Determinantes socioeconômicos e de gestão das internações por doenças do aparelho circulatório nas Unidades Federativas do Brasil

Abstract

The Ministry of Health (MS) in 2015 incorporated the first direct-acting antivirals (DAAs) for the treatment of Hepatitis C within the scope of the Unified Health System (SUS). These medications are better tolerated and safer, enabling highly effective and short-duration treatment, with approximately 65,000 treatments performed achieving a 95% cure rate among patients. The Planserv - Health Assistance Plan for Public Servants of the State of Bahia, provides coverage for DAA therapy for Hepatitis C, and the first requests for this treatment occurred in the second half of 2015. With the aim of reducing expenses on these high-cost drug therapies and seeking improvements in patient care, the process of direct purchase of the drug SOVALDI (Sofosbuvir) through the Price Registration of the Bahia State Health Secretariat (Sesab) was initiated. This included the dispensation to the patient and their pharmacotherapeutic monitoring, as well as negotiations with providers to obtain a differentiated price for the medication VIEKIRA PAK (3D), validated for price reduction in the Planserv's own table. Data for this study was obtained through consultation of the Planserv's Electronic System. The inclusion criteria applied were: treatment authorizations based on the Clinical Protocol for Hepatitis C Treatment and authorizations from judicial processes, containing Sofosbuvir and 3D medications from August 2016 to July 2018. The quantity of units acquired through price registration and those authorized through value negotiation totaled 214 units during the evaluated period, of which 154 units were dispensed at Planserv facilities, totaling 43 treatments. With the introduction of these actions, significant savings were achieved, resulting in a reduction of 64.38% in spending on Sofosbuvir and 42% on 3D. Thus, it is concluded that the strategies implemented by the Planserv's Pharmaceutical Assistance Program were indispensable in controlling expenditures on these therapies. This action allows for the expansion of coverage of new health technologies. The implementation of pharmaceutical care services for HCV patients, including pharmacotherapeutic monitoring, aims to improve quality of life and prevent potential problems associated with medication use, thereby contributing to the success of therapy.