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Essential Medicines List Implementation Dynamics: A Case Study Using Brazilian Federal Medicines Expenditures
Author(s) -
MagarinosTorres Rachel,
Lynd Larry David,
Luz Tatiana Chama Borges,
Marques Paulo Eduardo Potyguara Coutinho,
OsoriodeCastro Claudia Garcia Serpa
Publication year - 2017
Publication title -
basic and clinical pharmacology and toxicology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.805
H-Index - 90
eISSN - 1742-7843
pISSN - 1742-7835
DOI - 10.1111/bcpt.12783
Subject(s) - government (linguistics) , proxy (statistics) , distribution (mathematics) , medicine , public economics , business , economics , computer science , mathematical analysis , philosophy , linguistics , mathematics , machine learning
The aim was to analyse the implementation dynamics of the essential medicines list ( EML ). We used the government expenditures on medicines and Brazil as a case study. Drug purchases were considered as a proxy for utilization. The essential medicines ( EM s) expenditures were followed over time by Brazilian National EML s life‐time and defined by broad therapeutic categories and by specific medicines. Brazil increased the number of the medicines during the last four editions of Brazilian National EMLs and the federal government expenditures on them. The EML implementation dynamics changed the distribution of expenditures on EM s. We identified a common set of 404 EM s present in all four editions of the Brazilian National EML s. There was a proportional decrease in expenditures on anti‐infectives for systemic use, blood and blood‐forming organs and alimentary tract and metabolism, and increase in expenditures on antineoplastic and immunomodulating agents. The expenditures distribution per specific medicines revealed that a small set of EMs was responsible for 50% or more of expenditures considering Brazilian National EML life‐time for all four periods. The increase in expenditures on EM s in Brazil was a consequence of the newer medicines incorporated over time in the Brazilian National EML s. The use of the medicines expenditures as a source of data and the definition of an EML life‐time permitted follow‐up of the implementation dynamics of different versions of the Brazilian National EML s. Our results have implications for policymakers and stakeholders to gain a better understanding of the role EML s play in health system sustainability and in the provision of the most beneficial heath care.