Jéssica de Castro Alves1, Claudia Garcia Serpa Osorio-de-Castro2, Bjorn Wettermark3, Tatiana Chama Borges Luz1. 1. a René Rachou Institute , Oswaldo Cruz Foundation , Belo Horizonte , Minas Gerais , Brazil. 2. b Department of Pharmaceutical Policies and Pharmaceutical Services (NAF) , Sergio Arouca National School of Public Health/Oswaldo Cruz Foundation , Rio de Janeiro , RJ , Brazil. 3. c Department of Medicine, Clinical Epidemiology , Karolinska Institutet, Solna (MedS), K2 , Stockholm , Sweden.
Abstract
BACKGROUND: Immunosuppressants are recommended for treatment of autoimmune diseases, and in transplant therapy. The high cost of these drugs has been causing an important impact on global pharmaceutical spending. OBJECTIVE: Analyzing immunosuppressant expenditure in Brazil, using data from the Federal Procurement System database (SIASG), between 2010 and 2015. METHODS: The pharmaceutical products were classified in accordance with the Anatomical, Therapeutic and Chemical (ATC) classification system recommended by World Health Organization (WHO) and aggregated by volume and by expenditure. The expenditure variation was decomposed into three broad categories: price effects, quantity effects, and drug mix effects. RESULTS: During the period, annual expenditure increased by 49%, ranging from USD 494.5 million in 2010 to USD 738.7 million in 2015, while purchased quantities increased by 294%, ranging from 49.8 million in 2010 to 196.5 million in 2015. Two factors drove expenditures: the quantity effect and the drug-mix effect. CONCLUSION: These findings may contribute to understand immunosuppressant spending trends and the factors that influence them in order to formulate effective cost containment strategies and design optimum drug policy. Rigorous evaluations are recommended to reduce the drug-mix effect, including systems to monitor price, effectiveness, safety, therapeutic value and budget impact of pharmaceutical innovations.
BACKGROUND: Immunosuppressants are recommended for treatment of autoimmune diseases, and in transplant therapy. The high cost of these drugs has been causing an important impact on global pharmaceutical spending. OBJECTIVE: Analyzing immunosuppressant expenditure in Brazil, using data from the Federal Procurement System database (SIASG), between 2010 and 2015. METHODS: The pharmaceutical products were classified in accordance with the Anatomical, Therapeutic and Chemical (ATC) classification system recommended by World Health Organization (WHO) and aggregated by volume and by expenditure. The expenditure variation was decomposed into three broad categories: price effects, quantity effects, and drug mix effects. RESULTS: During the period, annual expenditure increased by 49%, ranging from USD 494.5 million in 2010 to USD 738.7 million in 2015, while purchased quantities increased by 294%, ranging from 49.8 million in 2010 to 196.5 million in 2015. Two factors drove expenditures: the quantity effect and the drug-mix effect. CONCLUSION: These findings may contribute to understand immunosuppressant spending trends and the factors that influence them in order to formulate effective cost containment strategies and design optimum drug policy. Rigorous evaluations are recommended to reduce the drug-mix effect, including systems to monitor price, effectiveness, safety, therapeutic value and budget impact of pharmaceutical innovations.
Entities:
Keywords:
Drivers; drug expenditure; immunosuppressants; trends
Authors: Ricardo Eccard da Silva; Elisangela da Costa Lima; Maria Rita C G Novaes; Claudia G S Osorio-de-Castro Journal: Front Pharmacol Date: 2020-05-19 Impact factor: 5.810
Authors: Tatiana Chama Borges Luz; Ana Karine Sarvel de Castro; Isabela Cristina Marques; Betania Barros Cota; Jèssica de Castro Alves; Michael Robert Law Journal: Front Pharmacol Date: 2022-09-02 Impact factor: 5.988