Claudia Garcia Serpa Osorio de Castro

A interação entre prescritores, dispensadores e pacientes: informação compartilhada como possível benefício terapêutico

The article presents a critical view of the interaction between prescribers, dispensers, and patients, considering information one of the key issues in enhancing the qualitative aspects involved in this complex relationship. It describes the acquisition of information by health professionals, possible sources of this information, and the process involved in transforming it into knowledge. Briefly discussed are the physicians and pharmacists roles, the patients expectations as recipient, and consequences of pertinent health interventions.

Aquisição de medicamentos no setor público: o binômio qualidade - custo

The authors discuss procurement and provision of pharmaceutical products from the perspective of supply management in the public health sector, focusing on two main aspects: quality and cost. The article analyzes issues to be considered by buyers when evaluating drug quality, especially formulation stability, bioequivalence, and the role of generics. Also discussed are factors involving costs and cost management in relation to technological innovations and consumer demands. New alternatives and suggestions are examined and presented for procurement of high-quality, cost-effective drug products.

Preços e disponibilidade de medicamentos no Programa Farmácia Popular do Brasil

OBJECTIVE To analyze the performance of the Programa Farmácia Popular do Brasil (FPB - Brazilian Popular Pharmacy Program) in the public and private sectors, in terms of availability and cost of medicines for hypertension and diabetes. METHODS The methodology developed by the World Health Organization, in partnership with the Health Action International, was used to compare medicines prices and availability. This study was performed in May 2007, in different sectors (public, private and the Programs government-managed [FPB-P] and private-sector-managed [FPB-E] categories), in 30 cities in Brazil. A total of four medicines were analyzed: captopril 25mg and hydrochlorothiazide 25mg for hypertension; and metformin 500mg and glibenclamide 5mg for diabetes. RESULTS FPB-E showed greatest medicine availability, while the public sector the lowest. The percentage of availability of similar medicines was higher than that of generic medicines, both in the public sector and in the FPB-P. Comparison of prices among sectors showed a lower purchase price in the FPB-E, followed by the FPB-P. The FPB-E charged prices that were over 90% cheaper than those in the private sector. The number of working days required to obtain treatment for hypertension and diabetes were fewer in the FPB-E. CONCLUSIONS The lower availability found in the public sector could be one of the reasons for the migration of users from the public sector to the FPB. The high prices in the private sector also contribute for this Program to be an alternative of medicine access in Brazil.OBJETIVO: Analizar el desempeno del Programa Farmacia Popular de Brasil frente a los sectores publico y privado, con relacion a: disponibilidad, precio y costo para el paciente, de medicamentos para hipertension y diabetes. METODOS: Fue utilizada la metodologia desarrollada por la Organizacion Mundial de la Salud en conjunto con la Accion Internacional para Salud, para comparar los precios y la disponibilidad de medicamentos. La investigacion fue aplicada en mayo de 2007, en establecimientos de diferentes sectores [publico, privado y las modalidades propia (FPB-P) y expansion (FPB-E) del Programa], en 30 municipios de Brasil. Los cuatro medicamentos analizados fueron: captopril 25 mg e hidroclorotiazida 25 mg, para hipertension, y metformina 500 mg y glibenclamida 5 mg, para diabetes. RESULTADOS: El FPB-E presento mayor disponibilidad de medicamentos y el sector publico, la menor. Tanto en el sector publico como en la FPB-P el porcentaje de disponibilidad de similares fue mayor que el de los genericos. La comparacion de precios entre los sectores mostro menor precio de adquisicion en el FPB-E, seguido por el FPB-P. El FPB-E presento economia superior a 90% con relacion al sector privado. El numero de dias de trabajo necesarios para adquisicion de tratamientos para hipertension y diabetes fue menor en el FPB-E. CONCLUSIONES: La menor disponibilidad encontrada en el sector publico puede ser una de las justificativas de la migracion de los usuarios del sector publico al FPB. Los altos precios practicados por el sector privado tambien contribuyen para que el Programa sea una alternativa de acceso a medicamentos en Brasil.

