Previsão de demanda de Palivizumabe para profilaxia em crianças contra o Vírus Sincicial Respiratório em Farmácia Regional do Estado de Minas Gerais

Abstract

Palivizumab provides protection against Respiratory Syncytial Virus (RSV), one of the main agents of infections affecting the lower respiratory tract among infants and children under two years of age, responsible for up to 75% of bronchiolitis, 40% of pneumonia and 60 million infections with 160,000 deaths annually worldwide. Palivizumab is provided through the Strategic Component of Pharmaceutical Assistance during the RSV seasonal period and became available after its incorporation by the National Commission for the Incorporation of Technologies into the Unified Health System (SUS). At the Belo Horizonte Regional Health Unit (URS-BH), requests are received at the Pharmaceutical Assistance Coordination (CAF) of the Minas Gerais State Health Department (SES/MG). The request analysis considers the following inclusion criteria for use: premature infants born with a gestational age ≤ 28 weeks and less than one year of age, and children under two years of age with chronic lung disease of prematurity or congenital heart disease. Considering the seasonal period and epidemiological profile of RSV infections, a demand forecast study became essential, aiming to assist in the Palivizumab management process, highlighting that programming, historical consumption and effective distribution are essential for pharmaceutical assistance. The study's general objective was to forecast demand and estimate the consumption of Palivizumab based on requests granted by the CAF/URS-BH of the SES/MG, for prophylaxis in children against RSV in the next periods of supply of the drug. This is a quantitative, predictive, times series analytical study that analyzes systematized secondary data and forecast demand for approved Palivizumab requests from 2014 to 2024. Data collection was carried out through the Citizen Information Service's electronic system. The total number of patients and, by inclusion criteria, the total annual medication consumption and per dose of application were identified. To choose the model for forecasting demand for Palivizumab, a comparison was made between Simple Linear Regression, Simple Exponential Smoothing, Holt's Exponential Smoothing, and ARIMA models. RStudio® software was used for data analysis. ARIMA was the chosen model because it presented the best performance, due to its lowest forecast error, lowest metrics, and highest accuracy, with an estimated consumption of 0.77 mL per application dose. A control panel for Palivizumab (three technical products) was created, including consumption history, number of patients, number of requests according to the inclusion criteria for use, as well as tools to assist in forecasting demand for future supply periods, with effective programming, thus contributing to the improvement of management.