Failures in Pharmaceutical Services management for Judicialized Medicines, in 16 municipalities of the Brazilian Southeast

ABSTRACT Since the 1990s, judicial demands for medicines have intensified. Several studies have outlined these demands. We describe the organization of the management of Municipal Pharmaceutical Services (PS) for the provision of medicines demanded through litigation. The sample included 16 municipalities, four for each state in the Brazilian Southeast. To describe the management profile of PS, a matrix of indicators was developed including dimensions of human and financial resources, and PS activities. In nine municipalities, management of medicines acquired through litigation was the responsibility of the local manager of PS. Indicators on expenditures with litigated medicines were the ones with the worst performance. Only six managers informed using technical analysis of prescriptions and regular contact with the judiciary. In seven municipalities, managers were unable to specify the modality of acquisition of medicines. Municipal management plays a major role in the management of PS and must be reviewed, with the need for a thorough questioning regarding its role and possible changes it needs to implement.

摘要 自20世纪90年代以来，医药相关司法诉求愈发凸显，已有多项研究对这类诉求进行了阐述。本研究旨在阐明市级药学服务（Municipal Pharmaceutical Services, PS）的管理架构，以应对通过诉讼途径提出的医药供给诉求。研究样本涵盖16个市级行政区，巴西东南部各州各选取4个。为刻画市级药学服务的管理特征，研究团队构建了一套涵盖人力资源、财务资源及药学服务活动维度的指标矩阵。在其中9个行政区中，诉讼所需医药产品的管理工作由当地市级药学服务负责人统筹负责。涉诉医药支出相关指标的表现最差。仅有6名负责人表示，其工作中会开展处方技术分析并与司法部门保持常态化沟通。另有7个行政区的负责人无法明确说明医药产品的采购方式。市级管理在药学服务管理中占据核心地位，亟需开展全面审视：需对其职能定位展开深入质询，并明确其亟需落实的各项变革举措。