Medication Budget Slashed by 4% in Brazil Despite Expansion of Treatment Coverage

Brazilian states' federal budget for pharmaceutical expenditure is expected to experience a 4% year-on-year (y/y) cutback for 2010, reports AE Noticiário quoting the National Council of Health Secretariats (Conass). As such, next year's pharmaceutical budget could reach 3.3 billion reais (US$1.9 billion). This announcement comes less than a week after the Ministry of Health (MoH) pronounced its intentions to expand treatment selection and indications within the national health system (SUS).

Treatment Expansion within Brazil's SUS

Earlier last week, Brazil's MoH announced the introduction of 18 new drugs within the national health system's (SUS) treatments list (Ultimo Segundo). Their inclusion boosts the system's coverage to 79 different conditions. New drugs incorporate treatments for three specific ailments, which include pulmonary arterial hypertension, psoriatic arthritis and thrombocytopaenic purpura.

Furthermore, 27 treatments will be now expanded to include 100 new indications (EPTV). Conditions favoured by this measure include the following:

Meanwhile, treatment protocols for more than 50 medical conditions are expected to be revised by the end of the year. This could possibly bring further changes to the guidelines and conditions on the provision of these treatments in the country.

Reactions from the Sector

Beatriz Dobashi, health secretary from Mato Grosso do Sul, has directed public attention to the feasibility of the MoH's plans. According to Dobashi, the country lacks the required economic resources to successfully expand the provision of new treatments, particularly as Brazilian states face funding cuts for the following year.

Meanwhile, the MoH has reported that Conass's budget information is still undergoing revisions. Its final approval and implementation will depend on the Ministry of Planning.

Outlook and Implications

While budgetary cuts are not yet confirmed, the reduction in Brazil's GDP during this year point to that direction. However, government plans to expand medical treatment provision in the country are not expected to be affected, as the government has shown a deep commitment to continue on this path (see Brazil: 1 December 2009: SUS Includes Six New Phytotherapy Drugs in Brazil).

In order to continue with its mission, the Brazilian government is expected to continue focusing upon the centralisation of drugs purchased by the ministry of health. The MoH had been responsible for the purchasing of 12 medications up to this year, a number which has been expanded to 38 drugs. Countries such as Peru and Mexico are also using this strategy to minimise their costs, showing great success in the process.

Other measures to ensure the sustainability of the system could include the strengthening of controls to reduce the over-consumption of expensive medications, such as oncology drugs. This comes hand in hand with the government's preventive strategy in the country, where it has been gaining momentum in recent years.

Meanwhile, prospects to continue updating the protocols of drug provision in the country reflect the long-term commitment to reduce legal action to obtain treatment in the country. These actions bring significant difficulties in budgetary planning and execution, as well as less favourable commercial deals for the government.