Percepções dos discentes do curso de fármacia de uma instituição de ensino superior

Este artigo investigou a associação entre a autoavaliação de saúde e as características socioeconômicas, demográficas, físicas, emocionais, comportamentais e acadêmicas dos discentes do curso de Farmácia da Universidade Federal de Minas Gerais. Foram utilizados dados da pesquisa “Avaliação do perfil de alunos do curso de graduação em Farmácia da Universidade Federal de Minas Gerais”, desenvolvida pelo Núcleo Docente Estruturante (NDE). A percepção de saúde foi mensurada por meio de uma escala que variou de 0 a 100, sendo 0 o pior estado de saúde e 100, o melhor estado de saúde possível. A amostra de 273 alunos foi analisada com a técnica estatística denominada CART (Classification and Regression Tree). A média geral da escala de saúde foi 70,6, e o desvio-padrão, 20,13. Observou-se associação positiva entre as características comportamentais, os aspectos físicos e emocionais vivenciados pelos alunos e a escala de saúde. Os fatores mais fortemente associados à escala de saúde dos discentes foram o sexo e o fato de possuir ou não trabalho com vínculo empregatício, nessa ordem de intensidade

Consumer willingness to pay for a hypothetical Chikungunya vaccine in Brazil and the implications

Background: Chikungunya fever is an important infectious disease transmitted by the bite of Aedes genus mosquitoes infected with the Chikungunya Virus (CHIKV). Information about consumers’ willingness to pay (WTP) for a hypothetical vaccine against CHIKV can help discussions about prices and funding in countries with limited resources. Methods: Cross-sectional study among adult residents of Minas Gerais, Brazil, asking if they were willing to pay the price for a hypothetical chikungunya vaccine defined by the authors with an effective protection of 80% and the possibility of local and systemic side-effects. Residents were provided with information if not familiar with the virus. The price was randomly varied between participants in five values: US$11.69 (45.00BRL), US$23.38 (90.00BRL), US$46.75 (180.00BRL), US$93.51 (360.00BRL) and US$187.90 (720.00BRL). We included this aspect due to issues with any anchoring effect. Results: 496 individuals were interviewed. Among these, 23 were excluded. Most of the respondents were female (57.3$ 31.17 (120.00 BRL) for a unique dose vaccine. There was a statistical significant correlation with monthly family income and access to private health insurance. Conclusion: This study can contribute to decision-making about potential prices for a CHIKV vaccine when it becomes available in Brazil. We also showed the anchoring effect as a possible influence on consumers’ WTP in studies with similar techniques. Finally, we encourage the development of a chikungunya virus vaccine to benefit the Brazilian population

Cost-effectiveness thresholds : methods for setting and examples from around the world

INTRODUCTION: Cost-effectiveness thresholds (CETs) are used to judge if an intervention represents sufficient value for money to merit adoption in healthcare systems. The study was motivated by the Brazilian context of HTA, where meetings are being conducted to decide on the definition of a threshold. AREAS COVERED: An electronic search was conducted on Medline (via PubMed), Lilacs (via BVS) and ScienceDirect followed by a complementary search of references of included studies, Google Scholar and conference abstracts. Cost-effectiveness thresholds are usually calculated through three different approaches: the willingness-to-pay, representative of welfare economics; the precedent method, based on the value of an already funded technology; and the opportunity cost method, which links the threshold to the volume of health displaced. An explicit threshold has never been formally adopted in most places. Some countries have defined thresholds, with some flexibility to consider other factors. An implicit threshold could be determined by research of funded cases. EXPERT COMMENTARY: CETs have had an important role as a “bridging concept” between the world of academic research and the “real world” of healthcare prioritization. The definition of a cost-effectiveness threshold is paramount for the construction of a transparent and efficient Health Technology Assessment system

Consumer willingness to pay for dengue vaccine (CYD-TDV, Dengvaxia®) in Brazil : implication for future pricing considerations

