Financial impact of centralized purchasing of rituximab by the Brazilian Ministry of Health for lymphoma treatment, 2015-2022: an exploratory study.

Abstract

Objective: To understand the financial impact of centralized purchasing of rituximab by the Brazilian Ministry of Health for treatment of follicular and diffuse large B-cell lymphomas in the period 2015-2022.

Methods: This is an exploratory study, with a quantitative approach, which performed documentary analysis of medication purchases by public authorities. Based on the average price weighted by the quantity purchased, the current strategy of centralized rituximab purchasing was compared to a hypothetical scenario, in which purchasing would have remained the responsibility of hospitals, by means of reimbursement by the federal government for billable chemotherapy procedures.

Results: Centralized purchasing initially enabled better contract terms in price negotiations, with the federal government achieving discounts close to 70.0% of the reference price. In the timeframe analyzed, there was a reduction in the price of rituximab. After 2020, with the participation of new drug manufacturers on the market, the prices paid by other bodies approached those negotiated by the Ministry of Health. If rituximab purchasing had remained the responsibility of oncology hospitals, the amount reimbursed for chemotherapy procedures would have been insufficient to cover the cost of purchasing this medication.

Conclusion: We estimated that by taking on the burden of centralized rituximab purchasing, the federal government achieved savings of BRL 81.6 million compared to the hypothetical scenario of rituximab purchasing by oncology hospitals. In addition to the economic benefit, the model ensured the population's access to rituximab and avoided health institution indebtedness.