Drug subsidy programs in the developing world: The impact of the 'Farmacia Popular' program on health outcomes in Brazil.

摘要

Improved access to medications is associated with not only improved health status, but also with reduced expenditure in more complex medical procedures. This paper uses regression analysis to evaluate the impact of the Brazilian prescription drug reimbursement program "Farmacia Popular" (hereafter FP) on health outcomes, while controlling for other factors that affect health. To date, no existing studies have evaluated the program using multivariate regression. These findings can provide guidance as to the usefulness of future program expansion. Publicly available data at the state level over the 2003-2007 period are combined into a panel dataset, which allows the analysis of the period before and after the program was implemented. Data on hospitalizations due to hypertension diseases is used as the dependent variable, and fixed-effects and random-effects analysis is used to control for state-specific characteristics that may confound the relationship of interest. Results show that the program had a weak statistically significant impact on health outcomes (p>0.109) and indicate that a 1% increase in the number of FP pharmacies is associated with a 0.02% decrease in hospitalizations, after controlling for other factors influencing hospitalization due to hypertension diseases. Among the control variables in the Fixed Effects model, only education was statistically significant (p>0.006), indicating that a 1% increase in illiteracy rates leads to a 0.51% increase in hospitalizations, holding all variables in the model constant. These finding on the importance of education levels for hypertension conditions are strongly supported by the literature.;Although there are a series of limitations regarding the variables used in the model and a lack of control variables for behavioral characteristics, results indicate that drug reimbursement programs can be an effective way to increase affordability and access to medications in developing countries. Nonetheless, policymakers should carefully analyze many other factors related to drug access and the effect of education on hypertension diseases.