Access to medication in the Public Health System and equity: populational health surveys in São Paulo, Brazil

• Published in: Revista brasileira de epidemiologia Vol. 19; no. 1; pp. 26 - 37
• Main Authors: Monteiro, Camila Nascimento, Gianini, Reinaldo José, Barros, Marilisa Berti de Azevedo, Cesar, Chester Luiz Galvão, Goldbaum, Moisés
• Format: Journal Article
• Language: English
• Published: Brazil Associação Brasileira de Saúde Coletiva 01-03-2016; Associação Brasileira de Pós-Graduação em Saúde Coletiva
• Subjects: Acesso universal a serviços de saúde; Adolescent; Adult; Assistência farmacêutica; Brazil; Child; Cross-Sectional Studies; Disparidades em assistência à saúde; Equidade em Saúde; Female; Health Services Accessibility - statistics & numerical data; Health Surveys; Healthcare Disparities - statistics & numerical data; Humans; Male; Middle Aged; Pharmaceutical Services - statistics & numerical data; Public Health; Public Sector; PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH; Sistemas de medicação; Socioeconomic Factors; Urban Population; Young Adult; Sistemas de medicação; Healthcare disparities; Equity in health; Equidade em Saúde; Acesso universal a serviços de saúde; Universal access to health care services; Equity in access; Disparidades em assistência à saúde; Assistência farmacêutica; Pharmaceutical services; Medication systems
• ISSN: 1415-790X; 1980-5497; 1980-5497; 1415-790X
• DOI: 10.1590/1980-5497201600010003

Since 2003, the access to medication has been increasing in Brazil and particularly in São Paulo. The present study aimed to analyze the access to medication obtained in the public sector and the socioeconomic differences in this access in 2003 and 2008. Also, we explored the difference in access to medication from 2003 to 2008.
Data were obtained from two cross-sectional population-based household surveys from São Paulo, Brazil (ISA-Capital 2003 and ISA-Capital 2008). Concentration curve and concentration index were calculated to analyze the associations between socioeconomic factors and access to medication in the public sector. Additionally, the differences between 2003 and 2008 regarding socioeconomic characteristics and access to medication were studied.
Access to medication was 89.55% in 2003 and 92.99% in 2008, and the proportion of access to medication did not change in the period. Access in the public sector increased from 26.40% in 2003 to 48.55% in 2008 and there was a decrease in the concentration index between 2003 and 2008 in access to medication in the public sector.
The findings indicate an expansion of Brazilian Unified Health System (Sistema Único de Saúde ) users, with the inclusion of people of higher socioeconomic position in the public sector. As the SUS gives more support to people of lower socioeconomic position in terms of medication provision, the SUS tends to equity. Nevertheless, universal coverage for medication and equity in access to medication in the public sector are still challenges for the Brazilian public health system.