Health equity and the usage of atypical antipsychotics within the Brazilian national health system : findings and implications

Zuppo, Isabella de Figueiredo and Ruas, Cristina Mariano and de Oliveira, Helian Nunes and Godman, Brian and Castel, Saulo and Wainberg, Milton L. and Reis, Edna Afonso (2021) Health equity and the usage of atypical antipsychotics within the Brazilian national health system : findings and implications. Expert Review of Pharmacoeconomics and Outcomes Research, 21 (4). pp. 743-751. ISSN 1473-7167 (https://doi.org/10.1080/14737167.2020.1804873)

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Abstract

Background: There is a need to evaluate the health equity of atypical antipsychotics users who obtain their medicines from the Brazilian National Health System (SUS) through the identification of key factors that influence their health status due to concerns with equity of care. Research design and methods: Cross-sectional study among patients attending state pharmacies in Brazil. Individuals were included if they used atypical antipsychotics, aged ≥18 years, and answered the EQ-5D-3 L questionnaire. Sociodemographic, behavioral, and clinical data were collected. The dependent variable was health status. Associations between the independent variables and the dependent variable were analyzed by adjusting a linear regression model. Results: Overall, 388 individuals met the eligibility criteria and were included in the analysis. The final multiple linear regression model demonstrated a statistically significant association between VAS and suicide attempts, private care, current antipsychotics, comorbidities, and perceived family support. Expert Commentary: The study identified several factors both individual and collective that correlate with the health status of atypical antipsychotic users and confirmed the importance of providing medicines for treating psychotic disorders. However, other factors are involved including social support. Our results suggest additional activities and policies are necessary including strategies to address the differences in private and public health care.