Título:	An analysis of the essential medicines policy in primary care : findings from MedMinas project
Autor(es):	Luz, Tatiana Chama Borges Tavares, Noemia Urruth Leão Marques, Isabela Cristina Castro, Ana Karine Sarvel de Cota, Betania Barros
Afiliação do autor:	Oswaldo Cruz Foundation (FIOCRUZ), René Rachou Institute (IRR), GETESA (Grupo de Estudos Transdisciplinares em Tecnologias em Saúde e Ambiente) Strathclyde University, Strathclyde Institute of Pharmacy and Biomedical Sciences (SIPBS), Glasgow, United Kingdom Faculty of Health Sciences, University of Brasília, Department of Pharmacy Oswaldo Cruz Foundation (FIOCRUZ), René Rachou Institute (IRR), GETESA (Grupo de Estudos Transdisciplinares em Tecnologias em Saúde e Ambiente) Oswaldo Cruz Foundation (FIOCRUZ), René Rachou Institute (IRR), GETESA (Grupo de Estudos Transdisciplinares em Tecnologias em Saúde e Ambiente) Oswaldo Cruz Foundation (FIOCRUZ), René Rachou Institute (IRR), GETESA (Grupo de Estudos Transdisciplinares em Tecnologias em Saúde e Ambiente)
Assunto:	Medicamentos - política - Brasil Atenção primária à saúde
Data de publicação:	2022
Editora:	Frontiers
Referência:	LUZ, Tatiana Chama Borges et al. An analysis of the essential medicines policy in primary care: findings from MedMinas project. Frontiers in Pharmacology, [S. l.], v. 13, out. 2022. DOI: https://doi.org/10.3389/fphar.2022.953329. Disponível em: https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.953329/full. Acesso em: 24 jun. 2024.
Abstract:	Background: Essential Medicines Policy (EMP) has been adopted in Brazil to improve the provision and use of pharmaceuticals. This mixed methods study aims to bring evidence of the EMP implemented in municipalities in the context of primary care in Minas Gerais (20,997,560 inhabitants), Southeast Brazil. Methods: We analysed the core output of the EMP, i.e., the municipal essential medicines lists (MEML) and the effects of the policy on the procurement and availability of medicines. Data sources included a sample of 1,019 individuals (patients, health managers and health professionals), 995 prescriptions, 2,365 dispensed medicines and policy documents from 26 municipalities. Data were collected between April and October 2019. Document analysis and thematic content analysis were performed, and four availability indexes were estimated. Results: The findings suggest an overall lack of standardised and methodologically sound procedures to elaborate the MEML. Funding and public purchasing processes were found to be the major obstacles to medicine procurement. Only 63% of medicines were available at public community pharmacies and just 46.2% of patients had full access to their pharmaceutical treatment. Conclusion: This study reveals weaknesses in the implementation of EMP and a clear disconnection between medicines selection, procurement, and availability, the three core elements of the supply system. These findings contribute to informing future policy improvement actions to strengthen this system. Other countries aiming to advance towards universal health coverage may learn from the challenges that primary care in Brazil still needs to address.
Unidade Acadêmica:	Faculdade de Ciências da Saúde (FS) Departamento de Farmácia (FS FAR)
Licença:	© 2022 Luz, Tavares, Marques, de Castro and Cota. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
DOI:	https://doi.org/10.3389/fphar.2022.953329
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