Variability in Drug Procurement within Group 1B of the Pharmaceutical Specialized Scheme in Brazil

Abstract

In the Brazilian Health System (SUS), drugs covered by the Specialized Pharmaceuti-cal Scheme (CEAF) receive federal funding and can be procured either centrally (Group 1A) or by individual states (Federal Units -UF) (Group 1B). Unlike other countries where national pro-curement prices are negotiated centrally by the government, public procurement in Brazil follows a public auction procedure, potentially resulting in varying purchase prices. To facilitate price comparisons, it is a legal requirement to register public acquisitions in the Health Prices Registry (BPS). This study aimed to assess the variabili-ty in the procurement prices for Group 1B drugs across the 27 Brazilian states during 2021. Data on the acquisitions of Group 1B drugs by the 27 Health Secretariats were obtained from the BPS. Drugs with no reported reimbursement prices as of December 2021 were excluded from the anal-ysis. The total reimbursement amount for each state was sourced from the SUS Ambulatory In-formation System. The findings revealed signifi-cant variability in drug procurement prices both across and within states. The study underscored a potential disparity in CEAF access, favoring wealthier states (those with larger populations and higher economic status) by securing lower drug prices.