Background
The World Health Organization Essential
Medicines List (WHO-LIST) and national essential medicines lists differ because
many countries face significant challenges, such as product availability, cost,
product quality and epidemiological disease profiles. In Brazil, governments
pay for drugs that are included on the federal, state and municipal government
(REMUME) lists. The extent to which municipal lists differ from state and
national lists and from the WHO-LIST is unclear. We investigate the use of the
WHO-LISTas a tool with which to evaluate the selection process for the
essential psychiatric medicines in the public system coverage list of Brazilian
communities (cities) and the use of the target drugs.
Methods
Municipal health secretaries were
interviewed regarding the selection process for REMUMEs and the antidepressants
and benzodiazepines included in REMUMEs and reference lists. We calculated the
use of REMUME drugs that appeared or did not appear on reference lists
according to the defined daily dose (DDD) per 10,000 inhabitants.
Results
Local physicians and pharmacists without
specific training or explicit criteria developed the REMUMEs. Of the 13 drugs
and 24 products (i.e., the different dosages of these 13 drugs) in the REMUMEs,
8 drugs and 10 products were included in at least one reference list and in one
municipal list; 4 drugs and 6 products were included in at least one reference
list but in none of the municipal lists; and 7 drugs and 8 products were
included in at least one municipal list but in none of the reference lists. The
antidepressants that appeared in at least one municipal list but in none of the
reference lists represented 25.1 % (mean 60.9 DDD/10,000 inhabitants-day)
of the usage. The benzodiazepines that appeared in at least one of the
municipal lists but in none of the reference lists represented 14.7 % mean
18.5 DDD/10,000 inhabitants-day) of the usage.
Conclusions
Brazilian cities have no rigorous
processes for selecting the drugs that appear on their lists, and drugs that do
not appear on the reference lists represent a significant proportion of
antidepressant and benzodiazepine use, resulting in public health and social
problems.
Full article at: http://goo.gl/3NDXI0
By: Izabela Fulone, Silvio Barberato-Filho, Michele FĂ©lix dos Santos,
Carolina de Lima Rossi, Gordon Guyatt and
Luciane Cruz Lopes
Pharmaceutical Sciences Master’s Course, University of Sorocaba,
UNISO
More at: https://twitter.com/hiv insight
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