Reducción de la cobertura social para los fármacos antiartrósicos sintomáticos de acción lenta: una iniciativa de desinversión en Argentina, 2015-2017
Autor: | Alejandro Regueiro, Ricardo Mastai, Martín Cañás, María Noble, Julián Bustin, Martín Urtasun |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Argentina
Psychological intervention lcsh:Medicine Social Welfare Cobertura de los Servicios de Salud 03 medical and health sciences Tratamiento Farmacológico 0302 clinical medicine Drug Therapy Osteoarthritis Medicine 030212 general & internal medicine Investments Glucosamine Health Services Coverage business.industry 030503 health policy & services Health Policy Incidence (epidemiology) Glucosamina lcsh:Public aspects of medicine Chondroitin Sulfates Anti-Inflammatory Agents Non-Steroidal lcsh:R Public Health Environmental and Occupational Health lcsh:RA1-1270 Sulfatos de Condroitina Osteoartritis Antiinflamatorios no Esteroideos 0305 other medical science business Sale price Healthcare system Demography Inversiones en Salud |
Zdroj: | Salud Colectiva, Vol 17 (2021) Salud colectiva, Volume: 17, Article number: e3246, Published: 06 MAR 2021 |
ISSN: | 1851-8265 1669-2381 |
Popis: | RESUMEN En abril de 2016, el Instituto Nacional de Servicios Sociales para Jubilados y Pensionados excluyó del subsidio social la cobertura al 100% de 159 fármacos, entre ellos, los antiartrósicos sintomáticos de acción lenta o symptomatic slow-acting drugs for osteoarthritis (SySADOA), por insuficiente evidencia de beneficio clínico significativo. Evaluamos el efecto de esta medida sobre la utilización de SySADOA y de los antiinflamatorios no esteroides (AINE), no afectados por la medida. Se compararon las dispensas ambulatorias de los SySADOA y los AINE de 2015 a 2017, midiendo unidades dispensadas, precio de venta al público y gasto de bolsillo del beneficiario para cada mes. Luego de la medida, descendieron un 61,6% los envases de SySADOA dispensados y un 63,4% el monto total del precio de venta al público, medido en valores constantes. La dispensa no se reorientó hacia los AINE, que descendieron un 6,1%. Disminuyó tanto la incidencia de nuevos tratamientos (de 6,4 a 3,3 tratamientos por 1.000 beneficiarios por mes) como su continuidad. El gasto de bolsillo de los beneficiarios en SySADOA aumentó un 75,8% (a valores constantes). La desinversión en intervenciones de valor terapéutico cuestionable es una herramienta valiosa para la sustentabilidad de los sistemas de salud. ABSTRACT In April 2016, the National Institute of Social Services for Retirees and Pensioners discontinued its policy of 100% coverage for 159 drugs (the “social subsidy”), including symptomatic slow-acting drugs for osteoarthritis (SYSADOAs), due to insufficient evidence of significant clinical benefit. We evaluated the effect of this measure on the use of SYSADOAs as well as non-steroidal anti-inflammatory drugs (NSAIDs), which were unaffected by this policy change. We compared outpatient dispensations of SYSADOAs and NSAIDs from 2015 to 2017, measuring dispensed units, retail price, and out-of-pocket expenses for beneficiaries each month. After the change in coverage, there was a 61.6% total decrease in SYSADOA units dispensed, and a 63.4% decrease in the final sales price to the public, measured in constant values. Dispensation was not reoriented towards NSAIDs, which fell by 6.1%. The incidence of new treatments decreased (from 6.4 to 3.3 treatments per 1,000 beneficiaries per month), as did their continuity. Beneficiaries’ out-of-pocket spending on SYSADOAs increased by 75.8% (at constant values). Disinvestment in interventions with questionable therapeutic value is an important tool in working toward the sustainability of health systems. |
Databáze: | OpenAIRE |
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