title: [Access to medicines for Alzheimer's disease provided by the Brazilian Unified National Health System in Minas Gerais State, Brazil].
abstract: This study evaluated barriers to access to treatment for Alzheimer's disease based on administrative cases involving cholinesterase inhibitors (ChEIs) and submitted to the Minas Gerais State Health Secretariat in Brazil in 2012 and 2013. Drawing on data from 165 randomly selected cases, the study addressed the following dimensions of access: geographic accessibility, accommodation, acceptability, availability, and affordability. The administrative processing to supply ChEIs took an average of 39 days and was influenced by characteristics of the path taken by the user. The majority of the prescribers met less than 80% of the required criteria in the Clinical Protocol and Therapeutic Guidelines (CPTG) for Alzheimer's disease. As a result, 38% of requests for medication were denied. Private treatment with ChEIs cost the equivalent of 21 days of the monthly minimum wage. In conclusion, bureaucratic administrative procedures and prescribers' difficulty in following the CPTG hindered access to treatment of Alzheimer's disease and imposed a heavy burden on patients' pockets.
authors: Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.
authors: Celline Cardoso
authors: CC
authors: Almeida-Brasil
authors: Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.
authors: Juliana de Oliveira
authors: Jde O
authors: Costa
authors: Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.
authors: Viviane Celestino Ferreira Dos Santos
authors: VC
authors: Aguiar
authors: Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.
authors: Daniela Pena
authors: DP
authors: Moreira
authors: Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.
authors: Edgar Nunes de
authors: EN
authors: Moraes
authors: Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.
authors: Francisco de Assis
authors: Fde A
authors: Acurcio
authors: Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.
authors: Augusto Afonso
authors: AA
authors: Guerra
authors: Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.
authors: Juliana
authors: J
authors: Álvares
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy*; D001938:Brazil; D003430:Cross-Sectional Studies; D016527:Drug Costs; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D004364:Pharmaceutical Preparations / Q000191:economics / Q000600:supply & distribution*; D010593:Pharmaceutical Services / Q000191:economics / Q000458:organization & administration / Q000600:supply & distribution*; D012111:Residence Characteristics; D012959:Socioeconomic Factors
chemical_list: D004364:Pharmaceutical Preparations