Medicine prices and availability in the Brazilian Popular Pharmacy Program

OBJECTIVE To analyze the performance of the Programa Farmácia Popular do Brasil (FPB - Brazilian Popular Pharmacy Program) in the public and private sectors, in terms of availability and cost of medicines for hypertension and diabetes. METHODS The methodology developed by the World Health Organization, in partnership with the Health Action International, was used to compare medicines prices and availability. This study was performed in May 2007, in different sectors (public, private and the Programs government-managed [FPB-P] and private-sector-managed [FPB-E] categories), in 30 cities in Brazil. A total of four medicines were analyzed: captopril 25mg and hydrochlorothiazide 25mg for hypertension; and metformin 500mg and glibenclamide 5mg for diabetes. RESULTS FPB-E showed greatest medicine availability, while the public sector the lowest. The percentage of availability of similar medicines was higher than that of generic medicines, both in the public sector and in the FPB-P. Comparison of prices among sectors showed a lower purchase price in the FPB-E, followed by the FPB-P. The FPB-E charged prices that were over 90% cheaper than those in the private sector. The number of working days required to obtain treatment for hypertension and diabetes were fewer in the FPB-E. CONCLUSIONS The lower availability found in the public sector could be one of the reasons for the migration of users from the public sector to the FPB. The high prices in the private sector also contribute for this Program to be an alternative of medicine access in Brazil.OBJETIVO: Analizar el desempeno del Programa Farmacia Popular de Brasil frente a los sectores publico y privado, con relacion a: disponibilidad, precio y costo para el paciente, de medicamentos para hipertension y diabetes. METODOS: Fue utilizada la metodologia desarrollada por la Organizacion Mundial de la Salud en conjunto con la Accion Internacional para Salud, para comparar los precios y la disponibilidad de medicamentos. La investigacion fue aplicada en mayo de 2007, en establecimientos de diferentes sectores [publico, privado y las modalidades propia (FPB-P) y expansion (FPB-E) del Programa], en 30 municipios de Brasil. Los cuatro medicamentos analizados fueron: captopril 25 mg e hidroclorotiazida 25 mg, para hipertension, y metformina 500 mg y glibenclamida 5 mg, para diabetes. RESULTADOS: El FPB-E presento mayor disponibilidad de medicamentos y el sector publico, la menor. Tanto en el sector publico como en la FPB-P el porcentaje de disponibilidad de similares fue mayor que el de los genericos. La comparacion de precios entre los sectores mostro menor precio de adquisicion en el FPB-E, seguido por el FPB-P. El FPB-E presento economia superior a 90% con relacion al sector privado. El numero de dias de trabajo necesarios para adquisicion de tratamientos para hipertension y diabetes fue menor en el FPB-E. CONCLUSIONES: La menor disponibilidad encontrada en el sector publico puede ser una de las justificativas de la migracion de los usuarios del sector publico al FPB. Los altos precios practicados por el sector privado tambien contribuyen para que el Programa sea una alternativa de acceso a medicamentos en Brasil.

