Social relevance of evidence-based medicine in the Brazilian drug market

Article type
Authors
Marin dos Santos D1, Barroso L1, Atallah A1, Silva E1
1Brazilian Cochrane Centre and Federal University of São Paulo, Brazil
Abstract
Background: Brazil is the ninth largest market for drugs and medicines in the world. It is expected to grow between 8% and 11% by 2013, according to data from IMS Health. A relevant share of this market is related to phytotherapics and self-medication, which occurs especially among the poorest families.

Objectives: Determine the use of drugs and other medical supplies according to social class and relate it to the market as a whole. Identify the expenditures made by the social classes C, D and E and relate them to classes A and B. Relate Evidence-bases medicine to social justice and the right to health.

Methods: We researched the online databases of the Ministry of Health, the National Agency of Sanitary Surveillance (Anvisa) and the Pharmaceutical Industry Association in Brazil (Interfarma), seeking for all the information about social class variation in medicine use in the country.

Results: In 2009, the Brazilian families spent about 23.8 billion reais (15.86 billion dollars) on drugs. Social classes A and B (with the highest income in the country) consumed, respectively, 2.2 and 3.1 billion reais (9.3% and 13% of total). Social class C consumed 5.5 billion reais (23.2%), class D consumed 8.1 billion dollars (34%) and class E consumed 4.9 billion reais (20.5%). Together, classes C, D and E spent 18,5 billion reais (77,7%).

Conclusions: Classes C, D and E are responsible for a relevant share of Brazilian pharmaceutical market. They have no access to any evidence, but to mass media. Therefore, lack of evidence, beyond the potential damage to health, can affect the income of poor families in Brazil. A comprehensive access to medical evidence can reduce unnecessary use of drugs and self-medication in social classes C, D and E in Brazil, protecting the right to health and increasing social justice.