Access to medicines for chronic diseases in Brazil: a multidimensional approach

Authors

  • Maria Auxiliadora Oliveira Fundação Oswaldo Cruz; Escola Nacional de Saúde Pública Sérgio Arouca; Departamento de Política de Medicamentos e Assistência Farmacêutica
  • Vera Lucia Luiza Fundação Oswaldo Cruz; Escola Nacional de Saúde Pública Sérgio Arouca; Departamento de Política de Medicamentos e Assistência Farmacêutica
  • Noemia Urruth Leão Tavares Universidade de Brasília; Faculdade de Ciências da Saúde; Departamento de Farmácia
  • Sotero Serrate Mengue Universidade Federal do Rio Grande do Sul; Faculdade de Medicina
  • Paulo Sergio Dourado Arrais Universidade Federal do Ceará; Faculdade de Farmácia, Odontologia e Enfermagem; Departamento de Farmácia
  • Mareni Rocha Farias Universidade Federal de Santa Catarina; Centro de Ciências da Saúde; Departamento de Ciências Farmacêuticas
  • Tatiane da Silva Dal Pizzol Universidade Federal do Rio Grande do Sul; Faculdade de Farmácia; Departamento de Produção e Controle de Medicamentos
  • Luiz Roberto Ramos Universidade Federal de São Paulo; Escola Paulista de Medicina; Departamento de Medicina Preventiva
  • Andréa Dâmaso Bertoldi Universidade Federal de Pelotas; Faculdade de Medicina; Departamento de Medicina Social

DOI:

https://doi.org/10.1590/s1518-8787.2016050006161

Abstract

OBJECTIVE 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.

Published

2016-01-01

Issue

Section

Original Articles

How to Cite

Access to medicines for chronic diseases in Brazil: a multidimensional approach . (2016). Revista De Saúde Pública, 50(supl2), 6s. https://doi.org/10.1590/s1518-8787.2016050006161