Federal procurement of antineoplastic drugs in Brazil: analysis of imatinib mesylate, trastuzumab and L-asparaginase, 2004-2013

Moraes, Elaine Lazzaroni; Osorio-de-Castro, Claudia Garcia Serpa; Caetano, Rosangela

doi:10.1590/S0103-73312016000400015

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Physis: Revista de Saúde Coletiva

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Temas Livres • Physis 26 (4) • Oct 2016 • https://doi.org/10.1590/S0103-73312016000400015 copy

Federal procurement of antineoplastic drugs in Brazil: analysis of imatinib mesylate, trastuzumab and L-asparaginase, 2004-2013

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To analyze the Brazilian federal procurement profile for imatinib mesylate, trastuzumab and L-asparaginase from January 2004 to December 2013.

Methods:

Information was extracted from the Brazilian Federal Government procurement database and included volume, unit price, date and type of purchase, government agency buyer. Prices were deflated to December 2013 by the Brazilian Pricing Index.

Results:

Purchase volumes of imatinib and trastuzumab increased progressively. The Ministry of Health was the main buyer. Weighted average prices (WAP) for these medicines showed a downward trend. A WAP reduction for imatinibe occurred before centralized purchases by the Ministry of Health began. After incorporation by CONITEC and centralized purchases in 2012, trastuzumab WAP was reduced by 57%. For L-asparaginase volumes and prices varied among different government agencies, but contrary to the two other medicines, L-asparaginase presented a 117% WAP increase, possibly reflecting stockouts in the international market.

Conclusions:

The setting of Productive Development Partnerships (PDPs) and centralized purchasing by the Brazilian Ministry of Health suggest a decrease in prices for imatinib and trastuzumab, underlining the government´s purchasing power. These reductions may contribute to availability of these medicines in the Brazilian Public Health System.

Keywords:
pharmaceutical services; drug price; antineoplastic agents; public procurement; public-private partnerships.

Medicamento/ Ano	Tipo de Compra
	Regulares			Demandas Judiciais		Total
	Nº Unid.	PMP^a	Nº Unid.	PMP^a	Nº Unid.	PMP^a
Imatinibe 100 mg				PMP^a	Nº Unid.	PMP^a
2004	313.700	87,47	(...)	NA	313.700	87,47
2005	424.888	61,36	960	61,97	425.848	61,37
2006	479.212	61,33	10.080	58,25	489.292	61,27
2007	732.478	63,75	6.360	65,54	738.838	63,76
2008	514.460	61,46	12.240	67,52	526.700	61,63
2009	476.830	46,23	7.560	68,22	484.390	46,57
2010	933.229	27,62	5.160	40,26	938.389	27,69
2011	2.298.836	24,74	(...)	NA	2.298.836	24,74
2012	164.266	23,09	(...)	NA	164.266	23,09
2013	441.848	18,47	360	20,60	442.208	18,48
Total	6.779.747		42.720		6.822.467
Imatinibe 400 mg					6.822.467
2004	(...)	NA	390	266,71	390	266,71
2005	92.750	235,95	1.080	247,90	93.830	236,09
2006	84.210	229,06	720	234,56	84.930	220,62
2007	215.061	255,14	1.590	271,32	216.651	255,26
2008	265.315	239,25	2.010	276,84	267.325	239,53
2009	290.206	202,68	3.270	272,10	293.476	203,45
2010	751.544	112,41	720	204,72	752.264	112,50
2011	4.437.490	98,54	(...)	NA	4.437.490	98,54
2012	171.680	92,36	960	89,20	172.640	92,36
2013	1.909.910	60,26	3.510	145,44	1.913.420	60,41
Total	8.218.166		14.250		8.232.416
Trastuzumabe 440mg					8.232.416
2004	(...)	NA	(...)	NA	(...)	NA
2005	50	11.939,18	7	11.939,18	57	11.939,18
2006	786	11.754,97	38	12.027,16	824	11.767,53
2007	875	11.462,08	120	8.502,78	995	11.105,18
2008	1.710	11.222,11	258	8.434,15	1.968	10.856,61
2009	3.140	10.989,29	838	8.443,17	3.978	10.452,93
2010	4.986	9.988,55	488	8.488,48	5.474	9.854,82
2011	9.192	8.462,82	45	7.822,47	9.237	8.459,70
2012	21.387	4.355,68	10.698	7.998,60	32.085	5.570,32
2013	15.463	8.207,48	(...)	NA	15.463	8.207,48
Total	57.589		12.492		70.081
L- asparaginase					70.081
2004	3.386	125,63	(...)	NA	3.386	125,63
2005	(...)	NA	(...)	NA	(...)	NA
2006	2.986	112,09	(...)	NA	2.986	112,09
2007	6.805	115,13	(...)	NA	6.805	115,13
2008	9.160	100,63	(...)	NA	9.160	100,63
2009	5.835	116,98	(...)	NA	5.835	116,98
2010	6.445	118,96	(...)	NA	6.445	118,96
2011	1.897	110,51	(...)	NA	1.897	110,51
2012	11.313	155,39	(...)	NA	11.313	155,39
2013	53.777	330,75	(...)	NA	53.777	330,75
Total	101.604		(...)		101.604

