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1.
Rev Saude Publica ; 54: 130, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33331524

RESUMO

OBJECTIVE: To analyze whether lawsuits for medicines filed against the state of Rio Grande do Norte agree with medical-sanitary and pharmaceutical assistance management criteria established by the public policies of access to medicines in force in Brazil. METHODS: This is a descriptive and retrospective study of the individual lawsuits that claimed medicines in the state of Rio Grande do Norte between 2013 and 2017. Information was collected from the procedural documents on the requested medicines, the diagnoses referred and the origin of the medical prescription, in order to analyze medical-sanitary and pharmaceutical assistance management characteristics. RESULTS: We analyzed 987 lawsuits, which requested 1,517 medications. Of these, 60.7% were not part of the National List of Essential Medicines, and, in 75% of the cases, there was a therapeutic alternative in the Brazilian Unified Health System. In 13.6% of the actions, at least one drug was prescribed for off-label use. Prescribers of philanthropic and private services often request medicines not covered by the pharmaceutical care policy. Even judicialized drugs that are part of the national list are constantly requested for non-standard indications. CONCLUSIONS: Court decisions for the supply of medicines violate health rules and make it difficult to manage pharmaceutical assistance, which may weaken the implementation of these policies.


Assuntos
Medicamentos Essenciais , Acesso aos Serviços de Saúde , Legislação como Assunto , Assistência Farmacêutica , Política Pública , Brasil , Política de Saúde , Humanos , Estudos Retrospectivos , Direito à Saúde
2.
Front Public Health ; 8: 585832, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33381485

RESUMO

Background: Countries have introduced a variety of measures to prevent and treat COVID-19 with medicines and personal protective equipment (PPE), with some countries adopting preventative strategies earlier than others. However, there has been considerable controversy surrounding some treatments. This includes hydroxychloroquine where the initial hype and misinformation lead to shortages, price rises and suicides. Price rises and shortages have also been seen for PPE. Such activities can have catastrophic effects on patients where there are high co-payment levels and issues of affordability. Consequently, there is a need to investigate this further. Objective: Assess changes in the availability, utilization and prices of relevant medicines and PPE during the pandemic among a range of Asian countries. Our approach: Narrative literature review combined with interviews among community pharmacists to assess changes in consumption, prices and shortages of medicines and PPE from the beginning of March 2020 until end of May 2020. In addition, suggestions on ways to reduce misinformation. Results: 308 pharmacists took part from five Asian countries. There was an appreciable increase in the utilization of antimicrobials in Pakistan (in over 88% of pharmacies), with lower increases or no change in Bangladesh, India, Malaysia and Vietnam. Encouragingly, there was increased use of vitamins/immune boosters and PPE across the countries, as well as limited price rises for antimicrobials in India, Malaysia and Vietnam, although greater price rises seen for analgesics and vitamin C/immune boosters. Appreciable price increases were also seen for PPE across some countries. Conclusion: Encouraging to see increases in utilization of vitamins/immune boosters and PPE. However, increases in the utilization and prices of antimicrobials is a concern that needs addressing alongside misinformation and any unintended consequences from the pandemic. Community pharmacists can play a key role in providing evidence-based advice, helping to moderate prices, as well as helping address some of the unintended consequences of the pandemic.


Assuntos
/terapia , Custos e Análise de Custo , Medicamentos Essenciais , Saúde Pública , Ásia , Medicamentos Essenciais/economia , Medicamentos Essenciais/provisão & distribução , Humanos , Hidroxicloroquina/provisão & distribução , Hidroxicloroquina/uso terapêutico , Equipamento de Proteção Individual/economia , Equipamento de Proteção Individual/provisão & distribução , Farmácias/provisão & distribução
3.
PLoS One ; 15(12): e0241555, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33362249