Primary health care in municipalities at high risk for malaria

This study aims to characterize aspects of Primary Health Care in the Amazon Region of Brazil, considered as the main endemic area for malaria in the country. The Ministry of Health recommends the expansion of Primary Health Care in endemic areas for malaria. A survey focusing on patients infected with malaria was conducted in 6 municipalities, in January and February 2007, to investigate specific aspects of Primary Health Care. Data was analyzed quantitatively and field records helped to give support to context and policy issues in the visited sites. Quality of access to health services and medicines, continuity of health care, system coordination and community orientation are still incipient in the visited areas. The study showed that there is little integration between Primary Health Care and malaria control in the region, which calls for development of joint strategies and for the strengthening of Primary Health Care per se, as a benefit to the population of this endemic area.Este estudio pretende caracterizar aspectos de la Atencion Basica en la region de la Amazonia Legal, principal area endemica para malaria en Brasil. El Ministerio de la Salud recomienda la expansion de la Atencion Basica en las areas afectada por la malaria. Fue realizado una encuesta transversal aplicada a los portadores de malaria en 6 municipios, durante los meses de enero y febrero de 2007. Los datos recolectados fueron tabulados y analizados utilizando tecnicas cuantitativas. Registros de campo auxiliaron en la composicion de las impresiones del contexto de estas politicas en los locales investigados. La calidad del acceso a consultas y medicamentos, el vinculo con los profesionales y con las Unidades Basicas de Salud, el sistema de referencia y contra-referencia y el abordaje familiar y comunitario de la salud por los profesionales en los municipios del estudio tambien son deficientes en este nivel de atencion. Existe una baja integracion entre el Programa Nacional de Control de Malaria y la Atencion Basica de un modo general.Descriptores: Atencion Primaria en Salud; Malaria; Brasil.

Atención primaria a la salud en municipios de alto riesgo para malaria

This study aims to characterize aspects of Primary Health Care in the Amazon Region of Brazil, considered as the main endemic area for malaria in the country. The Ministry of Health recommends the expansion of Primary Health Care in endemic areas for malaria. A survey focusing on patients infected with malaria was conducted in 6 municipalities, in January and February 2007, to investigate specific aspects of Primary Health Care. Data was analyzed quantitatively and field records helped to give support to context and policy issues in the visited sites. Quality of access to health services and medicines, continuity of health care, system coordination and community orientation are still incipient in the visited areas. The study showed that there is little integration between Primary Health Care and malaria control in the region, which calls for development of joint strategies and for the strengthening of Primary Health Care per se, as a benefit to the population of this endemic area.Este estudio pretende caracterizar aspectos de la Atencion Basica en la region de la Amazonia Legal, principal area endemica para malaria en Brasil. El Ministerio de la Salud recomienda la expansion de la Atencion Basica en las areas afectada por la malaria. Fue realizado una encuesta transversal aplicada a los portadores de malaria en 6 municipios, durante los meses de enero y febrero de 2007. Los datos recolectados fueron tabulados y analizados utilizando tecnicas cuantitativas. Registros de campo auxiliaron en la composicion de las impresiones del contexto de estas politicas en los locales investigados. La calidad del acceso a consultas y medicamentos, el vinculo con los profesionales y con las Unidades Basicas de Salud, el sistema de referencia y contra-referencia y el abordaje familiar y comunitario de la salud por los profesionales en los municipios del estudio tambien son deficientes en este nivel de atencion. Existe una baja integracion entre el Programa Nacional de Control de Malaria y la Atencion Basica de un modo general.Descriptores: Atencion Primaria en Salud; Malaria; Brasil.

Atenção primária à saúde em municípios de alto risco para malária

This study aims to characterize aspects of Primary Health Care in the Amazon Region of Brazil, considered as the main endemic area for malaria in the country. The Ministry of Health recommends the expansion of Primary Health Care in endemic areas for malaria. A survey focusing on patients infected with malaria was conducted in 6 municipalities, in January and February 2007, to investigate specific aspects of Primary Health Care. Data was analyzed quantitatively and field records helped to give support to context and policy issues in the visited sites. Quality of access to health services and medicines, continuity of health care, system coordination and community orientation are still incipient in the visited areas. The study showed that there is little integration between Primary Health Care and malaria control in the region, which calls for development of joint strategies and for the strengthening of Primary Health Care per se, as a benefit to the population of this endemic area.Este estudio pretende caracterizar aspectos de la Atencion Basica en la region de la Amazonia Legal, principal area endemica para malaria en Brasil. El Ministerio de la Salud recomienda la expansion de la Atencion Basica en las areas afectada por la malaria. Fue realizado una encuesta transversal aplicada a los portadores de malaria en 6 municipios, durante los meses de enero y febrero de 2007. Los datos recolectados fueron tabulados y analizados utilizando tecnicas cuantitativas. Registros de campo auxiliaron en la composicion de las impresiones del contexto de estas politicas en los locales investigados. La calidad del acceso a consultas y medicamentos, el vinculo con los profesionales y con las Unidades Basicas de Salud, el sistema de referencia y contra-referencia y el abordaje familiar y comunitario de la salud por los profesionales en los municipios del estudio tambien son deficientes en este nivel de atencion. Existe una baja integracion entre el Programa Nacional de Control de Malaria y la Atencion Basica de un modo general.Descriptores: Atencion Primaria en Salud; Malaria; Brasil.

