Avaliação da economicidade e vantajosidade da política pública das parcerias para o desenvolvimento produtivo

Abstract

The Partnerships for Productive Development Policy (PDPs in Portuguese) was put in place as a strategy by the Government towards strengthening the Healthcare Economic and Industrial Complex (CEIS in Portuguese). The policy aims at bringing in-house technologies that are strategic to the Brazilian Healthcare System (SUS in Portuguese), reducing the system´s outsourcing dependency, as well as reducing its overall vulnerability through the better economics and advantageous scenarios brought about by purchase deals and by broadening the public´s access to those strategic medicines, among others. Even though the first PDP was brought to life in 2009, the policy was only regulated in 2014, when Ministerial Order GM/MS nº 2531 was passed. While the Resolution describes the eight objectives of the afore mentioned policy, this work is intended at assessing the fourth of these objectives: “to protect the best interest of both the Administration and society by seeking the best economics and advantages, taking into account costs, quality, technology and benefit to the general public”. In order to achieve the objective of this work, a case study was conducted using a mixed methodology approach, through the nomination of four assessment indicators. At first, the assessment focused on the quantitative aspects related to the purchase of inputs carried out through the PDPs in comparison to purchases of the same medicines without the Partnerships (either prior, current or future ones). Subsequently, the assessment was done on the qualitative aspects of both the policy and the inclusion of medicaments that are part of the PDPs run by the Brazilian Healthcare System (SUS), through the analysis of the National List of Essential Medicines (Rename in Portuguese) as well as reports issued by the SUS’ National Committee for Technology Incorporation (CONITEC in Portuguese). The quantitative assessment confirmed that there was a reduction in the overall purchase cost of those medicaments evaluated as part of this work after the PDPs were put in place, while there was also an increase in the amount of the same medicines being purchased when compared to those purchases conducted outside of the Partnerships model, therefore contributing to the pursuit of the best economic scenario. On the other hand, the quantitative analysis of the same performance indicators demonstrates a lack of planning by the Government agents and a lack of compliance by the same agents with the guiding principles of the PDP policy with regards to achieving the most advantageous purchase. That conclusion comes from the fact that nearly 40% of the medicines covered by Partnership contracts with the Brazilian Healthcare Agency (Ministério da Saúde, in Portuguese) that are offered to the public cannot be considered advantageous from a cost-effectiveness perspective.