Análise das compras de medicamentos antineoplásicos pelo Instituto Nacional de Câncer no período 2012 a 2021

Abstract

Cancer is considered a serious public health problem, and its treatment is characterized by high costs and a differentiated financing system. The National Cancer Institute (INCA), a reference in oncology, is a budgeted unit and has the autonomy to carry out its bidding processes and purchase its products. This study analyzed purchases of antineoplastic drugs carried out by the Institute between 2012 and 2021, with the purpose of identifying the purchasing processes adopted, expenses and prices practiced in a period marked by changes in the political, economic and health scenario. A study was carried out with a descriptive and quantitative approach, retrospective in nature, in the form of a case study. Public data obtained from the Integrated General Services Administration System (SIASG) was collected. The medicines were categorized according to the Anatomical Therapeutic Chemical Classification (ATC) and prices were deflated for December/2021, through the annual variation of the Broad National Consumer Price Index (IPCA). The contracted financial amounts, acquisition modalities, contracted suppliers, periods of shortages and antineoplastic drugs with the greatest financial impact on INCA were observed. Regarding medicines, in the period between 2012 and 2021, INCA's contracted expenses, corrected for December/2021, reached R$ 1,722,446,971.13, of which R$ 766,735,627.05 related to antineoplastics drugs. During the period evaluated, 722 records of antineoplastic purchases were made, with a total of 6,639,601 pharmacotechnical units purchased and 87% of purchases were made through bidding. A tendency to reduce spending on the acquisition of antineoplastics was noted throughout the historical series. The highest contracted value was observed in the group of monoclonal antibodies and antibody drug conjugates followed by protein kinase inhibitors. Trastuzumab 440mg and rituximab 10mg/mL 50mL being the antineoplastics drugs with the greatest financial impact. The study made it possible to verify the importance of government policies on public purchasing processes as well as the influence of market factors on the acquisitions of health institutions.