RESUMO

BACKGROUND: Availability of essential medicines for non-communicable diseases (NCDs) is poor in low- and middle-income countries. Availability and cost are conventionally assessed using cross-sectional data. However, these characteristics may vary over time. METHODS: We carried out a prospective, descriptive analysis of the availability and cost of essential medicines in 23 Ugandan health facilities over a five-week period. We surveyed facility pharmacies in-person up to five times, recording availability and cost of 19 essential medicines for NCDs and four essential medicines for communicable diseases. RESULTS: Availability of medicines varied substantially over time, especially among public facilities. Among private-for-profit facilities, the cost of the same medicine varied from week to week. Private-not-for-profit facilities experienced less dramatic fluctuations in price. CONCLUSIONS: We conclude that there is a need for standardized, continuous monitoring to better characterize the availability and cost of essential medicines, understand demand for these medicines, and reduce uncertainty for patients.


Assuntos
Custos de Medicamentos , Medicamentos Essenciais/economia , Medicamentos Essenciais/provisão & distribução , Doenças não Transmissíveis/tratamento farmacológico , Doenças Transmissíveis/tratamento farmacológico , Doenças Transmissíveis/economia , Custos de Medicamentos/tendências , Instalações de Saúde/economia , Acesso aos Serviços de Saúde/economia , Acesso aos Serviços de Saúde/tendências , Humanos , Doenças não Transmissíveis/economia , Setor Privado/economia , Estudos Prospectivos , Setor Público/economia , Inquéritos e Questionários , Fatores de Tempo , Uganda
4.
Zhongguo Zhong Yao Za Zhi ; 45(16): 3749-3758, 2020 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-32893567

RESUMO

At present, most of Chinese patent medicines have problems, such as weak scientific basis, unclear clinical value evaluation, etc., which lead to the lack of sufficient evidence for the entry into the essential medicine list, medical insurance catalog and other important health resource allocation tools. This has a negative impact on the development of traditional Chinese medicine. It is urgent to establish a comprehensive evaluation methodology system of Chinese patent medicine in China. There are at least three reasons including producing evidence for clinical rational use scientifically, developing an objective and transparent selecting strategy, eventuating and highlighting its clinical value. The process and method of health technology assessment(HTA) can provide reference for the establishment of comprehensive evaluation method of Chinese patent medicine. However, HTA is rarely carried out in the field of traditional Chinese medicine. The latest domestic and international research showed that HTA combined with multi-criteria decision analysis(MCDA) can increase the transparency of decision-making and improve the quality of decision-making. The combined two formed the EVIDEM framework, which is conducive to drug selection and its clinical use. In this paper, the EVIDEM framework was introduced to establish the methodology framework of the comprehensive clinical evaluation system of Chinese patent medicine. A preliminary research idea has been put forward. In the future, we can establish a set of comprehensive clinical evaluation methods for Chinese patent medicine in cooperation with relevant national drug decision-making departments and management departments. It is believed that such cooperation could promote the full implementation of the re-evaluation for Chinese patent medicine.


Assuntos
Medicamentos Essenciais , Avaliação da Tecnologia Biomédica , China , Medicina Tradicional Chinesa , Medicamentos sem Prescrição
7.
Aust J Gen Pract ; 49(8): 530-532, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32738870

RESUMO

BACKGROUND: During the COVID-19 pandemic, vulnerable and older people with chronic and complex conditions have self-isolated in their homes, potentially limiting opportunities for consultations to have medications prescribed and dispensed. OBJECTIVE: The aim of this article is to describe initiatives to ensure ongoing access to medications during the COVID-19 pandemic. DISCUSSION: Cooperation between wholesalers and purchase limits in pharmacies have helped to ensure supply of essential medications. Therapeutic substitution by pharmacists is permitted for specific products authorised by the Therapeutic Goods Administration. Prescribers are permitted to issue digital image prescriptions, and implementation of electronic prescribing has been fast-tracked. Expanded continued dispensing arrangements introduced during the bushfire crises have been temporarily extended. Pharmacists are permitted to provide medication management reviews via telehealth. A Home Medicines Service has been introduced to facilitate delivery of medications to people who are vulnerable or elderly. Anticipatory prescribing and medication imprest systems are valuable for access to end-of-life medications within residential aged care.


