Insulin Analogs in Type 1 Diabetes Treatment: Is There Access After Unified Health System (SUS) Incorporation?

OBJECTIVES: Despite insulin analogs registration being dated since 1997 in Brazil, the availability in SUS came twenty years later, in 2017. Despite the final decision of incorporation, acquisition and distribution are mandatory to guarantee patients’ access to this drug. In this context, this study aims to analyze the effectiveness of analogue insulins offer after its incorporation to type 1 diabetes mellitus (T1DM) treatment.

METHODS: This exploratory, descriptive and retrospective research surveyed centralized purchases and dispensations of registered analogue insulins into General Services Administration's Integrated System (SIASG), integrated into Brazil’s Federal Purchasing Portal and Outpatient Information System (SIA-SUS) between 2011 and 2022. Data related to number of units purchased, unit price in BRL, total expenditure in current value in BRL, insulin dispensation after incorporation, number of units dispensed per year, total and by state or region were defined as variables.

RESULTS: In the defined interval, 88,452,426 DDD of insulin analogues were purchased, costing BRL 200,680,646.22 in amounts corrected for December 2022. This amount includes expenses with programmed purchases (only three in eleven years) and to attend lawsuits. There was a progressive increase in the amount of pharmacotechnical units of short-acting insulin analogues dispensed (12,498,584 units approved over the period), but regular purchases of long-acting insulins and their dispensation were not identified so far.

CONCLUSIONS: Despite costly purchases and a considerable number of short-acting insulin analogues dispensed, the implementation of insulin analogues in SUS still has several difficulties, mainly due to the absence of programmed purchases of long-acting insulin analogues, numerous failed auctions since the incorporation and shortage of short-acting insulin analogues in Ministry's stock.