药物经济学：开放获取

Background: This study aims to characterize the sources of information on pricing and public procurement available in some Latin American countries, in order to facilitate the development of comparative studies in the region and the implementation of pharmaceutical policies such as price regulation.

Methods: Description of the sources of information in terms of web portals characteristics, general characteristics of information, characteristics of pricing data and drug public procurement data.

Results: The sources of information described are Brazil’s Health Price Database (BPS), the Brazilian Drug Market Regulation Chamber (CMED), the Chilecompra Public Procurement Portal, the Mexican Social Security Institute (IMSS) Procurement Portal, Panamácompra Public Procurement Portal, Argentina’s K@iros portal, the Peruvian Pharmaceutical Products Observatory (OPFP), the National Public Procurement Service of Ecuador (SERCOP) and the Drug Price Information System of Colombia (SISMED). Eight of the nine portals belong to governmental entities such as ministries, public procurement centers or drug regulatory agencies. Portals such as the BPS provide visibility and transparency. Thus, each public institution exercises its role of social control and surveillance of the public administration. Other sectors of society are also benefited and use the information available for various consultations and studies. Commercial transactions data on open access websites more accurately account for the national drug volume and expenditure than other sources.

Conclusions: The characterization carried out enhances the transparency of information on prices and public procurement of medicines to contribute to the decision-making of Latin American governments regarding negotiations for the purchase of pharmaceutical products, fixing and building international reference prices and adjusting prices of already regulated medicines, as well as the consumption of this information for the development of drug use studies.

Background: The increasing Crohn’s Disease (CD) prevalence worldwide has contributed to CD related healthcare resource use increase and the disease treatment has a considerable economic burden, varying between countries. The aim of this study was to assess the direct medical cost of CD treatment over fifteen years of follow up in Brazil.

Methods: A total of 46,886 CD patients were included. Patients were identified from the Brazilian public health system databases between 2000 and 2014. The mean annual expenditure was calculated for each patient. Expenditures included the costs of all (CD-related or not) medications, diagnostics and monitoring exams, outpatient care and hospitalizations. Multivariate analyses were conducted to evaluate the relation between demographic and clinical variables in mean annual expenditure.

Results: The total expenditures were US$ 844.24 million over the entire study period (2000-2014) with annual mean [95% CI] of US$ 3,451.0 [3,399.2-3,502.7] per patient. Of the total expenditures, 90.3% were for CD medications with Tumor Necrosis Factor inhibitors being the primary cost driver, accounting for 76.0% of the total – medication cost in 2000 and 85.9% in 2014. Hospitalization cost accounted for 3.0% of the overall total expenditures. The multivariate analyses showed that gender, age, region of residence, and medication used at study entry can predict DC treatment costs.

Conclusion: In Brazil, the annual direct medical cost of CD treatment is substantial. Medication cost, in particular that of anti-TNF alpha agents is increasingly the most important cost driver.