Assuntos
Infecções por Coronavirus , Medicamentos Essenciais/provisão & distribução , Acesso aos Serviços de Saúde/organização & administração , Conduta do Tratamento Medicamentoso , Pandemias , Assistência Farmacêutica , Pneumonia Viral , Idoso , Austrália/epidemiologia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Prescrição Eletrônica , Humanos , Conduta do Tratamento Medicamentoso/organização & administração , Conduta do Tratamento Medicamentoso/tendências , Múltiplas Afecções Crônicas/terapia , Pandemias/prevenção & controle , Assistência Farmacêutica/organização & administração , Assistência Farmacêutica/tendências , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Telemedicina/métodos , Telemedicina/organização & administração , Telemedicina/tendências
8.
PLoS One ; 15(8): e0236411, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32745100

RESUMO

BACKGROUND: Access to affordable and good quality medicines is a key to meeting Sustainable Development Goal No. 3 by the year 2030. Prices, availability and affordability of essential medicines have been studied in many developing countries, but no such information has been published about Rwanda yet. This study aimed at providing data on prices, availability and affordability of medicines in different health facilities of Rwanda. METHODS: A survey was carried out on availability, prices and affordability of 18 medicines in Kigali City and five districts of Rwanda. 44 health facilities were surveyed, including public and faith-based hospitals, public and faith-based health centers and private pharmacies. The standardized methodology developed by WHO and Health Action International (HAI) was used to collect and analyze the data. FINDINGS: Prices for generic medicines in public and faith-based health facilities were remarkably low, with median price ratios (MPRs) of 1.0 in comparison to the international procurement prices published by Management Sciences for Health. In private pharmacies, prices were twice as high (MPR = 1.99 for generics). Availability of medicines fell short of the of 80% target set by WHO, but was better than reported from many other developing countries. Availability of medicines was highest in the private sector (71.3%) and slightly lower in the faith-based (62.8%) and public (59.6%) sectors. The government procurement agency was found to work efficiently, achieving prices 30% below the international procurement price given in the International Medical Product Price Guide. Affordability of medicines was better in the public and faith-based sectors than in the private sector. CONCLUSION: In Rwanda, medicines are affordable but poorly available in both the public and the faith-based sectors. Further improvements of the availability of medicines in the public and the faith-based health facilities represent the most important key to increase accessibility and affordability of medicines in Rwanda.


Assuntos
Medicamentos Essenciais/economia , Saúde Global , Instalações de Saúde/economia , Acesso aos Serviços de Saúde/economia , Custos e Análise de Custo , Medicamentos Essenciais/uso terapêutico , Medicamentos Genéricos/economia , Humanos , Farmácias/economia , Setor Privado , Setor Público/tendências , Ruanda/epidemiologia , Inquéritos e Questionários
9.
Einstein (Sao Paulo) ; 18: eAO5314, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32785451

RESUMO

Objective To estimate the prevalence of use of drugs to treat gastrointestinal disorders, according to demographic, socioeconomic, and health characteristics of the Brazilian population. Methods This is a population-based survey that interviewed individuals residing in cities of the five regions in Brazil. The study sample was composed of 32,348 individuals aged 20 or more years. The profile of use of drugs for gastrointestinal disorders was evaluated considering the variables sex, age, healthcare plan, region, and number of chronic diseases. We also analyzed the frequency of individuals who declared using other drugs, besides those already employed for treatment of gastrointestinal disorders. Additionally, the estimated frequencies of the drug classes used were determined. Results The prevalence of use of drugs for gastrointestinal disorders in Brazil was 6.9% (95% confidence interval - 6.4-7.6), higher in females, among persons aged over 60 years, in those who had a private healthcare insurance, and presented with two or more chronic diseases. It was noted that 42.9% of the aged who used drugs for gastrointestinal disorders were also on polypharmacy. As to the classes of drugs, 82% corresponded to drugs for the food tract and metabolism, particularly proton pumps inhibitors. Conclusion The use of drugs for treatment of gastrointestinal disorders was significant among women and elderly. In this age group, consumption may be linked to gastric protection due to polypharmacy. This study is an unprecedented opportunity to observe the self-reported consumption profile of these drugs in Brazil and, therefore, could subsidize strategies to promote their rational use.


