Navegando por Palavras-chave "National Drug Policy"
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- ItemAcesso aberto (Open Access)Distorções causadas pelas ações judiciais à política de medicamentos no Brasil(Faculdade de Saúde Pública da Universidade de São Paulo, 2007-04-01) Vieira, Fabiola Sulpino [UNIFESP]; Zucchi, Paola [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To describe how lawsuits, which demand the supply of drugs, impact on elements of the national drug policy. METHODS: This is a desk-based study using qualitative and quantitative methods. All legal proceedings brought by citizens against the Municipal Secretary of State of São Paulo, relating to the supply of drugs in 2005 were analyzed. A standardized form was used to collect data, with a view to carrying out an exploratory analysis. RESULTS: A total of 170 cases relating to the supply of drugs were brought against the Municipal Secretary of State. The National Health System (SUS) was the source for 59% of the prescriptions: 26% from the municipal level, 33% from other levels. Cancer and diabetes were the diseases most commonly involved (59%). About 62% of drugs requested are on the lists of SUS services. Total expenditure was R$876,000 (Brazilian Reais), covering only non-selected items (i.e. those which are not included in the Municipal Register of Essential Medicines), 73% of which could be substituted. Of the total expenditure, 75% was spent on purchasing anticancer drugs, for which further clinical trials are required to prove their effectiveness. Two of these medicines were not registered in Brazil. CONCLUSIONS: The majority of demands for drugs that have led to legal proceedings could be avoided if two SUS directives were followed, namely the organization of oncology services and the observance of reporting on essential medicines. Failure to do so causes a breakdown in the National Drug Policy, in equality of access and in the rational use of drugs within the National Health System.
- ItemAcesso aberto (Open Access)Ensino-aprendizagem da política nacional de medicamentos (RENAME e URM) na Graduação Médica da Universidade Federal do Tocantins(Universidade Federal de São Paulo (UNIFESP), 2014-03-21) Andrade, Elizangela Braga [UNIFESP]; Goldenberg, Paulete [UNIFESP]; http://lattes.cnpq.br/8655470743072105; http://lattes.cnpq.br/6173321272814063; Universidade Federal de São Paulo (UNIFESP)O estudo teve por objetivo geral caracterizar o ensino sobre a Política Nacional de Medicamentos (PNM) na graduação médica da Universidade Federal do Tocantins, focalizando a instituição e seus atores - coordenador do curso, docentes e alunos. Trata-se de um estudo descritivo, em caráter exploratório, apoiado em abordagem qualitativa, que comportou três movimentos investigativos. O primeiro se propôs a identificar, por meio do Projeto Político e Pedagógico, as disposições relativas ao ensino disponibilizado na instituição. O segundo, através de entrevistas semiestruturadas, buscou apreender o ensino da questão do medicamento na perspectiva do coordenador do curso e de docentes das disciplinas de Saúde Coletiva, Saúde da Família: Vivências em Atenção Básica I, Farmacologia Básica e Farmacologia Médica. O terceiro movimento, por sua vez, utilizando a estratégia de grupos focais, viabilizou a qualificação deste ensino sob a perspectiva de estudantes no ciclo básico (sétimo período) e no internato (nono e décimo períodos). Para efeito de análise, foi utilizada a técnica de análise do conteúdo, modalidade temática. Os resultados mostram que o PPP especificou o propósito de formar o aluno para atuar no SUS, com conhecimento aprimorado para as necessidades da população amazônica. Para tanto, em conformidade às Diretrizes Curriculares Nacionais, preconiza a articulação entre a instituição formadora e os serviços de saúde. De forma coerente, ao lado da valorização do ensino pela prática, na perspectiva pedagógica, o projeto aponta para o recurso às metodologias de participação ativa do aluno. No entanto, o PPP não permite antever o tratamento político explícito da questão dos medicamentos. As ementas das áreas de conhecimento da Saúde Coletiva e Farmacologia não abordam a questão formalmente e seus conteúdos não se cruzam. No Internato, algumas áreas discutem o tema, mas de forma pontual. Na perspectiva do coordenador do curso a temática não é priorizada na universidade como deveria. Os professores, por sua vez, afirmaram a falta de preparo a respeito da PNM. Segundo eles não constam do conteúdo programático das disciplinas a abordagem sobre a RENAME. A URM constitui tema mais valorizado, particularmente na Farmacologia, prevalecendo o foco restrito do ensino ao tratamento individual. Os estudantes declararam, enfim, que não foram orientados de forma sistemática sobre a assistência farmacêutica no SUS e reconheceram que esta falta de orientação compromete a prescrição e o acesso dos pacientes aos medicamentos (por eles) indicados. Diante do exposto, emerge a sugestão de aprimorar a relação teórico-prática desde o início do curso, sendo apontada “a prescrição e o acesso aos medicamentos no SUS” como temática relevante a ser explorada em todas as oportunidades existentes no currículo.
- 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.
- ItemAcesso aberto (Open Access)Propagandas de medicamentos psicoativos: análise das informações científicas(Faculdade de Saúde Pública da Universidade de São Paulo, 2008-06-01) Mastroianni, Patrícia C; Noto, Ana Regina [UNIFESP]; Galduróz, José Carlos Fernandes [UNIFESP]; Universidade Estadual Paulista (UNESP); Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: According to the World Health Organization, medicinal drug promotion should be reliable, accurate, truthful, informative, balanced, up-to-date and capable of substantiation. The objective of the present study was to review psychoactive drug advertisements to physicians as for information consistency with the related references and accessibility of the cited references. METHODS: Data was collected in the city of Araraquara, Southeastern Brazil, in 2005. There were collected and reviewed 152 drug advertisements, a total of 304 references. References were requested directly from pharmaceutical companies' customer services and searched in UNESP (Ibict, Athenas) and BIREME (SciELO, PubMed, free-access indexed journals) library network and CAPES journals. Advertisement statements were checked against references using content analysis. RESULTS: Of all references cited in the advertisements studied, 66.7% were accessed. Of 639 promotional statements identified, 346 (54%) were analyzed. The analysis showed that 67.7% of promotional statements in the advertisements were consistent with their references, while the remaining was either partially consistent or inconsistent. Of the material analyzed, an average 2.5 (1-28) references was cited per advertisement. In the text body, there were identified 639 pieces of information clearly associated with at least one cited reference (average 3.5 pieces of information per advertisement). CONCLUSIONS: The study results evidenced difficult access to the references. Messages on efficacy, safety and cost, among others, are not always supported by scientific studies. There is a need for regulation changes and effective monitoring of drug promotional materials.