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Study by researchers from CTS-Ipea can contribute to the elaboration of strategies to reduce the costs of the health system. The Brazilian government is responsible for a significant volume of pharmaceutical purchases, which also represent a substantial portion of the total public health expenditures in the country. Unfortunately, despite its relevance, there is a lack of detailed studies analyzing the behavior of pharmaceutical purchases by the federal government. This text aims to fill this gap by presenting the evolution of medicine acquisitions by the federal government over the last 20 years and identifying relevant patterns and trends. The SIASG is a government system designed to support the management of procurement processes, contracts, and general services. It is used by several public bodies and entities, including those responsible for medicine procurement. The ComprasNet is the module within SIASG responsible for centralizing information and facilitating government purchases, promoting greater efficiency, transparency, and control of public resources. This catalog records the description and unique identification of all materials available for public purchases and organizes them based on a taxonomy of classes. Among these classes, class encompasses drugs and medicines and was utilized in this study to identify and analyze all pharmaceutical acquisitions made by the federal government from to It is worth mentioning that the SIASG also includes some transactions from states and municipalities, which have been excluded from the scope of this analysis. Each record corresponds to a purchase and contains detailed information about the product description, its identifying code, price, quantity acquired, purchasing agency, supplier's name, as well as information about the procurement modality, date, justifications for exemption from bidding, disputes, and more. In total, there are 1,, records and 27 attributes variables in this dataset. All products acquired by the federal government and present in the SIASG database including medicines have a unique and mandatory identifier. In the case of drugs and medicines, each identifier corresponds to a specific medication, defined by its active ingredient, dosage, and form of presentation. Therefore, the same active ingredient can have multiple identifier codes if there are variations in dosage e. An important limitation of the SIASG data is the lack of information about the therapeutic class of each medication. This information can be particularly useful for investigating competition and identifying potential substitutes in the market. As a solution, each of the medications present in the federal government's purchases was associated with a therapeutic class using a table available from the Brazilian Health Regulatory Agency Anvisa that lists registered medications in Brazil. Since Anvisa's classification is based on the medication's name rather than a standardized code , the identification of the class was made based on this name, which sometimes resulted in imperfect associations due to errors or spelling differences, especially in the SIASG database. Nevertheless, a manual mapping effort was carried out for the most relevant medications in terms of expenditure volume to ensure significant coverage of the expenditures. We adjusted monetary information, such as prices and purchase values, for inflation using the IPCA Consumer Price Index and brought them to constant values for The first aspect to highlight in the analysis of pharmaceutical purchases by the Brazilian federal government is its significance in the Brazilian pharmaceutical market. Despite the relatively stable number of distinct products purchased by the federal government over the last decade, around 40, to 50, items per year, there has been a significant growth in the value of federal medicine purchases since One plausible explanation for this increase is the centralization of drug procurement for Brazil's Unified Health System SUS at the federal level rather than the state and municipal levels. This strategic move has minimized the fragmentation of purchases and bolstered the government's bargaining power in negotiations. This development was a result of a decision by the federal public administration in the late s and is particularly pronounced in the acquisition of complex and high-cost medications. Another possible reason that has contributed, though to a lesser extent, to the expansion of the federal government's medication expenses is the phenomenon of judicialization. This occurs when citizens resort to legal action to gain access to medications not available or not provided free of charge by the SUS. Figure 1. Quantity of items and value of medications acquired by the federal government between and at prices. Compiled by the authors. Regardless of the weight of each of these or other potential factors, there is a significant upward trend in medication expenses by the federal government. The distribution of medication purchases by therapeutic class can help to understand the profile of medicines acquired by the federal government. This information is particularly valuable because the therapeutic class defines a relevant market for analysis. The Brazilian Health Regulatory Agency Anvisa classifies registered medicines and pharmaceutical products into more than therapeutic classes. During the period from to , the federal government recorded acquisitions of medications in over different classes, with the major ones, in terms of values, presented in Table 1. Table 1. Total value of medications acquired by the federal government in the period , according to their main therapeutic classes in million Brazilian Reais - at prices. In the period from to , antivirals and vaccines continued as the two main classes, but antineoplastic drugs and enzyme replacements, used for rare genetic diseases in which the patient does not produce sufficient amounts of a specific enzyme, gained participation. Immunomodulators, medications with the ability to regulate the immune system to strengthen the body's response against infections or cancer or to reduce the response when the system is deregulated or overactive, also emerged as a relevant class in federal purchases during this period. Finally, in the period from to , the participation of vaccines in federal purchases increased even more, mainly due to the acquisition of immunizers for the Covid pandemic. Figure 2. Percentage share in federal medication purchases of the most relevant therapeutic classes in the period to , according to their participation in different sub-periods. This graph shows the percentage share, in the presented sub-periods, of the most relevant therapeutic classes throughout the entire period from to Therefore, some relevant therapeutic classes in specific sub-periods may not appear in this graph. Just like they are concentrated in certain therapeutic classes, federal purchases are also concentrated in a relatively small number of medications. On average, the top 20 medications account for a significant portion of these purchases each year. Despite this concentration of purchases each year, the ranking of the top 20 most purchased medications varies annually, although some substances consistently remain at the top of the list. Among the most purchased medications by the federal government is recombinant factor VIII, which is used in the treatment of blood clotting disorders, such as hemophilia A. Medications with the 'abe' suffix, such as adalimumab, infliximab, and trastuzumab, are also significant in government purchases. They are monoclonal antibodies designed to target specific proteins or cells in the body and interfere with biological processes associated with various diseases, from rheumatoid arthritis to cancer. Other notable medications are those with the 'vir' suffix, such as darunavir, sofosbuvir, and dolutegravir, which are antivirals used in the treatment of different infections. Figure 3. Total value and percentage share of purchases for the top 20 medications acquired by the federal government each year: to Public expenditures on medications are highly concentrated in a few items, which account for a significant portion of the total spending. Therefore, analyzing the evolution of these purchases is essential to support public strategies for improving the quality of these expenses and, why not, reducing the costs of the Unified Health System SUS. Identifying the main items of expenditure can contribute to the development of strategies to reduce healthcare system costs. Vieira, Fabiola Sulpino. Brasilia: Ipea. Introduction The Brazilian government is responsible for a significant volume of pharmaceutical purchases, which also represent a substantial portion of the total public health expenditures in the country. Trends in medication acquisitions and their distribution The first aspect to highlight in the analysis of pharmaceutical purchases by the Brazilian federal government is its significance in the Brazilian pharmaceutical market. Compiled by the authors Regardless of the weight of each of these or other potential factors, there is a significant upward trend in medication expenses by the federal government. Percentage share in federal medication purchases of the most relevant therapeutic classes in the period to , according to their participation in different sub-periods Source: Integrated System for General Services Administration SIASG and Brazilian Health Regulatory Agency Anvisa. Therefore, some relevant therapeutic classes in specific sub-periods may not appear in this graph Just like they are concentrated in certain therapeutic classes, federal purchases are also concentrated in a relatively small number of medications. Compiled by the authors 4. Final remarks Public expenditures on medications are highly concentrated in a few items, which account for a significant portion of the total spending. Back to Top. All content from site published under the license Creative Commons CC 3. Report Error. Please feel free to contact us if you notice errors. Please enable the javascript to submit this form.

