Análise de solicitações de medicamentos excepcionais prescritos aos usuários de planos privados de saúde no estado de Minas Gerais

Abstract

Access to medicines in Brazil is still a major challenge for the health system both inpublic and private sector. The legislation provides for the regulation of private healthplans determines the obligation of providing drugs only to patients who find themselvesin situations of hospitalization. Not entail the coverage of the delivery of medicines topatients outside the hospital. This work studied medicine exceptional requests made byusers of private health plans with the State Health Secretariat of Minas Gerais in thefirst half of 2008. The database of applicants for existing medicines in the StateDepartment of Health for this study was released and sent to the National HealthInsurance, in order to check whether applicants were or not registration of users ofprivate health plans. We obtained a single database consisting of medicines exceptionalapplicants, users of private health plans in the State of Minas Gerais in that period. Weconducted an observational study and cross-analyzed: sex of users, origin of therequests by reference to the Regional Health Managers, diagnoses and medicationsmentioned granted and costs. We analyzed 6,733 requests made by 6076 users. It wasfound that the study sample, 2,058 requests for exceptional drugs were made by users ofprivate health insurance with a predominance of females. The metropolitan region ofBelo Horizonte had the highest proportion of requests for medication. For users ofplans, the diagnosis of diseases of the genitourinary system stood out as the mostfrequent among the pathologies mentioned, followed by diseases of the nervous system.Overall, the pharmacological class of drugs was the most present of immunosuppressiveagents (18.5%) and anti-acne preparations (13.8%). It was found that spending on thesupply of drugs to users of private health plans representing 37% of drug expenses inthe period made exceptional and that the cost was higher compared to that provided tonon-users of plans. The study concluded that providing exceptional medicine to users ofprivate health occurs in a great number of applications and represents a significantinvestment of financial resources by the public sector in meeting these patients,justifying the urgent need for discussion and implementation of policy pharmaceuticalservices by private health plans.