Variability in public procurement prices for Group 1A drugs in the specialized pharmaceutical component: an observational study, 2013-2022.

Abstract

Objective: To assess the difference in acquisition prices of Group 1A drugs in the Specialized Pharmaceutical Component between purchases made by the Brazilian Ministry of Health and those made by the Paraná State Health Department.

Methods: This was a retrospective observational study comparing prices of medications acquired centrally by the Brazilian Ministry of Health and those acquired by the State of Paraná to meet court orders or to supply supplementary lists, from 2013 to 2022. The weighted average acquisition price was calculated for each procurement source, per year, based on data from the Paraná Health Department management information system. The ratio between Paraná's and the Brazilian Ministry of Health's weighted average prices was calculated, as well as the hypothetical cost of Paraná's purchases had they been made at the Ministry's prices. Total overpricing in Paraná's acquisitions was also calculated.

Results: A total of 500 price comparisons were conducted, covering 116 different drug presentations. In 84.6% of the comparisons, Paraná's prices exceeded those of the Ministry of Health. For seven pharmaceutical presentations, the state price was more than 10 times higher than the federal price, reaching as high as 47.32 times in the most extreme case. Overall, Paraná's expenditures exceeded by more than BRL 200 million the amount that would have been paid at the Ministry's prices, resulting in 55.7% overpricing.

Conclusion: There was considerable variation between prices of drugs acquired centrally by the Brazilian Ministry of Health and those acquired by the state of Paraná. To enhance cost-effectiveness within the Brazilian National Health System, mechanisms for centralized price negotiation or procurement should be further explored.