Precios y disponibilidad de medicamentos en el Programa Farmacia Popular de Brasil

OBJECTIVE To analyze the performance of the Programa Farmácia Popular do Brasil (FPB - Brazilian Popular Pharmacy Program) in the public and private sectors, in terms of availability and cost of medicines for hypertension and diabetes. METHODS The methodology developed by the World Health Organization, in partnership with the Health Action International, was used to compare medicines prices and availability. This study was performed in May 2007, in different sectors (public, private and the Programs government-managed [FPB-P] and private-sector-managed [FPB-E] categories), in 30 cities in Brazil. A total of four medicines were analyzed: captopril 25mg and hydrochlorothiazide 25mg for hypertension; and metformin 500mg and glibenclamide 5mg for diabetes. RESULTS FPB-E showed greatest medicine availability, while the public sector the lowest. The percentage of availability of similar medicines was higher than that of generic medicines, both in the public sector and in the FPB-P. Comparison of prices among sectors showed a lower purchase price in the FPB-E, followed by the FPB-P. The FPB-E charged prices that were over 90% cheaper than those in the private sector. The number of working days required to obtain treatment for hypertension and diabetes were fewer in the FPB-E. CONCLUSIONS The lower availability found in the public sector could be one of the reasons for the migration of users from the public sector to the FPB. The high prices in the private sector also contribute for this Program to be an alternative of medicine access in Brazil.OBJETIVO: Analizar el desempeno del Programa Farmacia Popular de Brasil frente a los sectores publico y privado, con relacion a: disponibilidad, precio y costo para el paciente, de medicamentos para hipertension y diabetes. METODOS: Fue utilizada la metodologia desarrollada por la Organizacion Mundial de la Salud en conjunto con la Accion Internacional para Salud, para comparar los precios y la disponibilidad de medicamentos. La investigacion fue aplicada en mayo de 2007, en establecimientos de diferentes sectores [publico, privado y las modalidades propia (FPB-P) y expansion (FPB-E) del Programa], en 30 municipios de Brasil. Los cuatro medicamentos analizados fueron: captopril 25 mg e hidroclorotiazida 25 mg, para hipertension, y metformina 500 mg y glibenclamida 5 mg, para diabetes. RESULTADOS: El FPB-E presento mayor disponibilidad de medicamentos y el sector publico, la menor. Tanto en el sector publico como en la FPB-P el porcentaje de disponibilidad de similares fue mayor que el de los genericos. La comparacion de precios entre los sectores mostro menor precio de adquisicion en el FPB-E, seguido por el FPB-P. El FPB-E presento economia superior a 90% con relacion al sector privado. El numero de dias de trabajo necesarios para adquisicion de tratamientos para hipertension y diabetes fue menor en el FPB-E. CONCLUSIONES: La menor disponibilidad encontrada en el sector publico puede ser una de las justificativas de la migracion de los usuarios del sector publico al FPB. Los altos precios practicados por el sector privado tambien contribuyen para que el Programa sea una alternativa de acceso a medicamentos en Brasil.