Access to Oncology Drugs in Brazil: Juggling Innovation and Sustainability in Developing Countries

Abstract

Unfortunately, Brazil's inequalities are also seen in the public's access to health care. The Brazilian public health system (SUS-Sistema Único de Saúde) was created with the new Brazilian constitution of 1988 (4), with the purpose to deliver equal, universal, and integral health care to all Brazilian citizens. The public health system is supposed to be organized in a decentralized manner, to locally adapt to the specific health problems of each region from the tropical diseases of the Amazon forest to the pollution-related diseases of its megalopolis. However, it is underfunded, spending around US$150 per patient per year (5, 6). Table I shows the median health expenditure per capita per year in Brazilian metropolitan regions. It is not yet organized or hierarchized to promote its objective and deal with the reallife health problems of its citizens (7). Nontransmissible chronic diseases in Brazil Currently, worldwide, nontransmissible chronic diseases (NTCD) are the major cause of death, accounting for 36 million deaths per year. This group of diseases is composed of cardiovascular diseases, diabetes, lung diseases, and cancer. It has been estimated that 80% of the deaths by NTCD have occurred in middle-and low-income countries. As a convention, deaths caused by these diseases in people under the age of 60 are considered to be premature, as they may reflect the lack of proper health assistance. When comparing NTCD premature deaths, 13% occurred in developed countries, whereas 29% occurred in developing countries.

A cross-sectional study of the quality of life of patients living with type 1 diabetes treated with insulin glargine and neutral protamine Hagedorn insulin and the implications

“…Another study, focusing on psoriatic arthritis, also showed that patients with access to medicines from CEAF/SUS are from the higher socioeconomic strata and that the prescriptions came from private medical offices (44) . Furthermore, medicines access barriers are pointed to other chronic diseases in Brazil (e.g., cancer) (45,46) , in the technical report of the Pan American Health Organization (47) and data from the National Survey on Access, Use and Promotion of Rational Use of Medicines (48) indicated greater access to medicines from higher economic classes to the detriment of the lower classes. This can be explained, in part, by the greater access to health services, such as private medical offices, private clinics and diagnostic tests by patients belonging to the highest socioeconomic strata (49,50) .…”

Padrões de tratamento, uso de recursos e custo do câncer de pulmão de não pequenas células avançado em instituições brasileiras privadas

“…Apenas em um caso foi identificado o pagamento pelo plano de saúde. As diferenças na taxa de pacientes testados podem ser mais significativas em instituições do sistema público de saúde, geralmente com financiamento escasso (Flores et al, 2015;Silva et al, 2017;Ades, 2017).…”

Treatment patterns and healthcare resource utilization for triple negative breast cancer in the Brazilian private healthcare system: a database study

“…Expenditures for the private healthcare system are high, totaling 77% of all oncology expenditures in Brazil 18 . The lack of data on treatment patterns, HCRU and costs of TNBC treatment and management are limited, hinders the development of accurate pharmacoeconomic studies, policy planning and private system budget allocations 19 .…”