Brazilian investments in medicines for poverty-related diseases: strategies to ensure access

Introduction: Financing the access to medicines has been one of the greatest challenges facing health systems all around the world. For diseases that attract lower levels of interest and medicine offers across the market, that challenge gets bigger. This study investigates the main strategies adopted by the Brazilian government to guarantee access to medicines for diseases identified as "poverty-related". 

Methods: We analyzed acquisitions made by the Brazilian federal government over 10 years (2005 to 2014) sourced from the database of the Ministry of Health, indicating three main strategies to face the difficulties of guaranteeing access to these medicines. (I) Centralization of the financing and acquisition for the great majority of the medicines; (II) Acquisition via multilateral organizations and (III) Production of medicines by official laboratories. 

Results: 132 medicines are included in the National List of Essential Medicines (RENAME in force, used in order to prevent and treat poverty-related diseases. More than a half (55.3%) of the items have only one national producer or are not registered and therefore can only be obtained through international acquisition to attend consolidated health programs such as tuberculosis, leprosy, malaria or even for disease prevention of nutritional actions and for immunization actions. However, the findings from this study document ways to approach access to medicines for poverty-related diseases.

Conclusions: The observation of these strategies enables us to verify the advances and improvement points of the Brazilian Pharmaceutical Policy, in view of preventing setbacks during moments of crisis and guaranteeing assistance to populations.