Medicamento/ Ano	Órgão Comprador
	Minist. Saúde			Minist. Educação			Minist. Defesa		Outros
	Nº Unid.	PMP^a	Nº Unid.	PMP^a	Nº Unid.	PMP^a	Nº Unid.	PMP^a
Imatinibe 100mg					Nº Unid.	PMP^a	Nº Unid.	PMP^a
2004	49.760	72,92	313.700	87,47	480	94,22	(...)	NA
2005	100.700	68,51	317.948	58,53	7.200	86,74	(...)	NA
2006	167.182	68,77	318.320	56,78	3.790	107,16	(...)	NA
2007	395.400	65,95	336.638	60,49	6.800	98,35	(...)	NA
2008	138.720	61,88	346.060	58,04	15.640	145,53	26.280	57,71
2009	72.360	47,44	379.540	44,42	32.490	69,86	(...)	NA
2010	115.942	26,67	816.187	27,71	500	92,71	5.760	40,56
2011	2.058.276	24,59	231.700	24,59	8.860	63,35	(...)	NA
2012	(...)	NA	154.176	23,09	2.320	23,09	7.770	23,09
2013	379.908	17,01	21.480	21,05	29.760	32,86	11.060	25,14
Total	3.478.248	50,42	3.235.749	46,22	107.840	81,39	50.870	36,63
Imatinibe 400mg					107.840	81,39	50.870	36,63
2004	390	266,71	(...)	NA	(...)	NA	(...)	NA
2005	1.080	247,90	83.480	229,75	9.270	291,79	(...)	NA
2006	720	221,49	82.450	215,17	1.760	475,97	(...)	NA
2007	88.710	271,22	123.560	241,56	1.681	486,59	2.700	213,53
2008	86.610	242,68	141.930	235,51	4.410	373,40	34.375	231,02
2009	76.560	163,91	144.140	191,05	52.976	288,18	19.800	219,95
2010	82.926	105,04	632.928	110,11	3.800	260,31	32.520	160,64
2011	4.286.430	98,36	142.600	98,36	8.460	192,06	0	NA
2012	8.160	92,36	122.760	92,35	8.340	92,36	33.380	92,36
2013	1.758.830	65,72	107.250	78,22	34.720	139,27	12.620	114,07
Total	6.390.416	177,54	1.581.098	165,79	125.417	288,88	135.395	171,93
Trastuzumabe 440mg					125.417	288,88	135.395	171,93
2004	(...)	NA	(...)	NA	(...)	NA	(...)	NA
2005	4	11.939,18	(...)	NA	53	11.939,18	(...)	NA
2006	38	12.027,16	20	11.574,24	166	11.947,99	600	11.707,60
2007	840	11.041,55	40	11.407,90	115	11.464,68	(...)	NA
2008	1.686	10.801,82	(...)	NA	282	11.184,18	(...)	NA
2009	2.094	9.759,99	56	10.901,95	1.770	11.252,84	58	10.625,91
2010	4.789	9.679,32	130	10.787,88	435	11.262,42	120	10.745,18
2011	2.169	9.239,53	148	10.427,90	920	10.460,39	6.000	7.822,47
2012	22.925	4.361,59	148	10.318,58	930	10.328,60	8.082	8.364,48
2013	5.409	8.637,79	1.240	9.314,25	1.230	9.409,62	7.584	7.524,64
Total	39.954	8.748,79	1.782	10.676,10	5.901	11.027,76	22.444	9.465,05
L-asparaginase					5.901	11.027,76	22.444	9.465,05
2004	1.343	127,81	1.875	124,29	168	123,18	(...)	NA
2005	(...)	NA	(...)	NA	(...)	NA	(...)	NA
2006	826	113,92	2.160	111,40	(...)	NA	(...)	NA
2007	3.471	118,55	1.050	111,06	10	109,39	2.274	111,81
2008	1.610	100,18	4.306	105,47	60	122,65	3.184	93,89
2009	1.050	98,25	4.185	122,84	600	108,92	(...)	NA
2010	600	94,19	5.845	121,50	0	NA	(...)	NA
2011	610	106,87	1.167	109,91	120	134,89	(...)	NA
2012	840	90,09	5.043	151,11	460	130,85	4.970	173,03
2013	52.990	334,20	780	98,36	(...)	NA	7	152,78
Total	63.340	131,56	26.411	117,33	1.418	121,65	10.435	132,88

Medicamento	PMP^a do ano anterior pré-centralização	Preço^b acordado para compra centralizada	% variação
Trastuzumabe 440mg f/a	8.459,70	3.625,54	-57,1
Imatinibe 400mg cp	112,50	98,36	-12,6
Imatinibe 100mg cp	27,69	24,59	-11,2
L-Asparaginase 10.000UI f/a	155,39	337,30	117,0

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