Estimación del gasto de bolsillo para la compra de medicamentos para los pacientes con hipertensión, diabetes y tuberculosis del Ministerio de Salud Pública y Asistencia Social, durante julio de 2018 a junio de 2020

Abstract

The aim of this article is to estimate the out-of-pocket expenditure for pharmacological treatment, according to the first and second level standards of care for diabetes, hypertension and tuberculosis. The methods used were the economic evaluation of the cost of pharmacological treatment of patients with diabetes, arterial hypertension and tuberculosis financed by the Ministry of Health and Social Assistance (MSPAS), through the different purchasing mechanisms and financed by out-of-pocket expenses at market prices, taking into account the average costs per drug for each pathology, with the application of the impoverishing and catastrophic expense formula to the income quintiles described in the National Survey of Income and Employment. As a reference, the pharmacological treatment established in the norms of integral care of the first and second level established by the Ministry of Public Health and Social Assistance was considered. The results obtained show that out-of-pocket spending averaged 16% for the pharmacological treatment of diabetes, while the average for the treatment of arterial hypertension was 11%; for the treatment of tuberculosis, out-of-pocket spending could not be estimated. In general, the price of the brand-name drug is 91% higher than the price of the generic treatment, and the state-purchased treatment is 80% cheaper than the generic drug. It is concluded that drug treatment for hypertension and diabetes is considered catastrophic and impoverishing for the first three income quintiles; it was not possible to estimate the catastrophic or impoverishing cost of drug treatment for patients with tuberculosis. The lower income quintiles are more affected by high drug costs.