Résumé
ABSTRACT OBJECTIVE To evaluate trends in the use of generic and non-generic medicines to treat hypertension and diabetes under the Farmácia Popular Program (FP) and its impact on generic medicines sales volume and market share in the Brazilian pharmaceutical market. METHODS This longitudinal, retrospective study used interrupted time series design to analyze changes in monthly sales volume and proportion of medicines sales (market share) for oral antidiabetic and antihypertensive medicines for generic versus non-generic products. Analyses were conducted in a combined dataset that aggregate monthly sales volumes from the Farmácia Popular program and from the QuintilesIMS™ (IQVIA) national market sales data from January 2007 to December 2012. The Farmácia Popular program phases analyzed included: a) 2009 reductions in medicines reference prices (AFP-II) and b) 2011 implementation of free medicines program for hypertension and diabetes, the Saúde não tem preço (SNTP - Health has no price). RESULTS Patterns of use for FP-covered antidiabetic and antihypertensive medicines were similar to their use in the market in general. After one year of the decreases in government subsidies in April 2010, market share of antidiabetic and antihypertensive medicines experienced relative declines of -54.5% and -59.9%, respectively. However, when FP-covered medicines were made free to patients, overall market volume for antidiabetic and antihypertensive generics increased dramatically, with 242.6% and 277.0% relative increases by February 2012, as well as non-generics with relative increase of 209.7% and 279% for antidiabetic and antihypertensive medicines, respectively. CONCLUSIONS Ministry of Health policies on the amount of patient cost sharing and on the choice of medicines on coverage lists have substantial impacts on overall generic sales volume in retail pharmacies.
Sujets)
Humains , Médicaments génériques/usage thérapeutique , Commerce/tendances , Services des pharmacies communautaires/tendances , Hypoglycémiants/usage thérapeutique , Programmes nationaux de santé/tendances , Antihypertenseurs/usage thérapeutique , Pharmacies/tendances , Pharmacies/statistiques et données numériques , Valeurs de référence , Facteurs temps , Brésil , Évaluation de programme , Études rétrospectives , Études longitudinales , Commerce/statistiques et données numériques , Services des pharmacies communautaires/statistiques et données numériques , Diabète/traitement médicamenteux , Analyse de série chronologique interrompue , Politique de santé , Hypertension artérielle/traitement médicamenteux , Programmes nationaux de santé/statistiques et données numériquesRésumé
La farmacología comunitaria se constituiría en el estudio y la aplicación de los conceptos generales de la farmacología en la comunidad, constituyendose en el principal soporte de la comunidad, dirigido especialmente a las zonas mas deprimidas, y viene a formar parte de los programas de la estrategia de la Atención Primaria de Salud. Siendo estos el uso racional de medicamentos, la farmacología del medio ambiente, la legislación y control, epidemiología, reacciones adversas, la información y aspectos de la medicina tradicional.