Abstract
The selection of medicines is a strategic process within Pharmaceutical Assistance, as it is responsible for choosing which medicines should be available to system users, aiming to promote rational use, improve therapeutic effectiveness, and optimize costs. In this perspective, the Pharmaceutical Assistance Coordination (COASF) of SESA/CE decided that the selection of the 2018 Primary Care medication list would be based on specific criteria to ensure the availability of quality medicines, thereby contributing to rational prescription and use. The process involved reviewing medicines from the Basic Pharmaceutical Assistance List (AF) and the Supplementary List (complementary) for therapeutic classes in the state of Ceará, from September to November 2017. Inclusion and exclusion of medicines were based on several criteria: epidemiological and pharmacoeconomic factors, alignment with priority Care Lines, presence in the 2017 National List of Essential Medicines (Rename), available scientific evidence (efficacy, effectiveness, and safety), organization and service availability, and funding. The process stages included: 1. Review by the COASF technical team (15 pharmacists) in 4 meetings, 2. Validation with specialists (family physicians, endocrinologists, cardiologists, psychiatrists, ophthalmologists, psychologists, nurses, pharmacists) from state and municipal institutions in Fortaleza, in multiple meetings, 3. Validation in the Technical Chamber of Pharmaceutical Assistance of the CIB/CE (Interagency Bipartite Committee of Ceará) in 4 meetings, 4. Approval by CIB/CE of the Lists, 5. Publication of Lists through CIB/CE Resolutions. In the Basic AF List, 7 medicines were included and 15 medicines and 1 health product were excluded, totaling 136 items, 6% fewer than in 2017. In the Supplementary AF List, 5 medicines and 1 health product were included, and 12 medicines were excluded, totaling 50 items, 11% fewer than in 2017. This process involved specific changes, such as transferring items between lists and substituting 3 types of insulin with the generic name of ultra-rapid insulin. Through this process, COASF aimed to enhance the efficiency of the selection process, bringing positive impacts for users, states, and municipalities, as rational selection ensures better efficacy, safety, and resource optimization.
