Household expenditures for medicines and the role of free medicines in the Brazilian public health system.
OBJECTIVE
We sought to investigate, across different socioeconomic groups, the proportion of household medicine expenses that were paid by households and the proportion paid by the Brazilian national health system.


METHODS
We carried out a survey in Porto Alegre, Brazil, that included 2988 individuals of all ages. We defined 2 expenditure variables: "out-of-pocket medicines value" (the sum of retail prices of all medicines used by family members within the previous 15 days and paid for out of pocket) and "free medicines value" (a similar definition for medicines obtained without charge).


RESULTS
In 2003, the Brazilian national health system provided, free of charge, 78% of the monetary value of medicines reported (79% in the bottom wealth quintile and 32% in the top 2 quintiles). The mean out-of-pocket expense for medicines was 6 times greater among the top wealth quintiles compared with those in lower quintiles, but free medicines constituted a 3-times-greater proportion of potential expenditures for medicines among the bottom quintile than among the top 2 quintiles.


CONCLUSIONS
Free provision of medicines seems to be saving substantial amounts of medicine expenditures for poor people in Brazil.
Bertoldi
Andréa D
AD
Programa de Pós-graduação em Saúde Coletiva, Universidade do Vale do Rio dos Sinos, São Leopoldo, Brazil. andreadamaso.epi@gmail.com
Barros
Aluísio J D
AJ
Camargo
Aline Lins
AL
Hallal
Pedro C
PC
Vandoros
Sotiris
S
Wagner
Anita
A
Ross-Degnan
Dennis
D
D001938:Brazil; D003430:Cross-Sectional Studies; D016527:Drug Costs / Q000706:statistics & numerical data*; D005191:Family Characteristics; D005382:Financing, Personal / Q000706:statistics & numerical data; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income; D009313:National Health Programs / Q000191:economics / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors