Problem Statement: Oncological drugs are standardized, purchased, and prescribed independently by oncology hospitals within SUS (public health system), with no intervention from individual state health secretariats or the Ministry of Health, so there is no national protocol or centralized process for negotiating acquisition prices.

Description: An economic exercise was carried out to evaluate the potential of developing a unified purchasing process, which would not necessarily require the centralization of logistics, but rather the establishment of a national ceiling for cancer drugs, where SUS units would pay only up to this limit. The Procuremed database was used to research registered public purchases of all cancer drugs in Brazil over the last six years, evaluating the quantity purchased and the amounts paid.

Lessons Learned: The results demonstrated that if each drug had been purchased at the lowest price paid in Brazil's public health system, it could have generated savings of R$1.124.877.194,30 (approximately US$216 million), a 20% reduction in spending on cancer drugs over the last six years, which could have been used, for example, to buy 2.400 mammography machines in SUS units. The exercise also revealed that the scale gain induces a price reduction of 8.5% on average, for each decade of the quantity purchased.

Another relevant finding was that the difference in the purchase price did not come only from the high-cost drugs, which varied on average 93,9%, but also from the lower-cost drugs, which had an average variation of 66,8% in the price paid by SUS unit.

Stakeholder perspective: The validity of the establishment a national price ceiling for cancer drugs in SUS, which would be a quick step in obtaining meaningful results for the financing of cancer treatment. This process combined with administrative changes and the establishment of national protocols might make a huge difference in increasing speed of access for cancer patients in Brazil