Costs and regulation in Brazilian market of immunosuppressive drugs used in the maintenance of renal transplantation in adults

Abstract

Objective: Analyze and compare, from the public and private perspectives, costs of immunosuppressive drugs used for maintenance treatment after kidney transplant in adult patients. Methods: It was a descriptive and comparative study of the costs of immunosuppressive drugs. For this was used the standard list of drug price of the Câmara de Regulação do Mercado Farmacêutico to the public costs of medicines, ABCFarma Magazine for private prices and International drug price guide 2010 to international prices. Results: It was identified 34 different pharmaceutical companies and four of these are government official laboratories. All immunosuppressants and the prednisone (P) were classified as essential. The lowest average price of the milligram was mycophenolate mofetil (MMF), followed by azathioprine (AZA) and cyclosporine (CsA) in all perspectives. On the other hand, the most expensive were everolimus (EVL) and sirolimus (SRL). Tacrolimus (TAC) is more expensive than CsA. Regarding treatment strategies, CsA+AZA+P, TAC+AZA+P and CsA+MMF+P showed lower annual cost respectively. The particular treatment is 170% more expensive if the patient has to take it. Overall the product is more expensive in Brazil than in the international scenario. Conclusions: The treatment after renal transplantation is chronic and has a high cost. The health system has guaranteed access to these medicines to the population since the particular patient’s treatment is not feasible. It was observed a lack of investment and valuation of government to the official laboratories that, in conflict situations, could contribute to, among other things, reduce costs and improve access.