Pharmaceutical Care as a cost management strategy in the Public Administration of the SUS

Abstract

This study analyzes the costs resulting from therapeutic failures associated with Pharmacotherapy-Related Problems (PRPs) in municipal pharmaceutical services from the perspective of Public Administration. This is an analytical, cross-sectional, quantitative study based on a panel of specialists and grounded in the probability pathway model proposed by Johnson and Bootman. The research was conducted in a municipality in the Metropolitan Region of Salvador, Bahia, Brazil, using DATASUS data and local administrative records. Estimates of therapeutic failure were obtained from professionals experienced in outpatient care within the Brazilian Unified Health System (SUS). The estimated mean indicated that 41.73% of patients without pharmaceutical care follow-up experience therapeutic failure requiring a new prescription. Approximately 192,816 prescriptions were attributed to these failures. Direct costs were estimated at R$ 2.39 million, while the total cost of the therapeutic cycle reached R$ 7.94 million, corresponding to 9.32% of the municipal health budget. The results suggest that non-optimized pharmacotherapy represents an important source of avoidable costs. It is concluded that pharmaceutical care may contribute to improving medication use and increasing the efficiency of public health expenditure within SUS.

The average estimate indicated that 41.73% of outpatients without pharmaceutical care follow-up experience therapeutic failure requiring a new prescription. Based on the parameters analyzed, approximately 192,816 prescriptions were attributed to these failures. Direct costs were estimated at R$ 2.39 million, while the total cost of the therapeutic cycle reached R$ 7.94 million after adjustments, corresponding to 9.32% of the municipal health budget.

The results show that non-optimized pharmacotherapy constitutes a significant source of inefficiency in the use of public resources, reflecting weaknesses in the capacity to implement pharmaceutical care policies. It is concluded that pharmaceutical care can act as an organizational strategy to improve the use of medications, reduce avoidable costs, and increase the efficiency of public spending in the Brazilian Unified Health System (SUS).