Exploratory analysis of requests for authorization to dispense high-cost medication to COPD patients: the São Paulo “protocol”
ABSTRACT Objective: A resolution passed by the government of the Brazilian state of São Paulo established a protocol for requesting free COPD medications, including tiotropium bromide, creating regional authorization centers to evaluate and approve such requests, given the high cost of those medications. Our objective was to analyze the requests received by an authorization center that serves cities in the greater metropolitan area of (the city of) São Paulo between 2011 and 2016. Methods: Data regarding the authorization, return, or rejection of the requests were compiled and analyzed in order to explain those outcomes. Subsequently, the clinical and functional data related to the patients were evaluated. Results: A total of 7,762 requests for dispensing COPD medication were analyzed. Requests related to male patients predominated. Among the corresponding patients, the mean age was 66 years, 12% were smokers, 88% had frequent exacerbations, and 84% had severe/very severe dyspnea. The mean FEV1 was 37.2% of the predicted value. The total number of requests decreased by 24.5% from 2012 to 2013 and was lowest in 2015. Most (65%) of the requests were accepted. The main reasons for the rejection/return of a request were a post-bronchodilator FEV1/FVC ratio > 0.7, a post-bronchodilator FEV1 > 50% of the predicted value, and failure to provide information regarding previous use of a long-acting β2 agonist. During the study period, the total number of requests returned/rejected decreased slightly, and there was improvement in the quality of the data included on the forms. Conclusions: Here, we have identified the characteristics of the requests for COPD medications and of the corresponding patients per region served by the authorization center analyzed, thus contributing to the improvement of local public health care measures.
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Sociedade Brasileira de Pneumologia e Tisiologia
2019
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oai:scielo:S1806-371320190006004002019-12-10Exploratory analysis of requests for authorization to dispense high-cost medication to COPD patients: the São Paulo “protocol”Carvalho-Pinto,Regina MariaSilva,Ingredy Tavares daNavacchia,Lucas Yoshio KidoGranja,Flavia MunhosMarques,Gustavo GarciaNery,Telma de Cassia dos SantosFernandes,Frederico Leon ArrabalCukier,AlbertoStelmach,Rafael Pulmonary disease, chronic obstructive Clinical protocols Drug costs Tiotropium bromide ABSTRACT Objective: A resolution passed by the government of the Brazilian state of São Paulo established a protocol for requesting free COPD medications, including tiotropium bromide, creating regional authorization centers to evaluate and approve such requests, given the high cost of those medications. Our objective was to analyze the requests received by an authorization center that serves cities in the greater metropolitan area of (the city of) São Paulo between 2011 and 2016. Methods: Data regarding the authorization, return, or rejection of the requests were compiled and analyzed in order to explain those outcomes. Subsequently, the clinical and functional data related to the patients were evaluated. Results: A total of 7,762 requests for dispensing COPD medication were analyzed. Requests related to male patients predominated. Among the corresponding patients, the mean age was 66 years, 12% were smokers, 88% had frequent exacerbations, and 84% had severe/very severe dyspnea. The mean FEV1 was 37.2% of the predicted value. The total number of requests decreased by 24.5% from 2012 to 2013 and was lowest in 2015. Most (65%) of the requests were accepted. The main reasons for the rejection/return of a request were a post-bronchodilator FEV1/FVC ratio > 0.7, a post-bronchodilator FEV1 > 50% of the predicted value, and failure to provide information regarding previous use of a long-acting β2 agonist. During the study period, the total number of requests returned/rejected decreased slightly, and there was improvement in the quality of the data included on the forms. Conclusions: Here, we have identified the characteristics of the requests for COPD medications and of the corresponding patients per region served by the authorization center analyzed, thus contributing to the improvement of local public health care measures.info:eu-repo/semantics/openAccessSociedade Brasileira de Pneumologia e TisiologiaJornal Brasileiro de Pneumologia v.45 n.6 20192019-01-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132019000600400en10.1590/1806-3713/e20180355 |
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Carvalho-Pinto,Regina Maria Silva,Ingredy Tavares da Navacchia,Lucas Yoshio Kido Granja,Flavia Munhos Marques,Gustavo Garcia Nery,Telma de Cassia dos Santos Fernandes,Frederico Leon Arrabal Cukier,Alberto Stelmach,Rafael |
spellingShingle |
Carvalho-Pinto,Regina Maria Silva,Ingredy Tavares da Navacchia,Lucas Yoshio Kido Granja,Flavia Munhos Marques,Gustavo Garcia Nery,Telma de Cassia dos Santos Fernandes,Frederico Leon Arrabal Cukier,Alberto Stelmach,Rafael Exploratory analysis of requests for authorization to dispense high-cost medication to COPD patients: the São Paulo “protocol” |
author_facet |
Carvalho-Pinto,Regina Maria Silva,Ingredy Tavares da Navacchia,Lucas Yoshio Kido Granja,Flavia Munhos Marques,Gustavo Garcia Nery,Telma de Cassia dos Santos Fernandes,Frederico Leon Arrabal Cukier,Alberto Stelmach,Rafael |
author_sort |
Carvalho-Pinto,Regina Maria |
title |
Exploratory analysis of requests for authorization to dispense high-cost medication to COPD patients: the São Paulo “protocol” |
title_short |
Exploratory analysis of requests for authorization to dispense high-cost medication to COPD patients: the São Paulo “protocol” |
title_full |
Exploratory analysis of requests for authorization to dispense high-cost medication to COPD patients: the São Paulo “protocol” |
title_fullStr |
Exploratory analysis of requests for authorization to dispense high-cost medication to COPD patients: the São Paulo “protocol” |
title_full_unstemmed |
Exploratory analysis of requests for authorization to dispense high-cost medication to COPD patients: the São Paulo “protocol” |
title_sort |
exploratory analysis of requests for authorization to dispense high-cost medication to copd patients: the são paulo “protocol” |
description |
ABSTRACT Objective: A resolution passed by the government of the Brazilian state of São Paulo established a protocol for requesting free COPD medications, including tiotropium bromide, creating regional authorization centers to evaluate and approve such requests, given the high cost of those medications. Our objective was to analyze the requests received by an authorization center that serves cities in the greater metropolitan area of (the city of) São Paulo between 2011 and 2016. Methods: Data regarding the authorization, return, or rejection of the requests were compiled and analyzed in order to explain those outcomes. Subsequently, the clinical and functional data related to the patients were evaluated. Results: A total of 7,762 requests for dispensing COPD medication were analyzed. Requests related to male patients predominated. Among the corresponding patients, the mean age was 66 years, 12% were smokers, 88% had frequent exacerbations, and 84% had severe/very severe dyspnea. The mean FEV1 was 37.2% of the predicted value. The total number of requests decreased by 24.5% from 2012 to 2013 and was lowest in 2015. Most (65%) of the requests were accepted. The main reasons for the rejection/return of a request were a post-bronchodilator FEV1/FVC ratio > 0.7, a post-bronchodilator FEV1 > 50% of the predicted value, and failure to provide information regarding previous use of a long-acting β2 agonist. During the study period, the total number of requests returned/rejected decreased slightly, and there was improvement in the quality of the data included on the forms. Conclusions: Here, we have identified the characteristics of the requests for COPD medications and of the corresponding patients per region served by the authorization center analyzed, thus contributing to the improvement of local public health care measures. |
publisher |
Sociedade Brasileira de Pneumologia e Tisiologia |
publishDate |
2019 |
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http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132019000600400 |
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