Seleção de medicamentos da atenção secundária em saúde no estado do Ceará: aspectos regulatórios e conceituais

Abstract

The selection of medicines is important to Pharmaceutical Services, according to Health Care Networks which represent organizational arrangements to guarantee a full health care. The selection of medicines is a qualified process of choosing medicines for health systems, and it is very important to promote the rational use of medicines. Therefore, the access of medicines to population is guaranteed, mainly, by the definition of medicine lists. The state of Ceará has The Coordination of Pharmaceutical Services from the State of Ceará and Commission of Managers from Ceará, which these two are responsible for the Medicine List for Secondary Health Level in the state. This study purposed to analyze regulatory and concepts aspects of selection of medicines for secondary health level in State of Ceara, performing a bibliography research in official documents and databases about the process of creation of this list and evaluating it historically. Besides, we evaluated if the medicines in the list had recommendation and strength of evidences levels in literature. The results show that it was released 19 documents for this list, which there were no Drug and Therapeutics Committees, there were no systematic procedures for selection of medicines, there were no reports for inclusion and exclusion of medicines in the list, and there were no other information about evidence-based medicine. Administrative and judicial processes were considered while creating and updating the list. Its present update shows that only a few of medicines were referenced in official documents and some of them did not have level of recommendation and strength of evidences evaluations to prove their safety of usage. Furthermore, the list is not according to secondary health level demand and there is no communication with primary health level and Health Care Networks. The selection of medicines in the state is not transparent and the selection is improperly performed. Actions, such inclusion of evaluation indicators and redefinition of real targets of the list can make the process more clear and guarantee the access of medicines with good quality to population.