title: Analysis of access to hypertensive and diabetic drugs in the Family Health Strategy, State of Pernambuco, Brazil.
abstract: OBJECTIVE
  To evaluate the access to drugs for hypertension and diabetes and the direct cost of buying them among users of the Family Health Strategy (FHS) in the state of Pernambuco, Brazil.
  
  
  METHODS
  Population-based, cross-sectional study of a systematic random sample of 785 patients with hypertension and 823 patients with diabetes mellitus who were registered in 208 randomly selected FHS teams in 35 municipalities of the state of Pernambuco. The selected municipalities were classified into three levels with probability proportional to municipality size (LS, large-sized; MS, medium-sized; SS, small-sized). To verify differences between the cities, we used the χ2 test.
  
  
  RESULTS
  Pharmacological treatment was used by 91.2% patients with hypertension whereas 85.6% patients with diabetes mellitus used oral antidiabetic drugs (OADs), and 15.4% used insulin. The FHS team itself provided antihypertensive medications to 69.0% patients with hypertension, OADs to 75.0% patients with diabetes mellitus, and insulin treatment to 65.4%. The 36.9% patients with hypertension and 29.8% with diabetes mellitus that had to buy all or part of their medications reported median monthly cost of R$ 18.30, R$ 14.00, and R$ 27.61 for antihypertensive drugs, OADs, and insulin, respectively.
  
  
  CONCLUSIONS
  It is necessary to increase efforts to ensure access to these drugs in the primary health care network.
authors.affiliation: Department of Public Health, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
authors.forename: Maria Nelly Sobreira de Carvalho
authors.initials: MN
authors.lastname: Barreto
authors.affiliation: Department of Public Health, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
authors.forename: Eduarda Ângela Pessoa
authors.initials: EÂ
authors.lastname: Cesse
authors.affiliation: Department of Public Health, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
authors.forename: Rodrigo Fonseca
authors.initials: RF
authors.lastname: Lima
authors.affiliation: Department of Public Health, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
authors.forename: Michelly Geórgia da Silva
authors.initials: MG
authors.lastname: Marinho
authors.affiliation: Department of Public Health, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
authors.forename: Yuri da Silva
authors.initials: Yda S
authors.lastname: Specht
authors.affiliation: Department of Public Health, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
authors.forename: Eduardo Maia Freese
authors.initials: EM
authors.lastname: de Carvalho
authors.affiliation: Institut de Recherche pour le Développement, Montpellier, França.
authors.forename: Annick
authors.initials: A
authors.lastname: Fontbonne
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001938:Brazil; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000188:drug therapy*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged
chemical_list: D000959:Antihypertensive Agents; D007328:Insulin