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

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

Title: Access to medicines for chronic diseases in brazil: a multidimensional approach;
Acesso a medicamentos para doenças crônicas no Brasil: uma abordagem multidimensional
Author Oliveira, Maria Auxiliadora Google Scholar
Luiza, Vera Lucia Google Scholar
Leao Tavares, Noemia Urruth Google Scholar
Mengue, Sotero Serrate Google Scholar
Dourado Arrais, Paulo Sergio Google Scholar
Farias, Mareni Rocha Google Scholar
Dal Pizzol, Tatiane da Silva Google Scholar
Ramos, Luiz Roberto Autor UNIFESP Google Scholar
Bertoldi, Andrea Damaso Google Scholar
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%. RESULTS: 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. CONCLUSIONS: 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.
Keywords Medication
Prevalence
Adults
Language English
Sponsor Department of Science and Technology (DECIT) of the Secretariat of Science, Technology, and Strategic Inputs (SCTIE) of the Ministry of Health (SCTIE/MS) [25000.111834/2011-31]
Department of Pharmaceutical Services and Strategic Health Supplies (DAF) of the Secretariat of Science, Technology, and Strategic Inputs (SCTIE) of the Ministry of Health (SCTIE/MS) [25000.111834/2011-31]
Grant number SCTIE/MS: 25000.111834/2011-31
Date 2016
Published in Revista De Saude Publica. Sao paulo, v. 50, n. 2, p. 6s, 2016.
ISSN 0034-8910 (Sherpa/Romeo, impact factor)
Publisher Univ Sao Paulo, Fac Filosofia
Extent 6s
Origin http://dx.doi.org/10.1590/s1518-8787.2016050006161
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000391447400011
SciELO ID S0034-89102016000300303 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/49287

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