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Public procurement of hepatitis C medicines in Brazil from 2005 to 2015
Gabriela Costa Chaves1, Claudia Garcia Serpa Osorio de Castro1, Maria Auxiliadora Oliveira1
1Departamento de Politica de Medicamentos e Assistência Farmacêutica, Escola Nacional de Saúde Publica Sergio Arouca, Fiocruz.R. Leopoldo Bulhões 1480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil. gabicostachaves@ ensp.fiocruz.br.
Insights
Minister of Health (MoH) hepatitis C medicine spending surged due to centralized procurement and new drug introductions. Universal access requires enhanced MoH negotiation strategies for monopoly drug price reductions.
Area of Science:
- Health Economics
- Pharmaceutical Policy
- Hepatology
Background:
- Hepatitis C treatment expenditure analysis is crucial for public health policy.
- Understanding drug procurement trends informs resource allocation and access strategies.
Purpose of the Study:
- To analyze the Minister of Health's (MoH) procurement expenditure for hepatitis C medicines between 2005 and 2015.
- To identify key drivers of increased spending on hepatitis C treatments over the decade.
Main Methods:
- Utilized data from the Integrated General Services Administration (SIASG) for expenditure estimation.
- Calculated unit prices based on the highest volume annual purchases.
- Included all recorded presentations and strengths of selected hepatitis C medicines.
Main Results:
- Expenditure increased 159.5-fold from 2005-2006 due to centralized procurement.
- Spending rose 730% in 2007 with the addition of pegylated interferons.
- Two direct-acting antivirals (DAAs) constituted 99% of expenditure in 2012; a new DAA drove a 230% increase in 2015.
Conclusions:
- Increased MoH spending on hepatitis C medicines resulted from higher volumes and the introduction of advanced therapies like pegylated interferons and DAAs.
- Achieving universal hepatitis C treatment access necessitates strategies to bolster the MoH's negotiation power with manufacturers of monopolized medicines.
Abstract:
This paper analyzes the Minister of Health's (MoH) procurement of medicines for hepatitis C from 2005 to 2015. Data sources were the Integrated General Services Administration (SIASG), to estimate annual expenditure for selected medicines of the MoH Clinical Protocols and Therapeutic Guidelines (PCDT) for Hepatitis C. All presentations and strengths recorded on SIASG were included. The unit prices were estimated based on the purchase with the highest volume each year. There was a 159.5 fold increase in expenditure of the selected medicines from 2005 to 2006, because procurement of those medicines became centralized. In 2007 there was 730% increase in spending due to the incorporation of pegainterferons alfa 2a and 2b. In 2012 the purchase of only two new direct-acting antivirals (DAA) accounted for 99% of total annual expenditure. In 2015 the adoption of a new DAA led to an increase of 230% (R$945 million) in MoH spending. The significant increase of MoH expenditure on medicines for hepatitis C from 2005 to 2015 was due to the increase of volumes purchased as well as the incorporation of alfapeginterferon and new DAAs. Ensuring universal access to treatment for hepatitis C will depend on the implementation of strategies that strengthen the MoH's bargaining power in price reduction negotiations with the manufacturers of monopoly medicines.
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