Abstract

IntroductionThe Brazilian Unified Health System (SUS) is known worldwide for ensuring universal assistance to citizens, which includes the supply of medicines free of charge. Biological drugs consume about 40 percent of the public budget for pharmaceutical services in the SUS and Rheumatoid Arthritis (RA) is the largest consumer of these resources, serving about 110,000 patients. Since 2002 there has been a clinical guideline for the care of patients with rheumatoid arthritis in Brazil, currently providing 10 biological drugs for treatment of RA. The objective of this study is to present data about the provision, expenditure and profile of users of biological drugs for rheumatoid arthritis in SUS.MethodsRetrospective and exploratory study, using administrative data regarding the purchase and consumption of biological drugs Infliximab, Etanercept, Adalimumab, Rituximab, Abatacept (intravenous and subcutaneous), Tocilizumab, Golimumab and Certolizumab pegol for the treatment of RA between 2012 and 2017 in SUS.ResultsThere was an expenditure of approximately USD 421.7 million from the Brazilian Ministry of Health with the supply of about 2 million pharmaceutical units of biological drugs for treatment of rheumatoid arthritis, 79 percent of them destined for female users and 89.2 percent for the 40-69 age group. The M05.8 and M.06.0 codes of the International Classification of Diseases (ICD-10) were the most prevalent among the arthritic population served. Adalimumab and Etanercept accounted for 68.3 percent of total expenditure. A reduction in the use of these medicines were observed after the availability of new drugs for the treatment of the disease between 2014 and 2017.ConclusionsBrazil is one of the largest consumers of biological medicines in the world. The use of real-life data allows monitoring trends and costs of the use of these drugs as well as changes with the entry of new therapies and biosimilar medicines.

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