ABSTRACT
BACKGROUND: In 2011, private pharmacies associated to the Brazilian Ministry of Health provided patients with two types of insulin (regular human insulin and isophane insulin or NPH) and three oral antidiabetic medications (5 mg glibenclamide and 500 and 850 mg metformin) free of charge. The aim was to evaluate the impact of the "Health Has No Price" Program [Saúde Não Tem Preço (SNTP)] for access to diabetes treatment medicines in Brazil. METHODS: This longitudinal and observational study is based on the number of units of oral hypoglycemic agents, insulin and insulin analogues supplied in 55,000 private pharmacies from February 1, 2010 to January 31, 2012. The number of tablets (oral hypoglycemic agents) and international units (insulins and insulin analogues) supplied in the first 12 months of the SNTP Program were compared with the number of tablets and international units supplied in the 12 months prior to its implementation. RESULTS: The insulins in the SNTP program had the highest percentage change in the number of international units supplied; regular human insulin increased by 97.8 % and isophane insulin (NPH) by 78.0 %. Among the oral hypoglycemic agents, 5 mg glibenclamide increased by 65.9 %, and 500 and 850 mg metformin increased by 46.8 and 39.9 %, respectively, in the number of tablets dispensed in the first year of the SNTP Program. Among the hypoglycemic agents not available in SNTP, 4 mg glimepiride had the highest percentage increase in units supplied (19.2 %) in the same period. Among the insulin analogues, which were not available in the SNTP Program, insulin glulisine showed the greatest increase in units dispensed (34.2 %). CONCLUSIONS: The SNTP Program contributed to increased access to medicines for the treatment of diabetes in Brazil.
ABSTRACT
PURPOSE: This article aims to evaluate access to antihypertensive agents during the first year of the "Health Has No Price" Program (Saúde Não Tem Preço [SNTP]) in Brazil. METHODS: A longitudinal and observational study was performed based on the number of antihypertensive medications supplied in 55,000 private pharmacies distributed throughout the Brazilian territory during the period February 1, 2010, through January 31, 2012. The number of antihypertensive pills supplied in the first 12 months of the SNTP Program was compared with the number of pills supplied in the 12 months before its implementation. FINDINGS: Six antihypertensive medicines showed an increase between 32% and 120% in the number of pills supplied in the first year of the program. In this same period, the growth of the Brazilian pharmaceutical market was ~13%. Additionally, 11 medicines containing the same active ingredients as the antihypertensive agents in the SNTP Program, but at concentrations not available for free, were analyzed; it was found that none showed a change >8%, and 5 showed a reduction in the number of pills supplied after the implementation of the SNTP Program. The analysis of 7 fixed-dose combinations not available in the SNTP Program that were formulated with the same active ingredients showed a change below the annual percentage growth of the Brazilian pharmaceutical market. IMPLICATIONS: The SNTP Program may have contributed to increased access to antihypertensive medicines in Brazil.