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      Análise de medicamentos novos registrados no Brasil na perspectiva do Sistema Único de Saúde e da carga de doença Translated title: Analysis of new drugs registered in Brazil in view of the Unified Health System and the disease burden

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          Abstract

          Resumo Para a saúde pública, a importância de um medicamento novo está no valor terapêutico e no benefício que produz para o paciente e para a sociedade. O objetivo do estudo foi analisar medicamentos novos registrados no Brasil de 2003 a 2013, sob a perspectiva da carga de doenças e da assistência farmacêutica no SUS. Estudo de coorte retrospectiva. Identificou-se os medicamentos novos registrados no Brasil por análise documental dos registros publicados pela Agência Nacional de Vigilância Sanitária. Os dados sobre carga de doença no Brasil foram obtidos do Global Burden of Disease Study, publicado em 2012 pela Organização Mundial de Saúde. O grau de inovação terapêutica foi determinado pelo Algoritmo de Motola. Identificou-se 159 medicamentos novos e somente 28 foram classificados como inovação terapêutica importante. Evidenciou-se uma relação desproporcional entre a porcentagem de medicamentos novos e a carga de doenças, com sub-representação de medicamentos para doenças respiratórias infecciosas, doenças cardíacas e doenças digestivas. Estratégias de incentivo à pesquisa e desenvolvimento de medicamentos devem ser priorizadas, para diminuir a desproporção em relação à carga de doença e contribuir para o desenvolvimento de medicamentos inovadores necessários ao quadro sanitário do país.

          Translated abstract

          Abstract The most important aspect of a new drug in terms of public health is its therapeutic value and benefit it provides for the patient and for the society. The aim of this study was to analyze new drugs registered in Brazil between 2003 and 2013 with respect to Pharmaceutical Assistance programs within the Brazilian health system and to the disease burden in the country. In our retrospective cohort study, new drugs registered in Brazil were identified through document analysis of databases and publicly available documents from National Health Surveillance Agency. The data on disease burden in Brazil was obtained from the Global Burden of Disease Study 2012, published by the World Health Organization. The level of therapeutic innovation was determined using the Motola algorithm. Although a total of 159 new medicines were used in the cohort, only 28 (17.6%) were classified as important therapeutic innovations. There is a disproportionate relationship between the percentage of new drugs and the burden of disease, with an under-representation of drugs for infectious respiratory diseases, heart disease, and digestive diseases. Incentive strategies for research and development of medicines should be prioritized to reduce the disparity regarding the burden of disease and to help develop innovative medicines necessary to improve health throughout the country.

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          Most cited references46

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          Transição epidemiológica e o estudo de carga de doença no Brasil

          No Brasil, a transição epidemiológica não tem ocorrido de acordo com o modelo experimentado pela maioria dos países desenvolvidos. Velhos e novos problemas em saúde coexistem, com predominância das doenças crônico-degenerativas, embora as doenças transmissíveis ainda desempenhem um papel importante. Neste estudo, os diferenciais, em relação ao padrão epidemiológico, são descritos para o Brasil e grandes regiões, para o indicador de saúde dos estudos da carga de doença, o DALY. Entre os principais resultados encontrados, para o Brasil, destaca-se que o grupo das doenças não-transmissíveis, infecciosas/parasitárias/maternas/perinatais/nutricionais, e das causas externas representaram, respectivamente, 66,3%, 23,5% e 10,2% da carga total de doença estimada. A utilização do indicador DALY propicia a identificação de prioridades em função do perfil epidemiológico, facilitando a tomada de decisões e destinação adequada de recursos por parte dos gestores.
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            The drug and vaccine landscape for neglected diseases (2000-11): a systematic assessment.

            In 1975-99, only 1·1% of new therapeutic products had been developed for neglected diseases. Since then, several public and private initiatives have attempted to mitigate this imbalance. We analysed the research and development pipeline of drugs and vaccines for neglected diseases from 2000 to 2011.
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              Cardiovascular drug development: is it dead or just hibernating?

              Despite the global burden of cardiovascular disease, investment in cardiovascular drug development has stagnated over the past 2 decades, with relative underinvestment compared with other therapeutic areas. The reasons for this trend are multifactorial, but of primary concern is the high cost of conducting cardiovascular outcome trials in the current regulatory environment that demands a direct assessment of risks and benefits, using clinically-evident cardiovascular endpoints. To work toward consensus on improving the environment for cardiovascular drug development, stakeholders from academia, industry, regulatory bodies, and government agencies convened for a think tank meeting in July 2014 in Washington, DC. This paper summarizes the proceedings of the meeting and aims to delineate the current adverse trends in cardiovascular drug development, understand the key issues that underlie these trends within the context of a recognized need for a rigorous regulatory review process, and provide potential solutions to the problems identified.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                csc
                Ciência & Saúde Coletiva
                Ciênc. saúde coletiva
                ABRASCO - Associação Brasileira de Saúde Coletiva (Rio de Janeiro, RJ, Brazil )
                1413-8123
                1678-4561
                January 2018
                : 23
                : 1
                : 215-228
                Affiliations
                [1] Belo Horizonte Minas Gerais orgnameUniversidade Federal de Minas Gerais orgdiv1Faculdade de Farmácia Brazil sf.botelho@ 123456hotmail.com
                Article
                S1413-81232018000100215
                10.1590/1413-81232018231.21672015
                29267825
                d39f0bcb-b15e-42af-b74a-841bd8a1573b

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 29 November 2015
                : 21 July 2015
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 48, Pages: 14
                Product

                SciELO Brazil


                Inovação,Sistema Único de Saúde,Carga de doença,Medicamentos novos,Unified Health System,Burden diseases,Innovation,New drugs

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