Abstract
Introduction: The State Department of Health of São Paulo (SES/SP) established the Pharmacology Committee (Resolution SS No. 54/2012), which, among its duties, manages the "administrative request" process responsible for evaluating requests for medications or enteral nutrition not available through the Unified Health System (SUS). These items are provided at 17 pharmacies across the state, serving 34,000 patients, with an average of 4,400 demands per month, of which 70% are medication requests (data from March 2019). Faced with this volume of demands and a limited budget, two main needs were identified: the observed medication wastage due to direct dispensation to patients, and the lack of in-person assessments, especially for complex pathologies requiring specialist consultations. To address these needs, SES/SP established partnerships with Reference Centers (CR) for in-person evaluations. Objective: This study aims to present the improvement in patient care quality through the evaluation of administrative demands and the cost savings achieved by establishing partnerships with CRs for SES/SP. Method: Data were obtained from the SCODES system, Excel, and Google Forms for the year 2018. Results: Reference Centers are active in ophthalmology, dermatology, endocrinology, and rheumatology. The use of bevacizumab is evaluated by CR for indications such as Age-Related Macular Degeneration (AMD), among others. In 2018, 4,464 dose-sharing applications were conducted, resulting in savings of R$ 4.8 million compared to ranibizumab usage. Patients with psoriasis requesting immunobiologic medications underwent 222 evaluations, with 18% of cases not being recommended for this treatment, leading to savings of R$ 1.9 million annually. CR evaluates the use of Insulin Infusion Pumps (BII), conducting 181 assessments, with 31% of cases not receiving the recommendation, representing savings of R$ 1.2 million per year. Additionally, CR facilities for evaluation and immunobiologic infusion, including triage rooms, infusion units, and consultation spaces, conducted 825 evaluations, with 21% of cases not being recommended, resulting in an estimated annual savings of R$ 1 million. Shared use of zoledronic acid also saved R$ 899,146.46 annually. Conclusion: In conclusion, beyond the demonstrated pharmacoeconomic benefits, CRs play a crucial role in Rational Drug Use, ensuring correct medication application at the appropriate time. This partnership with CRs allows for comprehensive patient assessment, dose-sharing when feasible, secure and specialized administration locations, patient safety, as well as effective logistics and storage, thereby fulfilling the principle of healthcare comprehensiveness through Pharmaceutical Care.
