Abstract
Some medications are classified as high cost, with monthly expenses exceeding R$ 200,000.000. For the distribution of such drugs, the Ministry of Health publishes lists called exceptional dispensing drugs, federally funded with cash transfers to states and municipalities. However the access to medicines, under the Health System, presents various administrative obstacles. To understand the reasons for the failures of exceptional drugs distribution as well as the consequences for management in public health it was the objective of this survey. A documental analysis of official lists of five Brazilian states and other ordinances related to the dispensing of high-cost drugs was performed, in addition to content analysis of secondary sources as the lawsuits brought by patients with rare diseases, with the Public Prosecutor. The paper also discusses new proposals and guidelines for the management of the list of high-cost medicines state. Keywords : High-cost, drugs, failure, dispensation, health management.
Highlights
INTRODUÇÃO Medicamentos de dispensação excepcional são aqueles de alto valor agregado, empregados em portadores de doenças raras ou órfãs que, pela cronicidade do tratamento, tornam-se excessivamente caros para serem custeados pela população, segundo o Ministério da Saúde (MS, 2001)
Some medications are classified as high cost
well as the consequences for management in public health it was the objective of this survey
Summary
Fonte: Elaborado pelos autores com base na análise das listas pesquisadas. A sigla NC indica os medicamentos que não foram encontrados ou não constam nas listas estaduais dos respectivos estados. A Tabela 2 demonstra aqueles medicamentos de dispensação pertencente a outro grupo, em outro estado. Apenas a Alfaepoetina excepcional que não constam da lista (NC) dos cinco estados se manteve como Grupo 1A em 4 das listas analisadas. Do total de analisados ou cujo mesmo medicamento advém de financiamentos medicamentos cruzados entre as listas, 98,0% não estavam e aquisição por diferentes fontes como o MS, estados e municípios, classificados num mesmo grupo pela fonte de financiamento. Tabela 2: Medicamentos com aquisição e financiamento por diferentes fontes (federal, estadual e municipal) e medicamentos que não constam na lista estadual
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