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- ItemAcesso aberto (Open Access)Aplicações diretas para aquisição de medicamentos no Sistema Único de Saúde(Faculdade de Saúde Pública da Universidade de São Paulo, 2011-10-01) Vieira, Fabiola Sulpino [UNIFESP]; Zucchi, Paola [UNIFESP]; Ministério da Saúde Secretaria Executiva Departamento de Economia da Saúde e Desenvolvimento; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To analyze resource allocation for pharmaceutical procurement by federative entities in the Brazilian Unified Health System. METHODS: The amounts allocated to purchase pharmaceuticals during 2009 in two information systems were analyzed: Siga Brasil (Follow Brazil) for national data and Sistema de Informações sobre Orçamentos Públicos em Saúde (Information System on Public Health Budgets) for states, the Federal District and municipalities data. Per capita spending and the mean and median spending were calculated by municipalities, according to region and population size. The Spearman correlation coefficient was calculated for some variables. The statistical analysis included tests of normality and multiple comparisons for differences between groups. RESULTS: In 2009 the total amount spent by the three spheres of government for purchase of medicines was approximately R$ 8.9 billion. States and the Federal District were the main players, accounting for 47.1% of the total amount spent in the health system. Some states had per capita spending well above the mean (R$ 22.00 per resident/year) and the median (R$ 17.00 per resident/year). There were differences in municipal spending by region. The mean per capita expenditure of municipalities with less than 5,000 residents was 3.9 times that of municipalities with over 500,000 residents. Municipalities with less than 10,000 residents had higher per capita spending than other municipalities. CONCLUSIONS: Economic aspects such as the scale of procurement and bargaining power may explain differences in per capita spending between federal entities, especially among municipalities. The study indicates inefficiencies in the use of financial resources to procure medicines in the Brazilian Unified Health System.
- ItemSomente MetadadadosCusto mensal do tratamento do glaucoma com colirios genericos e de referencia de maleato de timolol 0,5% em Marilia, estado de São Paulo, Brasil(Universidade Federal de São Paulo (UNIFESP), 2004) Ueda, Eder Massao [UNIFESP]
- ItemAcesso aberto (Open Access)Financiamento da assistência farmacêutica no sistema único de saúde(Faculdade de Saúde Pública, Universidade de São Paulo.Associação Paulista de Saúde Pública., 2013-03-01) Vieira, Fabiola Sulpino [UNIFESP]; Zucchi, Paola [UNIFESP]; Ministério da Saúde; Universidade Federal de São Paulo (UNIFESP)Objectives. To describe and discuss developments in the financing of pharmaceutical services in the Brazilian public health system - SUS. Methods. The amounts allocated for drug procurement, for the Farmácia Popular Program and for structuring of public pharmaceutical services were identified. The values regarding the financing of the Federal government were obtained from the Siga Brasil database. Data regarding states, Federal District and municipalities were obtained from Information System on Public Health Budget - SIOPS. Results. Federal funds for drugs purchasing increased by 65.3% between 2005 and 2009. In the same period, the volume of transfers made to the subnational levels increased. It was found that the states and the Federal District have increased by 112.4% the volume of own resources allocated to the financing of drugs and for municipalities this growth was 22.7%. In 2008, the share of drug expenses in relation to expenditure on health was 7.8%. The total drug spending in 2009 was 8.9 billion reais. There was an increase of 20.6 times of the amount allocated in the Farmácia Popular Program, and a growth of 41.6% in the resources destined to structuring services, which reached 10.1 million reais in 2009. Conclusion. there was expansion of the funding of medicines in SUS between 2005 and 2009.
- ItemAcesso aberto (Open Access)Medicamentos de dispensação excepcional: histórico e gastos do Ministério da Saúde do Brasil(Faculdade de Saúde Pública da Universidade de São Paulo, 2011-04-01) Carias, Claudia Mezleveckas [UNIFESP]; Vieira, Fabiola Sulpino [UNIFESP]; Giordano, Carlos V [UNIFESP]; Zucchi, Paola [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Ministério da SaúdeOBJECTIVE: To describe the technical aspects of the Exceptional Circumstance Drug Dispensing Program of the Brazilian Ministry of Health, especially with respect to the cost of dispensed medication. METHODS: Technical information was obtained from the ordinances that regulate the Program. Expenditure from 2000 to 2007 was obtained from the Sistema Único de Saúde's (Unified Healthcare System) Outpatient Information System. All drugs dispensed between 1993 and 2009 and the amount and cost of each procedure were evaluated, based on information from the high-complexity procedure authorization of each of the country's states. RESULTS: The Program changed with the increase in the number of pharmacological agents and presentations distributed by, and the number of diseases contemplated in the program. In 1993, the program distributed 15 pharmacological agents in 31 distinct presentations. This number increased to 109 agents in 243 presentations in 2009. Total Ministry of Health expenditure with medications was R$1,410,181,600.74 in 2007, almost twice the amount spent in 2000, R$684,975,404.43. Diseases whose expenditure increased in the period included chronic renal insufficiency, transplantation, and hepatitis C. CONCLUSIONS: The Exceptional Circumstance Drug Dispensing Program is in constant transformation, aimed at building instruments and strategies that can ensure and expand access to medication among the population. Alternatives should be sought to decrease the financial impact of the Program to a level that does not impact other sectors of the health care system, given the high cost associated with novel interventions.
- ItemSomente MetadadadosPerfil do paciente diabetico encaminhado ao departamento de retina de um servico de referencia terciaria em Sorocaba e suas repercussoes aministrativas de Saúde publica e privada(Universidade Federal de São Paulo (UNIFESP), 2002) Souto, Alexandre Cupello [UNIFESP]