Assuntos
Uso de Medicamentos/estatística & dados numéricos , Medicamentos Essenciais/uso terapêutico , Gastroenteropatias/tratamento farmacológico , Acesso aos Serviços de Saúde/estatística & dados numéricos , Adulto , Idoso , Brasil , Cidades , Estudos Transversais , Medicamentos Essenciais/provisão & distribução , Feminino , Inquéritos Epidemiológicos , Humanos , Pessoa de Meia-Idade , Preparações Farmacêuticas/provisão & distribução , Medicamentos sob Prescrição/provisão & distribução , Fatores Socioeconômicos , Adulto Jovem
10.
Washington; Organización Panamericana de la Salud; ago 25, 2020. 28 p.
Não convencional em Espanhol | LILACS | ID: biblio-1117908

RESUMO

En el transcurso de la pandemia de COVID-19, numerosos países, de ingresos bajos, medianos y alto, han visto agotadas sus reservas de medicamentos esenciales necesarios para el manejo de los pacientes con COVID-19 en las unidades de cuidados intensivos (UCI). El plan de preparación para emergencias sanitarias de los países requiere incluir una lista de medicamentos esenciales y otros dispositivos médicos necesarios en las UCI para afrontar emergencias sanitarias. La lista de medicamentos esenciales para el manejo de pacientes que ingresan a unidades de cuidados intensivos con sospecha o diagnóstico confirmado de COVID-19 es un documento de orientación fundamental que ayuda a los sistemas de salud de los países a priorizar los medicamentos esenciales que deben estar ampliamente disponibles y ser asequibles para manejar los pacientes en las UCI durante las situaciones de emergencia sanitaria, en este caso con sospecha o diagnóstico confirmado de COVID-19. Está dirigida a las autoridades sanitaras y a los encargados del manejo del sistema de salud de los países. Esta lista incluye fundamentalmente los medicamentos considerados esenciales para el manejo de los cuadros clínicos que con se observan con mayor frecuencia en pacientes hospitalizados en UCI a causa de una infección por SARS-CoV-2. No se incluyen la mayoría de los medicamentos que comúnmente se encuentran en las UCI para el manejo de otras patologías, comorbilidades o la estabilización del paciente (p. ej., insulina o antihipertensivos), salvo aquellos que pueden requerirse para el tratamiento o apoyo (p. ej., bloqueantes neuromusculares o anestésicos) de las dolencias generadas por la infección. Tampoco se incluyen medicamentos específicos para el tratamiento de la infección por SARS-CoV-2, puesto que no existe, por el momento, evidencia científica de alta calidad que avale su uso, salvo en el contexto de ensayos clínicos controlados. Un equipo de expertos en el tema realizó una búsqueda de información sobre la atención de pacientes en UCI durante la pandemia de COVID-19, en Medline (a través de PubMed), Cochrane, Tripdatabase, Epistemonikos y en buscadores generales de internet (Google). Se identificaron también revisiones o guías generadas por ministerios de Salud de varios países de la Región de las Américas, la Organización Mundial de la Salud (OMS), la Organización Panamericana de la Salud (OPS), el Instituto Nacional de Salud y Excelencia Clínica (NICE) de Reino Unido, los Centros para el Control y la Prevención de Enfermedades (CDC) de Estados Unidos y los Institutos Nacionales de Salud (NIH) de Estados Unidos.