Introduction and objective: Dengue virus is a serious global health problem with an estimated 3.97 billion people at risk for infection worldwide. In December 2015, the first vaccine (CYD-TDV) for dengue prevention was approved in Brazil, developed by Sanofi Pasteur. However, given that the vaccine will potentially be paid via the public health system, information is need regarding consumers’ willingness to pay for the dengue vaccine in the country as well as discussions related to the possible inclusion of this vaccine into the public health system. This was the objective of this research. Methods: We conducted a cross-sectional study with residents of Greater Belo Horizonte, Minas Gerais, about their willingness to pay for the CYD-TDV vaccine. Results: 507 individuals were interviewed. These were mostly female (62.4%) had completed high school (62.17%), were working (74.4%), had private health insurance (64.5%) and did not have dengue (67.4%). The maximum median value of consumers’ willingness to pay for CYD-TDV vaccine is US$33.61 (120.00BRL) for the complete schedule and US$11.20 (40.00BRL) per dose. At the price determined by the Brazil's regulatory chamber of pharmaceutical products market (CMED) for the commercialization of Dengvaxia® for three doses, only 17% of the population expressed willingness to pay for this vaccine. Conclusion: Brazil is currently one of the largest markets for dengue vaccine and the price established is a key issue. We believe the manufacturer should asses the possibility of lower prices to reach a larger audience among the Brazilian population

Consumer willingness to pay for a hypothetical Zika vaccine in Brazil

Introduction: Zika virus is a newly emerging infection associated with increasingly large outbreaks especially in countries such as Brazil where an estimated 326,224 cases were confirmed between 2015 and 2018. Common symptoms associated with Zika include headache, conjunctivitis, fever, erythema, myalgia, vomiting, diarrhea, and abdominal pain. However, the symptoms are usually self-limiting and last on average for 4 to 7 days, with patients typically not accessing the public healthcare system (SUS). In severe cases, symptoms include neurological disorders and neonatal malformations. A future Zika vaccine can contribute to decreasing the number of cases and associated complications. However, this has to be balanced against continuing costs to control this and other vector borne diseases. Consequently, information about consumers’ willingness to pay (WTP) for a hypothetical Zika vaccine can help with price setting discussions in Brazil starting with the private market before being considered within SUS. Methods: A cross-sectional study was conducted among residents in one of the main provinces of Brazil (Minas Gerais) regarding their WTP for a hypothetical Zika Vaccine with agreed characteristics. This included a mean effective protection of 80%, with the possibility of some local and systemic side-effects. The discussed price was US$56.41(180.00 BRL) per vaccination as this figure was utilized in a previous WTP study for a dengue vaccine. Results: 517 people were interviewed. However, 30 would not be vaccinated even if the vaccine was free. Most of the resultant interviewees (489) were female (58.2$31.34 (BRL100.00). Conclusion: WTP research can contribute to decision-making about possible prices alongside other economic criteria once a Zika vaccine becomes available in Brazil alongside other programmes to control the virus

Percepção de estudantes de graduação sobre a aprendizagem em disciplina adaptada para o ensino remoto emergencial

O objetivo deste artigo foi descrever as adaptações realizadas em uma disciplina introdutória do curso de Farmácia adaptada para o ensino remoto emergencial, bem como as percepções dos estudantes acerca dessa experiência educacional. Trata-se de um estudo qualitativo com análise temática de dados obtidos pela técnica de grupo focal. O contexto pandêmico exigiu que professores e estudantes buscassem novas formas de ensino e aprendizagem e a utilização de metodologias ativas nessa conjuntura permitiu a interação e criação de vínculos entre discentes e docentes, mesmo em ambiente virtual de aprendizagem. A percepção dos estudantes sobre o aprendizado na disciplina aponta que os objetivos propostos foram alcançados, embora a sobrecarga de atividades tenha sido apontada por eles como um aspecto negativo da experiência. A investigação realizada mostrou uma percepção positiva dos alunos sobre a experiência educacional, mesmo diante dos desafios da pandemia de covid-19. Os resultados obtidos evidenciam a necessidade de formação docente em métodos de ensino e aprendizagem e avaliação on-line, que poderão se tornar uma nova realidade na educação superior em tempos pós-pandemia

Health equity and the usage of atypical antipsychotics within the Brazilian national health system : findings and implications

Background: There is a need to evaluate the health equity of atypical antipsychotics users who obtain their medicines from the Brazilian National Health System (SUS) through the identification of key factors that influence their health status due to concerns with equity of care. Research design and methods: Cross-sectional study among patients attending state pharmacies in Brazil. Individuals were included if they used atypical antipsychotics, aged ≥18 years, and answered the EQ-5D-3 L questionnaire. Sociodemographic, behavioral, and clinical data were collected. The dependent variable was health status. Associations between the independent variables and the dependent variable were analyzed by adjusting a linear regression model. Results: Overall, 388 individuals met the eligibility criteria and were included in the analysis. The final multiple linear regression model demonstrated a statistically significant association between VAS and suicide attempts, private care, current antipsychotics, comorbidities, and perceived family support. Expert Commentary: The study identified several factors both individual and collective that correlate with the health status of atypical antipsychotic users and confirmed the importance of providing medicines for treating psychotic disorders. However, other factors are involved including social support. Our results suggest additional activities and policies are necessary including strategies to address the differences in private and public health care