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Brasilia buying MDMA pills

Brazil can match to other countries in South America that decriminalized the illegal drugs possession and show more tolerance for the consumption and cultivation for personal use. On Thursday Aug. For experts in public security, human rights and drugs, the STF has the chance to take an important step to grant the drug users' access to health care, in addition to end their stigma to being criminals. Luciana Boiteux, who is the coordinator of the Research Group in Drug Policy at the Federal University of Rio de Janeiro UFRJ, in the original acronym , points out that the drug law kept considering the possession as a crime, but it has not established a prison sentence — which was already a breakthrough. According to Pedro Abramovay, director of the Latin America Program in Open Society Foundation, a non-governmental organization that defends human rights and democratic governance, drug use has not increased in any country where drug possession became more flexible. He believes that the measure may provide easy access to health care by drug dependents. With the Supreme Court decision, the difference between drug dealer and drug user that has raised debates on discrimination and violation of human rights in prisons shall not keep being appreciated by the police, nor by the judiciary itself. He said the Supreme Court should set forth, in the sentence, the criteria for being considered a user. This is not a minor issue, the lack of definition leads to incarceration. According to him, trafficking is the second type of crime holding more people behind bars, following property crimes. For women, trafficking appears as the first in the list. Against the decriminalization of drug possession for personal drug use, the Congressman Osmar Terra from Rio de Grande do Sul believes that the measure is the first step towards the legalization of drugs which, according to him, would be bad for society. They would take them to school, to the square, give them to friends. And how can it not be a crime to buy, but be a crime to sell? How do you solve this paradox? It will end up legalizing the sale. Terra disagrees with the thesis that drug use is an individual freedom of choice, which only affects the user. The person will take it for the rest of life. This can reduce their ability to work and raise a family. He concludes: 'The freedom of using drug is the family's slavery. The deputy also relates the use of drugs, whether licit or illicit, to increased violence in the country. It's alcohol because it's a legal drug. It's not a crime to buy alcohol. Domestic violence will greatly increase due to the movement of illicit drugs,' he says. His NGO asks for more security and defends tougher laws to combat violence. His son Max was killed 13 years ago during an attempted robbery. In his opinion, the user should not be treated as a criminal. However, they often get involved in other crimes because of drug use. The psychiatrist Osvaldo Saide, from the Brazilian Association of Alcoholism and Drug Abrad, in the original acronym , says that the ideal is not to treat the user as a criminal, but to provide them treatment. However, in his view, it is necessary that the legislation clarifies what to do in cases when crimes are committed under the influence of drugs and in cases which drugs are sold by users to support their own addiction. To Saide, it would be necessary to create alternatives for the user to receive punishment for the other crime committed or to undergo compulsory treatment. Sometimes, even professional drowns in crack, for example,' he mentioned. The psychiatrist Ana Cecilia Marques, president of the Brazilian Association of Alcohol and Other Drugs Studies ABEAD, in the original acronym , believes that the decriminalization of use must be discussed by society, but she disagrees about the way it is bein done, in a Supreme Court judgment. I support decriminalizing, but I think we need all this rigor, which is already lacking in our drug laws. They are unclear, leaving several loopholes. We also lack drug policies. I support it but I fear this process of decriminalization,' she noted. Skip to main content. General Brazil may decriminalize drug possession The Supreme Court judges this week a lawsuit questioning the. Audio news. Share this content. More news. Economy Brazil's Finance Minister to launch green investment platform in U.

Brasilia buying MDMA pills