Abstract
This paper investigates difficulties related to access to medicines in SUS and factors associated with the inability to obtain medicines in SUS by non-communicable chronic disease (NCCD) patients who used this source for health care. We analyzed data from the National Survey on Access, Use and Promotion of Rational Use of Medicines. First analysis included individuals aged 20 years and over, diagnosed with at least one NCCD, with indication of medicine treatment and follow up of this disease (s) with a physician from SUS, and who reported having obtained some of the medicines in use from the SUS. The difficulties of obtaining medicines from SUS were investigated based on dimensions of access to medicines. Among 5.155 individuals investigated, 65.4% were women, 40 years old or older and 54.3% residents of the Southeast region of Brazil. Aspects related to availability and waiting time to obtain medicines were the most significant reported barriers to access to medicines. Regional differences were found in basically all dimensions of access and the low availability of medicines in SUS pharmacies was the main reason cited for their search in private pharmacies.
Highlights
Noncommunicable diseases (NCDs) account for seven of the nineteen groups of causes on the national list of primary care sensitive conditions (Rehem; Egry, 2011)
This paper aims to investigate barriers related to access to medicines for NCDs, except cancer, in SUS and factors associated with the inability to obtain this medicines in SUS by patients who used this source for health care
Acceptability was investigated in the Promotion of Rational Use of Medicines (PNAUM) household questionnaire by a set of questions about the routine dispensing of medicines at SUS pharmacies and the quality of service: “Can medicines be picked up any day of the week? Yes/No”; “Do you need to attend a group or meeting to pick up the medicines? Yes/No”; “How long do you usually wait to be served? Does not wait/waits a little/waits a lot of time”; “Are opening hours very good/good/fair/bad/very bad?” and “Is medicines pick-up service: very good/good/fair/bad/very bad?” We considered the negative response on medicine dispensing on any day of the week and an affirmative response on participation in some group or meeting to pick-up medicines for the analysis
Summary
Noncommunicable diseases (NCDs) account for seven of the nineteen groups of causes on the national list of primary care sensitive conditions (Rehem; Egry, 2011). The morbidity and mortality caused by NCDs is higher in poorest populations. This reinforces the importance of the control of these diseases as a priority for public health policies, and the assurance of access to medicines recognized as a fundamental strategy for. In Brazil, there are two publicly financed access to medicines mechanisms: the provision in SUS dispensing facilities and the copayment in Brazilian Popular Pharmacy Program (PFPB) (Luiza et al, 2018). SUS dispensing facilities at primary health care (PHC) are tasked with providing free access to essential medicines. Problems regarding availability of medicines, as well as with different pharmaceutical activities such as demand forecasting, acquisition and storage have been reported
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