Análise de utilização, difusão e acesso dos antivirais sofosbuvir, simeprevir e daclatasvir para hepatite C crônica no Sistema Único de Saúde

Abstract

Chronic hepatitis C is considered a public health problem and expanding access to direct-acting antiviral (DAA) treatment is one of the goals proposed by the World Health Organization. The Brazilian National Health System (SUS) start to offer the treatment with DAA (sofosbuvir, simeprevir and daclatasvir) as of June 2015. The aim of this study was to investigate the use, diffusion and access of patients with chronic hepatitis C to DAA from June 2015 to December 2017. Data from the SUS Outpatient Information System was used. A greater dispensing of sofosbuvir (~ 50%) was observed, followed by daclatasvir (41.8%) and simeprevir (8.2%) in all geographic regions except the Midwest. The findings showed a rapid difusion of DAA from the first to the second semester of use, increasing from 41% to 70% in the country. Access to DAA raised from 1.0% in 2015 to 21.2% in 2016 and reduced to 15.3% in 2017. Nevertheless, the goal of the Ministry of Health to provide treatment for all cases of advanced disease in 2017 has not been reached. These findings revealed the need to monitor the drug dispensing and carry out further studies to identify the determining factors of access to DAA in the SUS.