Disparities in Access to COPD Medications in Brazil - Impact of Geography and Socioeconomic Factors on Patient Travel Distances
Author(s)
Tulio Tadeu R. Sarmento, MSc, PharmD1, Fabiana Menezes, Dr2, Erick Kazu, Student3, Wender Aparecido Oliveira, Sr., Dr4.
1Data analysis specialist, Precision Data Engineering & Data Science, Contagem, Brazil, 2Value Proposal Manager, Chesi Farmaceutica, São Paulo, Brazil, 3Precision Data Science & Data Engineering, São Paulo, Brazil, 4Market Access Director, Chiesi Farmaceutica, São Paulo, Brazil.
1Data analysis specialist, Precision Data Engineering & Data Science, Contagem, Brazil, 2Value Proposal Manager, Chesi Farmaceutica, São Paulo, Brazil, 3Precision Data Science & Data Engineering, São Paulo, Brazil, 4Market Access Director, Chiesi Farmaceutica, São Paulo, Brazil.
Presentation Documents
OBJECTIVES: Brazil, the fifth-largest country in the world, spans an area of 8,514,876 km². Chronic Obstructive Pulmonary Disease (COPD) is projected to affect 17% of the Brazilian population. Considering the critical role of pharmacotherapy in managing COPD and the geographical challenges associated with medication distribution, this study aimed to estimate the distances patients must travel to access medications provided by the Brazilian public health system.
METHODS: Data on COPD medication dispensations were obtained from the Outpatient Information System, which records outpatient data from the Brazilian public health system. Zip codes of patients’ residences and health facilities were extracted, and geodesic distances were calculated for each residence-facility pair. These zip codes were classified as urban or rural based on data from the Brazilian Institute for Geography and Statistics (IBGE) and further categorized by their Human Development Index (HDI), stratified into quantiles.
RESULTS: Patients in urban areas traveled a median distance of 10.82 km to access medications, compared to 56.01 km for those in nearby rural areas and 266.08 km for those in remote rural areas. Similarly, patients residing in regions with the highest Human Development Index (top 25%) traveled a median distance of 11.18 km, whereas those in regions with the lowest HDI (bottom 25%) traveled 55.88 km. These differences were statistically significant (p < 0.05).
CONCLUSIONS: Patients in rural areas traveled 5 to 26 times farther than those in urban areas. A similar trend was observed with HDI data: patients in regions with the lowest HDI traveled approximately five times farther than those in regions with the highest HDI. This disparity highlights the inadequate availability of health services in certain regions, potentially compromising patients’ adherence to treatment and negatively impacting health outcomes and COPD management.
METHODS: Data on COPD medication dispensations were obtained from the Outpatient Information System, which records outpatient data from the Brazilian public health system. Zip codes of patients’ residences and health facilities were extracted, and geodesic distances were calculated for each residence-facility pair. These zip codes were classified as urban or rural based on data from the Brazilian Institute for Geography and Statistics (IBGE) and further categorized by their Human Development Index (HDI), stratified into quantiles.
RESULTS: Patients in urban areas traveled a median distance of 10.82 km to access medications, compared to 56.01 km for those in nearby rural areas and 266.08 km for those in remote rural areas. Similarly, patients residing in regions with the highest Human Development Index (top 25%) traveled a median distance of 11.18 km, whereas those in regions with the lowest HDI (bottom 25%) traveled 55.88 km. These differences were statistically significant (p < 0.05).
CONCLUSIONS: Patients in rural areas traveled 5 to 26 times farther than those in urban areas. A similar trend was observed with HDI data: patients in regions with the lowest HDI traveled approximately five times farther than those in regions with the highest HDI. This disparity highlights the inadequate availability of health services in certain regions, potentially compromising patients’ adherence to treatment and negatively impacting health outcomes and COPD management.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH50
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)