JORNAL DE ASSISTÊNCIA FARMACÊUTICA E FARMACOECONOMIA

Critical Analysis of Prescription Errors and Drug-Related Problems in a Hospital Setting

Sérgio Ricardo Fernandes de Araujo, Ana Roberta Pereira Johnson dos Anjos — Fri, 22 Aug 2025 00:00:00 +0000

_Objectives_{: This study aims to conduct a comprehensive qualitative and quantitative analysis of pharmaceutical occurrences recorded at the Prescription Assessment Center, focusing on prescription errors within the context of a university hospital (Onofre Lopes University Hospital). Methods: This research adopted a retrospective methodology, integrating qualitative and quantitative analyses to investigate pharmaceutical occurrences at Onofre Lopes University Hospital (HUOL) in 2022. Focusing on hospitalized adult patients, we evaluated recorded pharmaceutical interventions, covering aspects from indication to the risk of adverse effects. We utilized Python and its libraries for statistical analysis, including descriptive, association, temporal, and comparative analyses, adhering to strict statistical and ethical standards. Results: A total of 1,490 Medication-Related Problems (MRPs) were identified, with an average of 124 records per month, 41% of which were related to elderly patients. Excluding problems related to antimicrobial control, the primary MRPs identified were excessive dosage (26.63%), incomplete prescription (20.37%), and inadequate dilution (17.17%). Among high-risk medications, those most associated with recorded MRPs were 50% glucose (115 occurrences), opioid analgesics (37), and insulins (22). Conclusions: This study highlighted the importance of meticulous prescription evaluation in preventing Medication-Related Problems (MRPs) in a hospital setting. We identified a significant prevalence of MRPs, especially among elderly patients, underscoring the need for careful pharmacotherapy to mitigate risks. The analysis revealed that common errors included inadequate dosages and incomplete prescriptions, with high-risk medications frequently involved. The implementation of prevention strategies and continuous education for healthcare professionals is crucial to minimize the incidence of MRPs and optimize patient care.}

Cost-minimization and budget impact analysis of bypassing agents in hemophilia A with inhibitors: a Brazilian study

Thu, 14 Aug 2025 00:00:00 +0000

OBJECTIVE: The aim of the study was to compare the treatment with plasma-derived activated prothrombin complex concentrate (APCC) and recombinant activated FVII (rFVIIa) in patients with Hemophilia A with inhibitors, analyzing the costs and budget impact of prophylactic and on-demand treatment in the Brazilian Unified Health System (In Portuguese, Sistema Único de Saúde [SUS]). METHODS: This study performs a Cost-Minimization Analysis (CMA) and a Budget Impact Model) BIM for APCC versus rFVIIa in the prophylaxis and on-demand treatment in SUS perspective, based on analysis of guidelines and public databases from Brazil. RESULTS: The cost per patient for prophylaxis is estimated to be lower with APCC than in rFVIIa for the maximum dose with an incremental cost difference of BRL 2,730,798 (APCC BRL 3,325,894 versus rFVIIa BRL 6,056,692). The BIM estimated that 5 years after the partial substitution of rFVIIa for APCC (30% and 70%, respectively) brings the potential saving of BRL 201,622,888 considering prophylaxis in adults and BRL 83,095,850 in children. For on-demand usage, the amount saved could be BRL 42,696,097 in adults and BRL 17,596,556 in children. CONCLUSION: This analysis suggests a potential cost saving from payer’s perspective (SUS) using APCC instead rFVIIa for Hemophilia A patients with inhibitors, mainly for prophylaxis. The results could potentially bring value to patients and payers as resources could be reallocated to provide more care with the same budget, considering patient clinic response.