Assuntos
Humanos , Criança , Adulto , Pneumonia Viral/tratamento farmacológico , Succinilcolina/uso terapêutico , Antipsicóticos/uso terapêutico , Benzodiazepinas/uso terapêutico , Administração dos Cuidados ao Paciente/organização & administração , Dexametasona/uso terapêutico , Corticosteroides/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Medicamentos Essenciais/provisão & distribução , Dexmedetomidina/uso terapêutico , Síndrome Respiratória Aguda Grave/tratamento farmacológico , Antipiréticos/uso terapêutico , Pandemias/prevenção & controle , Betacoronavirus/efeitos dos fármacos , Haloperidol/uso terapêutico , Analgésicos Opioides/uso terapêutico , Unidades de Terapia Intensiva/organização & administração , Anti-Infecciosos/uso terapêutico , Pneumonia Viral/prevenção & controle , Respiração Artificial/enfermagem , Choque Séptico/prevenção & controle , Tromboembolia/prevenção & controle , Infecções por Coronavirus/prevenção & controle , Medicina Baseada em Evidências , Intubação/enfermagem , Hipóxia/tratamento farmacológico
12.
S Afr Med J ; 110(4): 271-273, 2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-32657737

RESUMO

Trastuzumab was added to the South African Essential Medicines List (EML) in 2017 for the adjuvant management of human epidermal growth factor receptor 2 (HER2)-positive early breast cancer. However, access has remained inconsistent, as some provinces continue to regard trastuzumab as unaffordable within the contexts of their respective oncology budgets. The intention of providing access to trastuzumab through its inclusion on the EML, therefore, has not been met. The National EML Committee (NEMLC) recently reviewed newly published peer-reviewed information investigating the impact of a shorter trastuzumab treatment period on both clinical efficacy and safety. On account of this review, and with a view to improving access while reducing cost and toxicity, the NEMLC has revised the duration of trastuzumab therapy, i.e. from 12 months to 6 months in the adjuvant management of early HER2-positive breast cancer. This article explores and reports on the data used to make this policy amendment.


Assuntos
Antineoplásicos Imunológicos/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Medicamentos Essenciais , Duração da Terapia , Política de Saúde , Mastectomia , Formulação de Políticas , Trastuzumab/uso terapêutico , Antineoplásicos Imunológicos/economia , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Orçamentos , Cardiotoxicidade/etiologia , Quimioterapia Adjuvante , Feminino , Acesso aos Serviços de Saúde , Humanos , Mastectomia Segmentar , Estadiamento de Neoplasias , Receptor ErbB-2/metabolismo , África do Sul , Trastuzumab/economia
13.
BMC Public Health ; 20(1): 1053, 2020 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-32620159

RESUMO

BACKGROUND: Access to sexual and reproductive health services continues to be a public health concern in Kenya, Tanzania, Uganda and Zambia: use of modern contraceptives is low, and unmet family planning needs and maternal mortality remain high. This study is an assessment of the availability, affordability and stock-outs of essential sexual and reproductive health commodities (SRHC) in these countries to inform interventions to improve access. METHODS: The study consisted of an adaptation of the World Health Organization/Health Action International methodology, Measuring Medicine Prices, Availability, Affordability and Price Components. Price, availability and stock-out data was collected in July 2019 for over fifty lowest-priced SRHC from public, private and private not-for-profit health facilities in Kenya (n = 221), Tanzania (n = 373), Uganda (n = 146) and Zambia (n = 245). Affordability was calculated using the wage of a lowest-paid government worker. Accessibility was illustrated by combining the availability (≥ 80%) and affordability (less than 1 day's wage) measures. RESULTS: Overall availability of SRHC was low at less than 50% in all sectors, areas and countries, with highest mean availability found in Kenyan public facilities (46.6%). Stock-outs were common; the average number of stock-out days per month ranged from 3 days in Kenya's private and private not-for-profit sectors, to 12 days in Zambia's public sector. In the public sectors of Kenya, Uganda and Zambia, as well as in Zambia's private not-for-profit sector, all SRHC were free for the patient. In the other sectors unaffordability ranged from 2 to 9 SRHC being unaffordable, with magnesium sulphate being especially unaffordable in the countries. Accessibility was low across the countries, with Kenya's and Zambia's public sectors having six SRHC that met the accessibility threshold, while the private sector of Uganda had only one SRHC meeting the threshold. CONCLUSIONS: Accessibility of SRHC remains a challenge. Low availability of SRHC in the public sector is compounded by regular stock-outs, forcing patients to seek care in other sectors where there are availability and affordability challenges. Health system strengthening is needed to ensure access, and these findings should be used by national governments to identify the gaps and shortcomings in their supply chains.


