OBJECTIVE To analyze the prevalence and associated factors regarding the use of medicines by self-medication in Brazil.METHODS This cross-sectional population-based study was conducted using data from the PNAUM (National Survey on Access, Use and Promotion of Rational Use of Medicines), collected between September 2013 and February 2014 by interviews at the homes of the respondents. All people who reported using any medicines not prescribed by a doctor or dentist were classified as self-medication practitioners. Crude and adjusted prevalence ratios (Poisson regression) and their respective 95% confidence intervals were calculated in order to investigate the factors associated with the use of self-medication by medicines. The independent variables were: sociodemographic characteristics, health conditions and access to and use of health services. In addition, the most commonly consumed medicines by self-medication were individually identified.RESULTS The self-medication prevalence in Brazil was 16.1% (95%CI 15.0–17.5), with it being highest in the Northeast region (23.8%; 95%CI 21.6–26.2). Following the adjusted analysis, self-medication was observed to be associated with females, inhabitants from the North, Northeast and Midwest regions and individuals that have had one, or two or more chronic diseases. Analgesics and muscle relaxants were the therapeutic groups most used for self-medication, with dipyrone being the most consumed medicines. In general, most of the medicines used for self-medication were classified as non-prescriptive (65.5%).CONCLUSIONS Self-medication is common practice in Brazil and mainly involves the use of non-prescription medicines; therefore, the users of such should be made aware of the possible risks.

Objective. To investigate whether the liver transplants undertaken at a University Hospital in Ceará are cost-effective. MethOds. The medical records of 62 liver transplant patients operated in 2007 were analyzed from the day of admission for transplantation up to hospital discharge or death in hospital. Indicators were analyzed, including the number of days in hospital and the wards occupied, the quantities of materials and medications employed and supplementary tests and procedures carried out. Results. The majority of this population were male and lived in the Northeast administrative region of Brazil. Mean age was 45 years. The mean cost of liver transplantation was US$ 20,605.01. The most expensive cost item was the fees paid to the professional team involved in organ harvesting and transplantation; followed by daily rates, surgical and inpatient medications; and products (materials and medications) used in organ harvesting. The Brazilian National Health Service (Sistema ùncio de Saúde, SUS) paid the HUWC US$1,322.97 for each organ harvesting, US$ 3,223.56 for professionals' fees and US$ 32,235.68 for the liver transplantation "package" that covers the surgical procedure and the first 7 days in hospital. cOnclusiOns. The figures observed were similar to those described for other Brazilian transplantation centers. Liver transplantation in Ceará is an economically viable procedure on the basis of the rates paid by the SUS.

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