Acesso regular a medicamentos do componente especializado da assistência farmacêutica e fatores associados em São Leopoldo, RS

Abstract

Access to medicines can be considered an important quality indicator of the Brazilian health system. In this sense, the Specialized Component of Pharmaceutical Assistance (CEAF) is a strategy that seeks to guarantee full access to high cost medication in the Unified Health System (SUS). OBJECTIVE: To evaluate, for the first time, the regular access to CEAF medication and the sales factors, as well as the regular availability of the medicines requested. METHODS: Cross-sectional study with adults aged 20 years or older, users of CEAF medication in São Leopoldo, RS. The users who accessed the CEAF services in the period from December-2014 to March-2015 were consecutively selected. Regular access to treatment was defined as the obtainment of all medicines according to the source of acquisition and classified into (none/paid/free). Free regular access to medicines was defined as the regular acquisition through CEAF and categorized into (none/some/all). Regular availability was defined when the medicine was never lacking during the period studied. Data analysis was performed using the Pearson chi-square test and multinominal logistic regression. RESULTS: The free regular access to treatment was 46.1% (IC95% 41.3%, 50.9%), while 28.2% (IC95% 23.8%, 32.5%) of users maintained regular access through purchase during the three months evaluated. Users who used CEAF medication due to problems related to transplanted organs/ tissues, to viral hepatitis and those who reported less difficulty in finding the medicines were more likely to have free regular access to the treatment, while users aged 60 or over were three times more likely to maintain regularity in the access of the treatment out-of-pocket payment when compared to adults younger than 40 years. The medicines with greater regular availability were Tacrolimus and Mycophenolate Sodium, about 90%, both used for the treatment of problems related to transplanted organs/tissues; on the other hand, the most frequently requested medicine, Formoterol + Budesonide, used for the treatment of asthma, presented the lowest regular availability (22%). CONCLUSION: Difficulties still persist for CEAF to reinforce itself as an effective strategy for the integrality of regular access to medicines. The continuous availability of the medicines contemplated by the component, due to the constant increase of users and registered medicines, requires planning and organization of the health services.