Consumer willingness to pay for a hypothetical Zika vaccine in Brazil and the implications

ABSTRACT : Background: Zika virus is a newly emerging infection, associated with increasingly large outbreaks especially in tropical countries such as Brazil. A future Zika vaccine can contribute to decreasing the number of cases and associated complications. Information about consumers’ willingness to pay (WTP) for a hypothetical Zika vaccine can help price setting discussions in the future in Brazil, starting with the private market. Methods: A cross-sectional study conducted among residents of Minas Gerais, Brazil, regarding their WTP for a hypothetical Zika Vaccine. The mean effective protection was 80%, with the possibility of some local and systemic side- effects. Results: 517 people were interviewed. However, 28 would not be vaccinated even if the vaccine was free. Most of the resultant interviewees (489) were female (58.2%), had completed high school (49.7%), were employed (71.2%), had private health insurance (52.7%), and did not have Zika (96.9%). The median individual maximum WTP for this hypothetical Zika vaccine (one dose) was US$31.34 (BRL100.00). Conclusion: Such discussions regarding WTP can contribute to decision-making about prices once a Zika vaccine becomes available in Brazil alongside other ongoing programs to control the virus

Costs in the Treatment of Schizophrenia in Adults Receiving Atypical Antipsychotics: An 11-Year Cohort in Brazil

Background: Schizophrenia is associated with significant economic burden. In Brazil, antipsychotics drugs, outpatient and hospital services are provided by the Brazilian National Health System for patients with schizophrenia. However, there are few studies that capture the cost of managing these patients within the Brazilian NHS. This is important to appraise different management approaches within universal healthcare systems. Objective: Describe the costs associated with the treatment of schizophrenia in adults receiving atypical antipsychotics in Brazil from 2000 to 2010 through real world data. Methods: We integrated three national databases for adult patients with schizophrenia receiving one or more atypical antipsychotics. Only direct medical costs were assessed as the perspective is a public payer. A multivariate log-linear regression model was performed to evaluate associations between costs and clinical and demographic variables. Results: 174,310 patients with schizophrenia were identified with mean (± SD) annual costs of USD 1,811.92 ± 284.39 per patient. Atypical antipsychotics accounted for 79.7% of the total cost, with a mean (± SD) annual cost per patient of USD 1,578.74 ± 240.40. Mean (± SD) annual costs per patient of psychiatric hospitalization were USD 2,482.90 ± 302.92 and outpatient psychiatric care was USD 862.96 ± 160.18. Olanzapine was used by 47.7% of patients and represented 62.8% of the total cost of atypical antipsychotics. Patients who used clozapine had the highest mean annual cost per patient regarding outpatient psychiatric care and psychiatric hospitalization. Conclusions: Atypical antipsychotics were responsible for the majority of the schizophrenia treatment cost, and psychiatric hospitalization costs were the highest mean annual cost per patient. As a result, authorities should ensure good quality of use of atypical antipsychotic and encourage outpatient psychiatric care over psychiatric hospitalization where possible

