Abstract
This article aims to analyze the development of pharmaceutical services in the context of the primary health care (PHC) in the period 2008- 2014, focusing on selection, procurement and financing of medicines. A retrospective study was undertaken, using as data sources administrative documents of Rio de Janeiro Municipality Health Secretariat (SMS-RJ) as well as secondary database. We found a growth of numbers medicines offered for PHC of 57 items in 2008 to 222 in 2014. Actual spending on drugs paid by the city has grown 38% in the period, with a reversal from 2010, of the proportion of PHC related to tertiary care drugs, reaching 2.4 times in 2014, the year that public spending on medicines per capita of PHC was 9% greater than the value agreed between the three federal levels. It can be concluded that there have been important changes in pharmaceutical services in Rio de Janeiro Municipality in the period following the reform of PHC held in this territory, with increasing the conditions for therapeutic coverage and increased drug funding. The growth of per capita public spending on medicines above the agreed value raises the need to strengthen the rationalization of management measures.
Pharmaceutical services; Drugs; Health expenditures; Healthcare financing; Primary Health Care
NB: Amounts restated based on the IPCA(Consumer Price Index) as at December 31, 2014.Source: Prepared by the authors based on Sistema de Informação sobre Orçamentos Públicos em Saúde (SIOPS). (Public Healthcare Budget Information System)
Source: * Considering the medical visits approved at Rio de Janeiro municipal level, where the following classifications are computed: Procedure: 0301010013 (visit of cured tuberculosis patient (supervised treatment)), 0301010021 (medical visit w/identification of new tuberculosis cases), 0301010030 (medical visit with high level professionals at basic aid level (except for the doctor)), 0301010056 (worker healthcare medical visit), 0301010064 (medical visit at basic aid level), 0301010080 (medical visit to monitor growth and development (pediatric)), 0301010099 (medical visit for clinical assessment of a smoker), 0301010110 (pre-natal medical visit), 0301010129 (puerperal medical visit), 0301010137 (medical visit/house call), 0301010145 (newborn’s first pediatric visit); **
IBGE population estimate for the Tribunal de Contas da União (Federal Accounts Court) obtained from SIOPS; *** minimum financing amounts as per Ordinances GM/MS 176/99, 2.084/05, 3.237/07, 4.217/10, and 1.555/13; **** amounts obtained from the Basic Aid Department of MS obtained from the Departamento de AtençãoBásica do MS portal
