Access To Medicines: Developing An Indicator To Assess The Impact of Public Policies

Measurement of access to medicines is fundamental to evaluate economic efficiency of public health policies. Access to medicines is one of the five indicators related to advances in guaranteeing the right to health care. Due to the complexity and difficulty of measuring access, studies involving synthesis of multiple indicators for the various dimensions of access are still scarce and, frequently, restricted to the supply/availability of services and/or specific medicines. There are few studies in the literature on synthesis indicators to measure access to medicines simultaneously in all dimensions. OBJECTIVES: To propose a unique indicator capable of synthesizing the dimensions of access to medicines. METHODS: The synthesis indicator was calculated by measuring the weight of the importance and satisfaction given by the citizens (n=580) to the access dimensions. For this measurement it was used a Likert scale in previously formulated questions about access to medicines. Data collection was done in 2016 with citizens who used private and/or public health services. The relative weight of each dimension was calculated by the ratio between the assigned weight and the sum of all of them together. The calculation was stratified by the place the medicine was obtained (public and/or private). RESULTS: All mean weights attributed to each of the dimensions were higher among individuals who exclusively used private services, when compared to those who exclusively used public services. The weight of economic accessibility showed to be about 30% higher for citizens who used the private sector compared to those who used public services. CONCLUSIONS: The synthesis indicator developed on access to medicines will allow to evaluate economic efficiency of public health policies. In addition, it enables to perform comparisons between policy models that enable access through the private, public or public-private to subsidize management and decision-making on health investments in Pharmaceutical Care field.