0056/2014 - Federalismo, Complexo Econômico-Industrial da Saúde e Assistência Farmacêutica de Alto custo no Brasil Federalismo, Complexo Econômico-Industrial da Saúde e Assistência Farmacêutica de Alto custo no Brasil
• Elize Fonseca - Fonseca, Elize - SP , São Paulo, - Fundação Getúlio Vargas - Escola de Administração de Empresas de São Paulo São Paulo, SP - <EMASSARD@GMAIL.COM>
Coautor(es):
• Nilson do Rosario Costa - Costa, Nilson do Rosario - Escola Nacional de Saúde Pública - <EMASSARD@GMAIL.COM>
Área Temática:
Políticas em Saúde
Resumo:
O Brasil possui um relevante, porém pouco conhecido, programa de medicamentos especializado, com distribuição de produtos de alto custo, como no caso do tratamento do câncer. Em 2009 a compra destes medicamentos passou a ser de responsabilidade federal. Até então não existiam normas claras sobre as responsabilidades da União e estados na gestão e financiamento deste programa. O presente estudo qualitativo analisa a evolução do processo de transição deste programa para a esfera do governo federal. Através de uma consulta das atas da Comissão Intergestora Tripartite de 2000 e 2012 e entrevistas com onze informantes, o estudo demonstrou que ao longo da última década foram realizadas alterações institucionais relevantes na gestão federativa destes programas como a recentralização da compra destes medicamentos e elaboração de critérios para introdução de novos medicamentos neste programa, o que é explicável pela eficácia dos mecanismos de coordenação do governo federal. Esses achados reforçam a ideia de que o Ministério da Saúde, além de constituir o principal indutor de políticas públicas de saúde, tem optado pela recentralização de atividades por força do projeto desenvolvimentista implícito na agenda do Complexo Econômico e Industrial da Saúde.
Palavras-chave:
descentralização; medicamentos de alto custo; medicamentos especializados; desenvolvimentismo; complexo econômico e industrial da saúde.
Abstract:
Brazil has a relevant, although relatively unknown, special medicines programme that distributes high-cost products, such as drugs needed for cancer treatments. In 2009, the purchase of these medicines became the responsibility of the Brazilian Federal Government. Until then, there were no clear norms regarding the responsibilities, in terms of the management/financing of these medicines, of the Brazilian Federal Government and of the states themselves. This qualitative study analyses the policy process needed to transfer this programme to the central government. The study examines the reports of the Tripartite Commission between 2000 and 2012, and in-depth interviews with eleven key informants were conducted. The study demonstrates that throughout the last decade, institutional changes have been made in regard to the federal management of these programmes (such as recentralisation of the purchasing of medicines and the formulation of criteria to introduce new products into the programme). It concludes that these changes can be explained because of the efficiency of the coordinating mechanisms of the Federal Government. These findings reinforce the idea that the Ministry of Health is the main driver of public health policies, and it has opted for the recentralisation of activities as a result of the development project implicit in the agenda of the Industrial and Economic Heal
Keywords:
decentralisation
high cost medicines
special medicines
development
industrial and economic health complex
Federalismo, Complexo Econômico-Industrial da Saúde e Assistência Farmacêutica de Alto custo no Brasil
Resumo (abstract):
Brazil has a relevant, although relatively unknown, special medicines programme that distributes high-cost products, such as drugs needed for cancer treatments. In 2009, the purchase of these medicines became the responsibility of the Brazilian Federal Government. Until then, there were no clear norms regarding the responsibilities, in terms of the management/financing of these medicines, of the Brazilian Federal Government and of the states themselves. This qualitative study analyses the policy process needed to transfer this programme to the central government. The study examines the reports of the Tripartite Commission between 2000 and 2012, and in-depth interviews with eleven key informants were conducted. The study demonstrates that throughout the last decade, institutional changes have been made in regard to the federal management of these programmes (such as recentralisation of the purchasing of medicines and the formulation of criteria to introduce new products into the programme). It concludes that these changes can be explained because of the efficiency of the coordinating mechanisms of the Federal Government. These findings reinforce the idea that the Ministry of Health is the main driver of public health policies, and it has opted for the recentralisation of activities as a result of the development project implicit in the agenda of the Industrial and Economic Heal
Palavras-chave (keywords):
decentralisation
high cost medicines
special medicines
development
industrial and economic health complex
Fonseca, Elize, Costa, Nilson do Rosario. Federalismo, Complexo Econômico-Industrial da Saúde e Assistência Farmacêutica de Alto custo no Brasil. Cien Saude Colet [periódico na internet] (2014/out). [Citado em 24/12/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/federalismo-complexo-economicoindustrial-da-saude-e-assistencia-farmaceutica-de-alto-custo-no-brasil/15040?id=15040&id=15040
