Avaliação da eficiência na aquisição e distribuição de medicamentos do componente básico da assistência farmacêutica

Abstract

Decentralization is an organizational principle of the National Unified Health System that designates a single direction in each sphere of government and the transfer of manage-ment responsibilities, with an emphasis on municipalization, ensuring that it is closer to the population. The financing of medicines intended for Primary Health Care in Brazil is the responsibility of the three federated entities. In most municipalities in Minas Gerais, the management of these medicines was the responsibility of the State Department of Health. Since 2016, this management format has been abolished, leaving the municipalities to acquire the medicines, supported by the state, through Acts State Price Registration (ARPE). Thus, this study aimed to compare prices and quantities of medicines purchased in different modalities: ARPE (2015), ARPE (2018) and its own municipal instrument and compare the costs of two medicine supply strategies: centralized in the state and decentralized in the municipality. To this end, a price comparison study and a cost minimization assessment (AMC) were carried out. The results of the price compari-son pointed to an average increase in medicine prices of 19.0% in 2018, compared to 2015; and an average increase of 75.0% in the acquisition made by ARPE in relation to municipal instruments. At AMC, savings of 14.0% were estimated in 2018, when compared to 2015, in the acquisition of medicines. It is concluded, therefore, that the process of decentralizing the supply of medicines in the Basic Component of Pharmaceutical Assistance in Minas Gerais allows for saving resources