Avaliação econômica dos programas Rede Farmácia de Minas e Farmácia Popular do Brasil: Estratégias para o acesso a medicamentos com financiamento do SUS

Abstract

Introduction: In a scenario of limited budget, constantly high health expenditures results in the need to evaluate, from an economic stand point, the best form of public resources allocation. In this perspective, it becomes necessary to evaluate cost efficiency after the privatization of pharmaceutical assistance services, seen as an alternative for the state to run these services in their own public networks. Objectives: The purpose of this dissertation was to carry out an economic assessment of pharmaceutical assistance programs available in Brazil - The Program Farmácia Popular do Brasil (FPB), "Aqui tem Farmácia Popular" and Rede Farmácia de Minas Gerais (RFMG) - from the literature review of the models of pharmaceutical assistance programs. Methods: In Article 1, a narrative review of literature was done, with a view to establishing a legal framework of the Rede Farmácia Popular do Brasil and the Farmácia Popular do Brasil Rede Própria, as well as surveying documents that could shed more light on the structure, funding / costs involved, available drugs, location and the number of pharmacies set up. Next, a survey of the scope of coverage, as well as the prices of common drugs of both programs was carried out. In Article 2, a cost minimization type economic assessment, from public funding perspective was carried out between "Aqui tem Farmácia Popular" and RFMG (Minas Gerais Pharmacy Network). To do this, a model, which consisted of a study of incurred cost in both programs, up to the dispensing of medicines to citizens was developed. The uncertainties of the model were tested through the Monte Carlo Method. Results: When the RFMG and the FPB programs were compared, it was found out that in the state of Minas Gerais, the number of FPB units " Own Network " set up, covers only 5.9 % of the municipalities in the state while the number of RFMG Units, already inaugurated, covers approximately 60 % of the municipalities in Minas Gerais.In addition, 53 of the total number of medicines made available by the RFMG program are also found on the list of medicines provided by the FPB "Own Network" program, indicating duplicated actions. When evaluating the results of Article 2, it was found out that if the entire population, initially estimated in the RFMG program, is attended to in the program -"Aqui tem Farmácia Popular", there would be an additional cost of R $ 139,324,050.19. Adding to this, the Monte Carlo appeared to be favorable to the RFMG program. Conclusions: The public healthcare service model, consistent with the principles and guidelines of the SUS model, seems to be more appropriate in ensuring complete and universal quality healthcare services to the citizens. The comparative economic assessment carried out between the PFB and RFMG programs, demonstrates greater efficiency in the alternative to use resources directly in the public health network