Neuropsychiatric drugs expenditure’ trends and drivers in Minas Gerais, Brazil, from 2010 to 2017

Background: Increasing consumption of neuropsychiatric drugs leads to rising expenditure with the potential to compromise public health budgets. This study analyzes public expenditures on neuropsychiatric drugs, its trends and drivers.

Methods: Drug Utilization Study based on longitudinal data from the Integrated System for Materials and Services Management (SIAD) database from Minas Gerais’ State (20.8 mi inhab.), Brazil. Volume and inflation-adjusted expenditure were calculated for neuropsychiatric drugs purchased from 2010 to 2017. Procurement trends were estimated. Decomposition analysis was performed to identify the determinants of public expenditure variation (price, volume and / or therapeutic choice).

Results: From 2010 to 2017, 168 chemical substances in 565 pharmaceutical products were purchased, totaling 4.03 million drug packages of neuropsychiatric drugs. Purchased quantities decreased by 34.5%, from 472 million in 2010 to 163 million units in 2017. Total accumulated expenditure for the period was USD 256.3 million, also recording a downward trend, falling 36% in 2017 when compared to 2010. Main expenditure variation drivers were volume and therapeutic choice.

Conclusion: This study contributes to a better understanding of public expenditures on neuropsychiatric drugs. The observed reduction on expenditures and purchased volumes may have been influenced by the new procurement policy for medicines, adopted in Minas Gerais in 2016, with management centered on the municipalities. It is necessary, however, to further evaluate this policy’s impact on municipalities to avoid the risk of shortage of medicines for their population.