Legal demands of the tiotropium bromide for treatment of chronic obstructive pulmonary disease and their financial impact for the State of Paraná, Brazil

Einstein (Sao Paulo). 2019 Sep 26:18:eGS4442. doi: 10.31744/einstein_journal/2020GS4442. eCollection 2020.
[Article in English, Portuguese]

Abstract

Objective: To analyze the legal demands of tiotropium bromide to treat chronic obstructive pulmonary disease.

Methods: We included secondary data from the pharmaceutical care management systems made available by the Paraná State Drug Center.

Results: Public interest civil action and ordinary procedures, among others, were the most common used by the patients to obtain the medicine. Two Health Centers in Paraná (Londrina and Umuarama) concentrated more than 50% of the actions. The most common specialty of physicians who prescribed (33.8%) was pulmonology. There is a small financial impact of tiotropium bromide on general costs with medicines of the Paraná State Drug Center. However, a significant individual financial impact was observed because one unit of the medicine represents 38% of the Brazilian minimum wage.

Conclusion: Our study highlights the need of incorporating this medicine in the class of long-acting anticholinergic bronchodilator in the Brazilian public health system.

Objetivo: Analisar as demandas judiciais do brometo de tiotrópio para tratar a doença pulmonar obstrutiva crônica.

Métodos: Foram considerados dados secundários dos sistemas gerenciais de assistência farmacêutica, disponibilizados pelo Centro de Medicamentos do Paraná.

Resultados: Ações civis públicas e ações ordinárias, de procedimento comum, entre outras, foram as mais praticadas pelos pacientes para obter o medicamento. Duas Regionais de Saúde do Paraná (Londrina e Umuarama) concentraram mais de 50% das ações. Quanto à especialidade dos médicos prescritores, 33,8% eram pneumologistas. Verificou-se discreto impacto financeiro do brometo de tiotrópio nos gastos gerais com medicamentos pelo Centro de Medicamentos do Paraná. Entretanto, também houve relevante impacto financeiro individual, pois uma unidade do medicamento consome 38% do salário mínimo.

Conclusão: O estudo aponta para a necessidade de incorporação deste medicamento da classe broncodilatadores anticolinérgicos de longa duração, no Sistema Único de Saúde.

MeSH terms

  • Brazil
  • Bronchodilator Agents / economics*
  • Drugs, Essential / economics
  • Drugs, Essential / supply & distribution*
  • Health Services Accessibility / economics
  • Health Services Accessibility / legislation & jurisprudence
  • Health Services Accessibility / trends
  • Health Services Needs and Demand / economics
  • Health Services Needs and Demand / legislation & jurisprudence*
  • Health Services Needs and Demand / trends
  • Humans
  • Judicial Role*
  • National Health Programs
  • Pulmonary Disease, Chronic Obstructive / drug therapy
  • Pulmonary Disease, Chronic Obstructive / economics*
  • Retrospective Studies
  • Statistics, Nonparametric
  • Time Factors
  • Tiotropium Bromide / economics*

Substances

  • Bronchodilator Agents
  • Drugs, Essential
  • Tiotropium Bromide