The pharmacy chain serves people with chronic diseases, such as asthma and hypertension, and who are therefore at risk for the coronavirus.
In 2020, the first year of the pandemic, there were 20.1 million beneficiaries in the program. This is 1.2 million less than in the previous year. 2020 coverage was the lowest since 2014.
The data are from the Ministry of Health, obtained by sheet through the Access to Information Law.
Created in 2004, Farmácia Popular distributes basic medicines free of charge for hypertension, diabetes and asthma through private pharmacies with agreements. Medicines to control rhinitis, Parkinson’s disease, osteoporosis and glaucoma, in addition to contraceptives, are sold at a discount of up to 90%.
For the president of Conasems (national council of municipal health secretariats), Willlames Freire Bezerra, the Popular Pharmacy expands access to medicines for people with comorbidities, who, without the program, have to go to a Covid treatment site, such as public hospitals, to try to get the medicine through the public health network.
“The program reduces the value of medicines for the most deprived and also improves access [aos remédios] at a time of pandemic in which the population is experiencing financial and mobility difficulties ”, said Bezerra, who is the municipal secretary of Pacatuba (CE).
The number of pharmacies also dropped last year to 30,988 units. This is the lowest level since 2013. In 2015, the peak of the service network, there were 34,625 pharmacies.
New pharmacies have been prevented from registering for the program since December 2014. At the time, the government of ex-president Dilma Rousseff (PT) suspended accreditation because it had already reached the coverage network goal that year.
The process, however, has not been reopened until today. Wanted, the Ministry of Health reported that there is no deadline for return of accreditation.
The accredited units receive reimbursement from the federal government for the drugs distributed through the program.
Since the beginning of the government, Bolsonaro’s team has put Farmácia Popular on the list of programs to be closed. The objective, according to members of the team of Minister Paulo Guedes (Economy), is to use this public resource in other actions.
When the government sought funds to finance a new social program, after an eventual reformulation of Bolsa Família, one of the possibilities was to end the action of Farmácia Popular. These studies were done last year, that is, in the midst of the coronavirus pandemic.
“The Popular Pharmacy cannot end. It is the treatment of diseases that need continuous medication. Without medication, the situation can worsen and lead to hospitalization, which has a much higher cost for the health system ”, said the deputy, Carmen Zanotto (Cidadania-SC), who chairs the Mixed Parliamentary Health Front in Congress.
For 2021, the program budget has been reduced. Last year, R $ 2.7 billion were reserved, in amounts adjusted for inflation. For this year, the budget is R $ 2.5 billion, despite the worsening of the pandemic.
The cut contrasts with the boosted budget approved by Congress for parliamentary amendments, in the amount of R $ 48.8 billion, mainly in the area of government works. Amendments are ways for a deputy or senator to direct resources to projects with a direct impact on electoral bases and, thus, to gain political capital for the next elections.
The Ministry of Health stated that “Farmácia Popular does not replace the actions and programs of responsibility of state and municipal health managers, regarding the availability of medicines for the population”.
According to the folder, access to medicines by the program is complementary to the actions of these entities and care must be guaranteed in basic health units and municipal pharmacies.
The government also declared that, despite the drop in the number of people served by the Popular Pharmacy, it adopted more flexible rules last year, on an exceptional and temporary basis, such as extending the period of validity of medical prescriptions, reports and certificates to 365 days from from the date of issue. This, according to the ministry, generated an increase in the number of drugs released by the program.
The program currently operates in 4,394 municipalities – about 80% of Brazilian cities.
The National Health Plan, which outlines strategies for the portfolio until 2023, sets the goal of expanding coverage in cities with up to 40,000 inhabitants. The goal is for the network to serve 90% of these small municipalities.
The document highlights that “evidence has shown that the PFPB [Programa Farmácia Popular do Brasil] reduced hospital admissions and mortality in relation to hypertension and diabetes ”.
But the size of the program has been registering successive setbacks. In 2016, for example, 4,467 municipalities were served.
In 2017, the government of ex-president Michel Temer (MDB) closed all of its own units in the Farmácia Popular program with public budget resources.
There were about 400 service points, including in cities that did not have a private pharmacy accredited in the other modality. Pharmacy Popular’s own chain, in addition, distributed a greater variety of medicines — 1,112 medicines, against 32 available at private drugstore agreements.
The argument, at the time, was that transfers to the own units of Farmácia Popular ended up improving management, because of the R $ 100 million spent per year, R $ 80 million were administrative costs. The amount, however, is small in relation to the total available for the program. The cut in the cities served occurred mainly in the North and Northeast regions.
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