Assuntos
Acesso aos Serviços de Saúde/economia , Acesso aos Serviços de Saúde/estatística & dados numéricos , Saúde Reprodutiva/estatística & dados numéricos , Saúde Sexual/estatística & dados numéricos , África Oriental , África Austral , Medicamentos Essenciais/provisão & distribução , Instalações de Saúde , Humanos , Quênia , Setor Privado/estatística & dados numéricos , Setor Público/estatística & dados numéricos , Organização Mundial da Saúde
14.
Artigo em Inglês | MEDLINE | ID: mdl-32708060

RESUMO

BACKGROUND: Developing countries, such as the Philippines, started implementing policies to improve access to medicines, which is a vital step toward universal healthcare coverage. This study aimed to evaluate the prices, availability and affordability of prescribed medicines for diabetes, hypercholesterolemia and hypertension with the exemption of 12% value-added tax in the Philippines. METHODS: The prices and availability of 50 medicines were collected in August 2019 from 36 public and 42 private medicine outlets in six regions of the Philippines, following a modified methodology developed by the World Health Organization and Health Action International. Availability is reported as the percentage of outlets in which the surveyed medicine was found at the time of visit. Medicine prices are expressed as median unit prices (MUPs) in Philippine Peso. Affordability is calculated based on the number of days' wages required for the lowest-paid unskilled government worker to purchase a monthly treatment. RESULTS: The mean availability of surveyed medicines was low in both public and private sectors, with 1.3% for originator brands (OBs) and 25.0% for lowest-priced generics (LPGs) in public outlets, and 34.7% and 35.4% in private outlets, respectively. The MUP of medicines were higher in private outlets, and OBs have higher unit price compared to the generic equivalents. Treatments with OBs were unaffordable, except for gliclazide, but the affordability of most LPGs is generally good. CONCLUSION: Access to medicines in both sectors was affected by low availability. High prices of OBs influenced the affordability of medicines even with tax exemption. A review of policies and regulations should be initiated for a better access to medicines in the Philippines.


Assuntos
Medicamentos Essenciais/economia , Medicamentos Essenciais/provisão & distribução , Isenção Fiscal , Estudos Transversais , Acesso aos Serviços de Saúde , Humanos , Filipinas , Inquéritos e Questionários
15.
PLoS One ; 15(7): e0232966, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32645019

RESUMO

OBJECTIVE: To assess the importance of ensuring medicine quality in order to achieve universal health coverage (UHC). METHODS: We developed a systems map connecting medicines quality assurance systems with UHC goals to illustrate the ensuing impact of quality-assured medicines in the implementation of UHC. The association between UHC and medicine quality was further examined in the context of essential medicines in low- and middle-income countries (LMICs) by analyzing data on reported prevalence of substandard and falsified essential medicines and established indicators for UHC. Finally, we examined the health and economic savings of improving antimalarial quality in four countries in sub-Saharan Africa: the Democratic Republic of the Congo (DRC), Nigeria, Uganda, and Zambia. FINDINGS: A systems perspective demonstrates how quality assurance of medicines supports dimensions of UHC. Across 63 LMICs, the reported prevalence of substandard and falsified essential medicines was found to be negatively associated with both an indicator for coverage of essential services (p = 0.05) and with an indicator for government effectiveness (p = 0.04). We estimated that investing in improving the quality of antimalarials by 10% would result in annual savings of $8.3 million in Zambia, $14 million in Uganda, $79 million in two DRC regions, and $598 million in Nigeria, and was more impactful compared to other potential investments we examined. Costs of substandard and falsified antimalarials per malaria case ranged from $7 to $86, while costs per death due to poor-quality antimalarials ranged from $14,000 to $72,000. CONCLUSION: Medicines quality assurance systems play a critical role in reaching UHC goals. By ensuring the quality of essential medicines, they help deliver effective treatments that lead to less illness and result in health care savings that can be reinvested towards UHC.


