of life, despite this worrying data were found for patients who report not having access to their medication. Resource management by municipal health secretaries and those responsible for PA in the municipality directly influences access to medication. It is necessary that the autonomy of the municipalities regarding the management of funds be reviewed so that the funds are used in order to cover the municipal needs in AF. The provision of computerized systems that help with the supply of consumption data, historical series and seasonality can be fundamental for improving this process. It is necessary that the evaluation of access to medicines is constant and that there is a restructuring of existing policies, providing increased access to medicines, thus sustained financing and an adequate supply system are important tools for promoting access.