Farmácia Popular Program in a health system perspective (Brazil, 2002–2013)
| Potential effects | Findings | Source | |
| FPG-public | AFP-private | ||
| I. Individual, household and community health service delivery | |||
| Profile of target population | Controversial findings on actual users’ profile regarding the target population of FPP | Literature review ISAUM data set | |
| Availability of medicines | No direct information, but found as highly satisfied patients with availability | Literature review | |
| User satisfaction | Satisfaction with FP service and interventions over time | Literature review | |
| Affordability and expenditures | Lower spending in regard to private pharmacies and to AFP-private; zero copayment from users after SNP for covered medicines | Patient share of copayment increased with the implementation of AFP-private-2, following decrease of the reference price, and decreased with SNP (zero copayment for patients). | ISAUM data set |
| Equitable access to medicines | No gender difference in access to FP | ISAUM data set | |
| Changes on medicines-seeking behaviour | Increased number of dispensations over time, but SUS-DF remained the most important source for medicines, especially for HTN and DM | Literature review | |
| Adherence to treatments | No information | PDC decreased after AFP-private2 and increased with SNP | ISAUM data set |
| II. Health service delivery | |||
| Pharmaceutical sector information system | An information system for FRG but not so detailed | AFP-private has a huge information system able to identify information at the patient level. | Literature review |
| Availability of medicines | Good availability | Literature review | |
| Quality of pharmaceutical services | Pharmaceutical services better than in SUS-DF and in private pharmacies | No improvements on pharmaceutical services provided | Literature review |
| Changes on prescribing behaviour | The inclusion of medicines in FP reference list increased its use in the whole market. | ISAUM data set | |
| Geographical accessibility | FPG-public is more present in the north and north-east regions, poorest regions in Brazil. | More present in big municipalities rather than in small and poorest ones | ISAUM data set |
| Changes on healthcare-seeking behaviour | No information | Hospitalisation for HTN and DM decreased in all studied period, and it is not possible to determine the contribution of FP since there were important changes on PHC and health promotion in Brazil in the last years. Outpatient healthcare increased for both HTN and DM as well, but again it is not possible to isolate the contribution of FP. | ISAUM data set |
| III. Health sector | |||
| Effects on pharmaceutical market | Low effect in the pharmaceutical market because of the low number of facilities | The inclusion in FP increased sales volume of medicines included in the reference list, especially losartan. | ISAUM data set |
| Generics represent the biggest market share within FPP sales. | |||
| Government expenditures on medicines | Low prices for medicines | Government expenditure increased for anti-HTN and anti-DM treatments in FP. This increase was followed by patients’ entrance in the programme. Despite the increase, the cost per treatment was reduced after the AFP-private implementation. | ISAUM data set |
| Financial sustainability | This arm was interrupted in 2017; MoH justified this decision because of administrative costs. | Government cost on FP is higher than in SUS-DP. | ISAUM data set |
| IV and V. National and international context | |||
| Alignment with national health policies and cross-cutting policies | It is argued by some authors that Farmácia Popular plays a role as part of the MoH strategy to contain the pharmaceutical industry’s commercial deficit by encouraging the link between national production of pharmaceuticals and SUS network management. | Literature review | |
| Alignment with national politics environment | Farmácia Popular constituted an important government programme during Lula mandate. | Literature review | |
AFP-private, here we have Farmácia Popular (Aqui tem Farmácia Popular); AFP-private 2, implemented in 2009; AFP-private1, implemented in 2006; DM, diabetes; FPG, Programa Farmácia do Brasil - Rede Própria (Governmental Farmacia Popular); FPP, Farmácia Popular Program; HTN, hypertension; ISAUM, Impact of consecutive subsidies policies on access to and use of medicines in Brazil; MoH, Ministry of Health; PDC, proportion of days covered; SNP, health has no price (Saúde Não Tem Preço); SUS-DF, Unified Health System dispensing facilities.