Drug utilization studies as a tool to decision making in health care policy: Contributions of the Brazilian health-price databank to health technology assessment

Health Technology Assessment (ATS) plays an essential role in modern health care by supporting evidence based decision making in health care policy. Initiatives of the World Health Organization as the Essential Drugs, Medicines Policy and Pharmacovigilance have been made. Drug Utilization Studies (DUS) can provide information on the use of medicines, thus contributing to the evaluation of their use in society in order to achieve their best performance.This work analyzes the Brazilian Health-Price Databank (BPS), from January 2004 to December 2005. The BPS is a database with information on medicines costs in the private and the public sectors. Medicines were classified according to the Anatomical Therapeutic Chemical Classification (ATC). The most constantly informed medicines in the BPS were identified, according to the tendering specifications and sales volume. Analysis considered three different units of measurement of drug consumption: number of Defined Daily Dose, number of units tendered and the total sales value. It considered also their presence or not, in Pharmaceutical Assistance Programs of the Ministry of Health and Brazilian List of Essential Medicines. There were 13.272 registres concearning to 777 medicines and 335 drugs. Differences between the results of the three instruments for measuring consumption have been identified and different drugs were selected according to each unit of measurement. The Defined Daily Dose (DDD) seems to be the best tool for measure consumption, because this instrument does not present difficulties of space, time and manner of presentation the medicine as the other instruments have and it´s possible to be used to compare data of different places and time. Drug Utilization Studies, specifically, the study of consumption, are of great value to identify priorities for assessment from the use of scientific evidence, as well as serve as a methodology to monitoring the use of technologies.