Assuntos
Preparações Farmacêuticas/normas , Garantia da Qualidade dos Cuidados de Saúde , Assistência de Saúde Universal , África ao Sul do Saara , Antimaláricos/normas , Medicamentos Essenciais/normas , Humanos , Garantia da Qualidade dos Cuidados de Saúde/economia
16.
Rev. Saúde Pública St. Catarina ; 12(1): 01-14, jul. 2020. tab
Artigo em Português | Coleciona SUS, CONASS, SES-SC | ID: biblio-1123557

RESUMO

Este estudo objetivou analisar a organização da assistência farmacêutica em Marema, estado de Santa Catarina (SC), em relação à hipertensão arterial sistêmica, no ano de 2017. A metodologia consistiu na pesquisa em documentos clínicos dos pacientes cadastrados no Programa Municipal de Hipertensão e na entrevista com a farmacêutica da unidade básica de saúde de Marema. No município, há 276 pacientes cadastrados no referido programa com diagnóstico de hipertensão arterial e/ou diabetes (6 pacientes foram excluídos pelo diagnóstico restrito a diabetes). A prevalência de hipertensão no município foi de 13,83%, com prevalência de mulheres (60%) e idosos (73,7%). No total, os pacientes usam 27 anti-hipertensivos, sendo os mais frequentes hidroclorotiazida 25 mg, losartano 50 mg, anlodipino 10 mg e enalapril 20 mg. O município não dispõe de Comissão de Farmácia e Terapêutica. Conclui-se que a Assistência Farmacêutica de Marema, quanto ao tratamento dos pacientes com hipertensão, no período estudado, está satisfatória e colabora, efetivamente, para o manejo adequado dos hipertensos.


This study aimed to analyse the organization of Pharmaceutical Services in Marema (SC), in relation to hypertension, in 2017. The methodology consisted of research in clinical documents of patients enrolled in the Municipal Hypertension Program and in the interview with pharmacist of public health system of Marema. In the city, there were 276 hypertensive and/or diabetic patients enrolled in program (6 patients were excluded because they have just diabetes). The prevalence of hypertension in the city was 13.83%, with prevalence of women (60%) and elderly (73.7%). In total, patients use 27 antihypertensives drugs, the most frequent being hydrochlorothiazide 25 mg, losartan 50 mg, amlodipine 10 mg and enalapril 20 mg. The municipality does not have a Pharmacy and Therapeutics Committee. It is concluded that the Pharmaceutical Services of Marema, regarding the treatment of individuals with hypertension, during 2017, is satisfactory and contributes effectively to the adequate management of hypertensive patients.


Assuntos
Humanos , Masculino , Feminino , Assistência Farmacêutica/organização & administração , Qualidade da Assistência à Saúde , Medicamentos Essenciais/uso terapêutico , Hipertensão/tratamento farmacológico
17.
Bull World Health Organ ; 98(6): 413-419, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32514215

RESUMO

Objective: To obtain the perspectives of some small- and medium-sized organizations on the World Health Organization (WHO) prequalification programme for medicines and to ascertain organizations' unmet needs. Methods: We conducted an exploratory, qualitative study in 2018 among 17 representatives of 15 small- and medium-sized Belgian and non-Belgian organizations who purchase medicines for humanitarian, development or public programmes in low- and middle-income countries. We used semi-structured interviews to obtain respondents' views and experiences of using WHO prequalification guidance when procuring medicines. We identified emerging themes and formulated recommendations about the activities of the WHO Prequalification Team. Findings: Most respondents suggested expanding prequalification to essential antibiotics, particularly paediatric formulations; and insulin, antihypertensives and cancer treatments. Respondents were concerned about irregular availability of WHO-prequalified medicines in the marketplace and sometimes high prices of prequalified products. Small organizations, in particular, had difficulties negotiating low-volume purchases. Organizations working in primary health care and hospitals seldom referred to the prequalified lists. Conclusion: We recommend that the WHO-prequalified products be expanded to include essential antibiotics and medicines for noncommunicable diseases. The WHO Prequalification Team could require prequalified manufacturers to make publicly available the details of their authorized distributors and facilitate a process of harmonization of quality assurance policies across all donors. Prequalification of distributors and procurement agencies could help create more transparent and stringent mechanisms. We urge WHO Member States and funders to sustain support for the WHO Prequalification Team, which remains important for the fulfilment of universal health coverage.


