Economic evaluation of the acquisition and distribution of medicines of the Pharmaceutical Assistance in Primary Care

Abstract

Decentralization is a principle of the Unified Health System that defines the transfer of management responsibility to the municipalities, ensuring that it is closer to the population. The financing of medical drugs for Primary Health Care in Brazil is the responsibility of the three federated entities. In most municipalities in Minas Gerais, medication management was under the responsibility of the State Department of Health. Since 2016, this format has been abolished, with the municipalities being responsible for the acquisition of medication, under the support of the state in the preparation of the Registration Act of State Price (ARPE). Thus, this study aimed to carry out a comparison of prices and quantities of medicines purchased in different modalities: state ARPE (2015), state ARPE (2018), and its own municipal instrument. Additionally, compare the costs of the two supply strategies: centralized in the state and decentralized in the municipality. The results of this study indifferent to savings of 14% in 2018, when compared to 2015. In the comparison of prices observed an average price increase of 18% compared to 2015 and 76% compared to the municipal instrument. Price increases over time are authorized by the government. And the efficiency of the state in relation to the municipality can be related to the scale of purchases. It is concluded, therefore, that the process of decentralization of the supply of medicines in the Basic Component of Pharmaceutical Assistance in Minas Gerais allows for savings in resources and strengthens the principle of decentralization, recommended by the Federal Constitution.