title: Free access to hypertension and diabetes medicines among the elderly: a reality yet to be constructed.
abstract: The study evaluated free access to hypertension and diabetes medicines and the reasons reported for lack of access. The sample included 4,003 elderly people living in Primary Care Unit coverage areas from 41 Southern and Northeastern Brazilian cities. Free access was higher in the Northeast (62.4%). The strategy of the Family Health Program (Programa Saúde da Família - PSF) was more effective in providing access than the traditional model, with higher results in the Northeast (61.2%) than in the South (39.6%). Around 20% of medicines included in the Hypertension and Diabetes Program and 26% of those included in the National Essential Medicines List (RENAME) were paid out of pocket. In the Northeast, 25% of insulin and 32% of oral antidiabetics were paid out of pocket. Unavailability in the public sector and a lack of money determined the lack of access. Although the PSF, Hypertension and Diabetes Program and RENAME expanded free access, supplies were insufficient. A greater connection between programs and a clear definition of responsibilities can improve medicine acquisition process, increasing the effectiveness of pharmaceutical assistance.
authors.affiliation: Universidade Federal de Pelotas, Pelotas, Brasil. vpvieira@terra.com.br
authors.forename: Vera Maria Vieira
authors.initials: VM
authors.lastname: Paniz
authors.forename: Anaclaudia Gastal
authors.initials: AG
authors.lastname: Fassa
authors.forename: Luiz Augusto
authors.initials: LA
authors.lastname: Facchini
authors.forename: Roberto Xavier
authors.initials: RX
authors.lastname: Piccini
authors.forename: Elaine
authors.initials: E
authors.lastname: Tomasi
authors.forename: Elaine
authors.initials: E
authors.lastname: Thumé
authors.forename: Denise Silva
authors.initials: DS
authors.lastname: da Silveira
authors.forename: Maria Aparecida
authors.initials: MA
authors.lastname: Rodrigues
authors.forename: Marlos Rodrigues
authors.initials: MR
authors.lastname: Domingues
authors.forename: Andréa Dâmaso
authors.initials: AD
authors.lastname: Bertoldi
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000600:supply & distribution*; D001938:Brazil; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000188:drug therapy; D018954:Drugs, Essential / Q000600:supply & distribution*; D006301:Health Services Needs and Demand; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000600:supply & distribution*; D007407:Interviews as Topic; D009313:National Health Programs; D011320:Primary Health Care / Q000706:statistics & numerical data*
chemical_list: D000959:Antihypertensive Agents; D018954:Drugs, Essential; D007004:Hypoglycemic Agents