Initiatives to promote access to medicines after publication of the Brazilian Policy on the Comprehensive Care of People with Rare Diseases

Author:

Cunico CássiaORCID,Vicente Geison,Leite Silvana Nair

Abstract

Abstract Background Rare diseases affect a small number of people compared to prevalent diseases. The vast majority of these diseases are of genetic origin, have no cure, are chronic and can lead to death. Although the right to access medicines is included in the constitutionally guaranteed right to health in Brazil, problems in the supply of medicines for rare diseases are reported in the country. This study aimed to describe and analyse the initiatives to promote access to medicines for treating rare diseases in the Unified Health System, Brazil, after the publication of the Brazilian Policy on the Comprehensive Care of People with Rare Diseases. Based on the model published by the WHO Regional Office for Europe, which described access to medicines in prelaunch, perilaunch and postlaunch policies, the initiatives referring to each category were summarized based on documentary research searched in online databases from January 2014 to December 2020. Results Different actions and policy interventions were identified, which went through the expansion of resources for research and development, health regulations, incorporation of new drugs, review and publication of clinical guidelines, and expansion of the network of care facilities by the Ministry of Health. On the other hand, aspects related to care policies, pricing methods, technological development, and development of pharmaceutical service processes were not implemented. Conclusions Although it is impossible to determine the explicit motivation of such actions concerning the Policy, its publication certainly was a landmark in Brazilian society, allowing greater recognition of the needs of rare disease patients and the specificities of treatment’. However, this study suggests that the steps that make up the life cycle of medicines are not linked, lacking articulation and integration of the care network, and consequently, there is no evidence that rare disease policy publication has generated a broad impact on the promotion of access to medicines to treat rare diseases in Brazil.

Publisher

Springer Science and Business Media LLC

Subject

Pharmacology (medical),Genetics (clinical),General Medicine

Reference44 articles.

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2. Nguengang Wakap S, Lambert DM, Olry A, Rodwell C, Gueydan C, Lanneau V, et al. Estimating cumulative point prevalence of rare diseases: analysis of the Orphanet database. Eur J Hum Genet. 2020;28(2):165–73. https://doi.org/10.1038/s41431-019-0508-0.

3. Brasil. Ministério da Saúde. Ordinance no. 199, 2014, January 30. Establishes the Brazilian Policy on the Comprehensive Care of People with Rare Diseases, approves the Guidelines for Comprehensive Care of People with Rare Diseases within the Unified Health System (SUS) and establishes financial incentives for funding. Diário Oficial da União, 2014. Available from: http://bvsms.saude.gov.br/bvs/saudelegis/gm/2014/prt0199_30_01_2014_rep.html. Accessed 12 Oct 2022.

4. Brasil. Comissão Nacional de Incorporação de Tecnologias no SUS. Recommendation Report no. 142: Prioritisation of protocols and therapeutic guidelines for comprehensive care of rare disease patients. 2015. Available from: https://www.gov.br/conitec/pt-br/midias/relatorios/2015/relatrio_pcdt_doenasraras_cp_final_142_2015.pdf. Accessed 2 Mar 2020.

5. Brasil. Portaria de Consolidação nº 2, de 28 de setembro de 2017. Consolidation of the rules on national health policies of the Unified Health System. Annex XXVIII—Title IV—Treats rules for financing and execution of the Specialized Component of Pharmaceutical Care within the scope of the SUS. Available from: http://bvsms.saude.gov.br/bvs/saudelegis/gm/2017/prc0002_03_10_2017.html. Accessed 2 Mar 2020.

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