Abstract
ABSTRACTOBJECTIVE To analyze the access to medicines to treat non-communicable diseases in Brazil according to socioeconomic, demographic, and health-related factors, from a multidimensional perspective.METHODS Analysis of data from the National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM), household survey, sampling plan by conglomerates with representativeness of the Brazilian population and large areas of the country, according to sex and age domains. Data collected in 2013–2014 with sample of adults (≥ 20 years) who reported having non-communicable diseases and medical indication for use of medicines (n = 12,725). We assessed the prevalence of access to medicines for self-reported non-communicable diseases, considering four dimensions: availability, geographic accessibility, acceptability, and affordability. We applied Pearson’s Chi-square test to assess the statistical significance of the differences between strata, considering the level of significance of 5%. We found prevalence of 94.3%, 5.2%, and 0.5% for full, partial, and null access, respectively. Higher prevalence was observed among seniors in the South compared to the Northeast; for those who reported having one non-communicable disease compared to those who reported having two or more; for those who needed one medicine compared to those who needed three or more; and for those who self-assessed their health as good or very good. Geographic accessibility was similar in the Unified Health System and in the private pharmacies (72.0%). Total availability of medicines was 45.2% in the Unified Health System, 67.4% in the Popular Pharmacy Program, and 88.5% in private pharmacies. Acceptability was 92.5% in the Unified Health System, 97.8% in the Popular Pharmacy Program, and 98.7% in private pharmacies. As to affordability, 2.6% of the individuals failed to take the medicines they should in the 30-day period prior to the interview due to financial difficulty. Prevalence of full access to medicines for non-communicable diseases in Brazil is high and presents significant differences for age group, region of the country, number of non-communicable diseases, and for medicines prescribed and self-assessment of health. The major barriers to access to medicines were identified in the dimensions analyzed.
Highlights
Medicines save lives and improve the health of people, preventing, curing, or controlling and reducing morbidity and mortality associated with acute and chronic diseases[2]
Higher prevalence was observed among seniors in the South compared to the Northeast; for those who reported having one non-communicable disease compared to those who reported having two or more; for those who needed one medicine compared to those who needed three or more; and for those who self-assessed their health as good or very good
This study considered a sample of adults aged 20 years or older who reported having some non-communicable diseases (NCD) diagnosed by physician: “Has a physician ever told you that you have hypertension or high blood pressure and medical indication for use of medicines?”
Summary
Medicines save lives and improve the health of people, preventing, curing, or controlling and reducing morbidity and mortality associated with acute and chronic diseases[2]. The rapid demographic transition, with an increase in the relative weight of adults and seniors in the population pyramid, indicates trend of increasing for the burden of these diseases and for consumption of medicines in the country[23]. Control of these diseases and of their risk factors depends on a set of health actions, which includes timely health care and adequate provision of medicines[16]. This program is a strategy to scaling up access, in which a set of medicines is supplied for free and another, broader, is sold at subsidized pricesa
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