Public spending on drugs for the treatment of osteoporosis in post-menopause

OBJECTIVE: To analyze expenditure on treatment for postmenopausal osteoporosis and associated factors on mean per capita expenditure. METHODS: A probabilistic-deterministic linkage between the database of Authorizations for Highly Complex Procedures and the mortality information system was constructed, resulting in a historical cohort of patients using high-cost medications for the treatment of postmenopausal osteoporosis, between 2000-2006. Mean monthly spending on medicines was stratified by age group and described according to demographic and clinical characteristics and the type of drug used. A linear regression model was used to assess the impact of demographic and clinical characteristics on per capita mean monthly expenditure on medicines. RESULTS: We identified 72,265 women who received drugs for the treatment of postmenopausal osteoporosis. The average monthly expenditure per capita in the first year of treatment was $54.02 (sd$ 86.72). The population was predominantly composed of women aged 60-69 years old, who had started treatment in 2000, resident in the Southeast of Brazil, who had previously suffered osteoporotic fractures, and Alendronate sodium was the drug most commonly used at baseline. For most of the patients, the same active ingredient remained in use throughout the treatment period. During the program, 6,429 deaths were identified among participants. More than a third of women remained in treatment for up to 12 months. Raloxifen and calcitonin were the therapeutic alternatives with the greatest impact on the average monthly expenditure on medicine using alendronate sodium as a reference standard. CONCLUSIONS: Due to the high impact of the type of drug used on expenditure on medication, it is recommended that criteria for prescribing and dispensing be established by prioritizing those with lower costs and greater effectiveness in order to optimize the process of pharmaceutical care and provide the population with a greater number of pharmaceutical units.OBJETIVO: Analisar os gastos com medicamentos para o tratamento da osteoporose na pós-menopausa e os fatores associados ao gasto médio per capita . MÉTODOS: Pareamento probabilístico-determinístico a partir das bases das Autorizações de Procedimentos de Alta Complexidade com o Sistema de Informação sobre Mortalidade, resultando em coorte histórica de pacientes que utilizaram medicamentos de alto custo para o tratamento da osteoporose na pós-menopausa de 2000 a 2006. O gasto médio mensal com medicamentos foi estratificado por faixas etárias e descrito de acordo com as características demográficas, clínicas e tipo de medicamento utilizado. Foi utilizado modelo de regressão linear para avaliar o impacto de características demográficas e clínicas sobre o gasto médio mensal per capita com os medicamentos. RESULTADOS: Foram identificadas 72.265 mulheres que receberam medicamentos para o tratamento da osteoporose na pós-menopausa. O gasto médio mensal per capita no primeiro ano de tratamento foi de R$90,00 (dp R$ 144,49). A maioria das mulheres tinha de 60 a 69 anos de idade, iniciaram tratamento em 2000, eram residentes na região Sudeste, tinham fraturas osteoporóticas prévias e o alendronato de sódio foi o medicamento mais utilizado no início do tratamento. A maioria das pacientes permaneceu em uso do mesmo princípio ativo durante o tratamento. Foram identificados 6.429 óbitos entre as participantes. Mais de um terço das mulheres permaneceram no programa por até 12 meses. Raloxifeno e calcitonina sintética foram as alternativas com maior impacto sobre o gasto médio mensal com medicamentos, tendo como padrão de referência o alendronato de sódio. CONCLUSÕES: Dado o alto impacto do tipo de medicamento utilizado no gasto com medicação, recomenda-se estabelecer critérios para prescrição e dispensação, com prioridade para aqueles com menores custos e maior efetividade. Isso pode otimizar o processo de assistência farmacêutica e a provisão de maior número de unidades farmacêuticas à população.OBJETIVO: Analizar los gastos con medicamentos para el tratamiento de la osteoporosis en la post-menopausia y los factores asociados al gasto promedio per cápita. MÉTODOS: Pareamiento probabilístico-deterministico a partir de las bases de las Autorizaciones de Procedimientos de Alta Complejidad con el Sistema de Información sobre Mortalidad, resultando en cohorte histórica de pacientes que utilizaron medicamentos de alto costo para el tratamiento de la osteoporosis en la post-menopausia de 2000 a 2006. El gasto promedio mensual con medicamentos fue estratificado por grupos etarios y descrito de acuerdo con las características demográficas, clínicas y tipo de medicamento usado. Se utilizó modelo de regresión linear para evaluar el impacto de las características socio demográficas y clínicas sobre el gasto promedio mensual per cápita con los medicamentos. RESULTADOS: Se identificaron 72.265 mujeres que recibieron medicamentos para el tratamiento de la osteoporosis en la post-menopausia. El gasto promedio mensual per cápita en el primer año de tratamiento fue de R$90,00 (de R$ 144,49). La mayoría de las mujeres tenía de 60 a 69 años de edad, iniciaron tratamiento en 2000, eran residentes en la región Sureste, tenían fracturas osteoporóticas previas, y el alendronato de sodio fue el medicamento más utilizado en el inicio del tratamiento. La mayoría de los pacientes permaneció en uso del mismo principio activo durante el tratamiento. Se identificaron 6.429 óbitos entre las participantes. Más de un tercio de las mujeres permanecieron en el programa por 12 meses. Raloxifeno y calcitonina sintética fueron las alternativas con mayor impacto sobre el gasto promedio mensual con medicamentos, teniendo como patrón de referencia el alendronato de sodio. CONCLUSIONES: Dado el alto impacto del tipo de medicamento utilizado en el gasto por parte del SUS, se recomienda establecer criterios para prescripción y dispensación, priorizando aquellos con menores costos y mayor efectividad. Esto puede optimizar el proceso de asistencia farmacéutica y la provisión de mayor número de unidades farmacéuticas para la población