MACRO-COSTING OF THE USE OF BORTEZOMIB IN THE TREATMENT OF MULTIPLE MYELOMA FROM THE PERSPECTIVE OF THE SUS

Wed, 23 Jul 2025 00:00:00 +0000

Introduction: Bortezomib is one of the most widely used medications in the treatment of multiple myeloma (MM). Objective: To conduct a macro-costing study of the use of bortezomib in the treatment of MM from the perspective of the Unified Health System (SUS). Methods: Direct costs related to the acquisition of bortezomib were considered. The annual incidence of MM cases and the estimated number of patients undergoing treatment were calculated using data from the Department of Information Technology of the Unified Health System (DATASUS). The cost of bortezomib was obtained from the Health Price Database - BPS. The approximate cost per patient was compared to the amount reimbursed by the Outpatient Procedure Authorization (APAC). Two treatment possibilities were considered: 9 cycles, used for patients who are candidates for autologous hematopoietic stem cell transplantation (ASCT) (30% of the population), and 12 cycles used for patients who are not candidates for ASCT (70%). Results: Considering 1.3mg/m and 1.5mg/m, and a dose wastage of 10%, the cost per patient in 9 cycles was R$17,678.30 and R$18,023.64, respectively. For 12 cycles the cost was R$23,569.94 for a dose of 1.3mg/m and R$24,030.39 for a dose of 1.5mg/m. According to the current APAC value, which is R$5,224.65, the total amount paid for the treatment of 9 cycles is R$47,021.85 and for 12 cycles it is R$62,695.80. Discussion and Conclusion: The average cost of treatment with bortezomib per patient was R$22,100.59, and the amount reimbursed by APAC was R$57,993.62. However, it is emphasized that only the direct costs of acquiring bortezomib were computed.

Pharmaceutical Care in the Unified Health System – Profile and Federal Financing of Services

Adriane Lopes Medeiros Simone, Tainá Freitas Saldanha, Daniela Oliveira de Melo — Wed, 06 Aug 2025 00:00:00 +0000

Introduction: In June 2024, the National Guidelines for Pharmaceutical Care in the Unified Health System (Sistema Único de Saúde, SUS) were published. Their implementation requires the engagement of professionals and the availability of resources to develop and consolidate this practice in healthcare settings.

Objective: To characterize the profile and federal financing for outpatient pharmaceutical care in SUS.

Methods: Data from 2022 and 2023 from SUS systems were used to evaluate clinical assistance services (CAS) and technical pedagogical services (TPS) provided by pharmacists. The analysis excluded the dispensing of medicines from the Specialized Component of Pharmaceutical Assistance and used the "Reference Instrument for Pharmaceutical Services in Primary Care" to categorize the services. The results were adjusted by the National Broad Consumer Price Index for 2023 and presented in absolute and relative frequency, and rate per 100,000 inhabitants, based on the 2022 census.
Results: In 2022 and 2023, 13,052,476 and 13,592,014 CAS and TPS procedures were performed, with rates of 6,427 and 6,693, respectively. Federal financing increased by 3.9% during this period (from R$ 49.5 million to R$ 51.5 million). CAS accounted for 96% of the allocated funds, while TPS accounted for 4%, distributed regionally as follows: Southeast (33%), Northeast (24%), North (21%), South (14%), and Central-West (8%).
Conclusion: Despite the increase in the number of procedures and federal funding, regional inequalities persist, and the funding remains modest compared to investment in the acquisition of medicines. Expanding access and the proper use of medicines are essential for the quality of health care.

Uso de dashboards em serviços farmacêuticos: uma revisão integrativa

Caroline Barboza Arnaudin, Tacio de Mendonça Lima — Thu, 04 Sep 2025 00:00:00 +0000

A large volume of data generated in pharmaceutical services can make it difficult to visualize, interpret results, and decision-making. Dashboards are a useful tool in this process. The aim of this review was to synthesize studies that described the use of dashboards in pharmaceutical services. The literature search was conducted until May 2024 in the Medline (via PubMed), Lilacs, Scopus databases, and the Google Scholar search engine (the first 60 records), using keywords or combinations of terms in English and/or Portuguese: “dashboards,” “pharmacist,” “pharmaceutical services,” “pharmacy.” Nine studies were included in this review. Most of the studies were conducted in the United States, in the hospital pharmacy context and for logistic services. The studies demonstrated positive results from the use of dashboards for improving both the services provided to patients and the performance of pharmacists, although challenges have been identified, such as lack of data, insufficient professional training, and resistance to use. Thus, the study suggests that, despite barriers to implementation, the use of dashboards should be encouraged to improve the quality of pharmaceutical services.

Medicinal, Not Alternative: Regulation, Access, and Safety in the Therapeutic Use of Cannabis Products in Brazil

Wed, 20 Aug 2025 00:00:00 +0000

This perspective article offers a critical reflection on the regulatory, health, and social challenges related to the therapeutic use of cannabis-based products in Brazil. Through an analysis of the current regulatory framework and the implications of classifying these products outside the category of medicines, the article discusses the fragility of existing mechanisms for quality control, traceability, and pharmacovigilance. It also addresses existing gaps, the lack of structured public policies, and the barriers that compromise equitable access.