Assuntos
Medicamentos Essenciais/provisão & distribução , Saúde Global , Organizações/organização & administração , Medicamentos sob Prescrição/provisão & distribução , Organização Mundial da Saúde/organização & administração , Antibacterianos/provisão & distribução , Humanos , Doenças não Transmissíveis/tratamento farmacológico , Organizações/normas , Pesquisa Qualitativa
18.
Indian J Public Health ; 64(Supplement): S211-S216, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32496257

RESUMO

Health systems' responsiveness is the key to addressing infectious disease threats such as pandemics. The article outlines an assessment of health systems based on World Health Organization's building blocks for select countries. It also compares these with the findings from a more comprehensive analysis of Global Health Security (GHS) Index, which assesses the preparedness of the health system for such pandemics. The GHS report (2019) spelt out very objectively that none of the countries of the world was prepared to effectively handle such emergencies, should they arise. Observations emerging from different countries highlight these findings although some of them seem to be discordant. Overall, it appears that Asian countries could fight the battle better than most developed nations in the Europe and America during the current pandemic, despite having poor GHS scores. Experiences of these countries in facing similar crisis in the past probably sensitized their strained health systems for a greater good. There are several lessons to be learned from such countries.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Assistência à Saúde/organização & administração , Saúde Global , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Betacoronavirus , Assistência à Saúde/normas , Medicamentos Essenciais/provisão & distribução , Sistemas de Informação em Saúde/organização & administração , Mão de Obra em Saúde/organização & administração , Humanos , Organização Mundial da Saúde
20.
BMC Health Serv Res ; 20(1): 424, 2020 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-32410676

RESUMO

BACKGROUND: More alternatives have become available for the diagnosis and treatment of cancer in low- and middle-income countries. Because of increasing demands, governments are now facing a problem of limited affordability and availability of essential cancer medicines. Yet, precise information about the access to these medicines is limited, and the methodology is not very well developed. We assessed the availability and affordability of essential cancer medicines in Mexico, and compared their prices against those in other countries of the region. METHODS: We surveyed 21 public hospitals and 19 private pharmacies in 8 states of Mexico. Data were collected on the availability and prices of 49 essential cancer medicines. Prices were compared against those in Chile, Peru, Brazil, Colombia and PAHO's Strategic Fund. RESULTS: Of the various medicines, mean availability in public and private sector outlets was 61.2 and 67.5%, respectively. In the public sector, medicines covered by the public health insurance "People's Health Insurance" were more available. Only seven (public sector) and five (private sector) out of the 49 medicines were considered affordable. Public sector procurement prices were 41% lower than in other countries of the region. CONCLUSIONS: The availability of essential cancer medicines, in the public and private sector, falls below World Health Organization's 80% target. The affordability remains suboptimal as well. A national health insurance scheme could serve as a mechanism to improve access to cancer medicines in the public sector. Comprehensive pricing policies are warranted to improve the affordability of cancer medicines in the private sector.


Assuntos
Antineoplásicos/economia , Antineoplásicos/provisão & distribução , Medicamentos Essenciais/economia , Medicamentos Essenciais/provisão & distribução , Neoplasias/tratamento farmacológico , Comércio/estatística & dados numéricos , Custos e Análise de Custo/estatística & dados numéricos , Hospitais Públicos , Humanos , México , Farmácias , Setor Privado , Setor Público , Inquéritos e Questionários
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