Determinant Factors of the Administrative Pathway to Access Medicines in the Brazilian Health System.

ha mantenido la inequidad de acceso a medicamentos afectando mayormente aquellos grupos que están en necesidad. OBJECTIVES: Examine the operative capacity of health networks in seven districts of the Great Buenos Aires to provide effective access to care to poor, non-formal coverage population groups, and provide insights about how patients select their main sources of care, and how those decisions relate to objective measures of quality. METHODS: Identification of key prioritized interventions: breast, colon and lung cancer, normal and high risk deliveries, rehabilitation and mental health, cronic kidney diseases, vascular illness and main risk factors. Mutiple choice interviews with a sample of 296 hospital patients, about motives of consultation, choice of institution to seek care, quality perception, waiting times, perception of health network organization, and 308 hospital physicians and nurses, about health network organization, flow of patients clinical history, motives of referrals from health care centers, and on-the-job satisfaction. In-depth interviews with 15 Provincial and Municipal Hospital Directors, about outputs, human resources, equipments, procesess and resolution capacity. The data collected allowed to design a set of tables of descriptive statistics and correlation coefficients on users' behavior and staff's perceptions. RESULTS: The actual operation of health care networks show patients attending directly to hospitals' emergency rooms instead of looking for care mainly at primary health care facilities. This conduct creates underutilization of health posts and over-demand of services at crowded hospitals, even when low-risk related care is required. In high-risk related care, formal norms and protocols are scarce and informal referrals based on contacts among professionals across services are frequently identified. CONCLUSIONS: A solid health care network requires listening people's decisions, translated in the way of choosing their sources of care. They provide relevant insights about what procedures, technologies and patterns of care should be prioritize in order to build a sound structure of attention. OBJECTIVES: Biosimilar drugs will play an important role worldwide, especially in Brazil, where there is an urgent need for improvement on access to biotechnology treatments for patients. Several ongoing clinical trials (CT) evaluating biosimilar drugs are facing recruitment issues mainly associated to safety, efficacy and quality questions. Therefore, we aimed to identify barriers, and propose actions to overcome those issues.METHODS: The barriers faced by ongoing biosimilarity CTs were identified according to Libbs Farmacêutica (sponsor) experience. In addition, an action plan was proposed to solve the identified issues. RESULTS: The main barrier experienced during biosimilarity CTs was …