OBJECTIVES: ‘Farmácia Popular’ Program (FPP) is a Brazilian medicines subsidy programme. We evaluated regulatory journey of the FPP and classified the Ordinances according to the type of policy changes during 3 periods: between 2004-2010 (Lula Government), 2011-2016 (Dilma Government) and 2016-2018 (Temer Government).

METHODS: This is a qualitative investigation using a bibliographic review of the regulatory publications on pharmaceutical policies and political facts related to the FPP.

RESULTS: The FPP was established by Decree 5,090/2004, which regulated Law 10,858/2004. During the Lula Government, 7 ordinances were published: 2 related to changes in operating rules (749/2009; 3,089/2009) and 5 related to financial incentives for the FPP (2,587/2004) or greater access to drugs, such as the subsidization of 90% of drug costs for hypertension and diabetes (491/2006), contraceptives (1,414/2007), insulin, simvastatin (947/2010), osteoporosis, glaucoma, rhinitis, asthma, Parkinson’s disease, and geriatric diapers (3,219/2010). During the period of the Dilma Government, 8 ordinances were published: 5 related to changes in operating rules (185/2011; 726/2011; 971/2012, 111/2016; 957/2016); and 3 related to financial incentives for the FPP (1019/2014) or implementation of the subsidization of 100% of the cost of drugs for hypertension, diabetes (184/2011) and asthma (1,146/2012). Finally, the Temer Government published the decree to consolidate the operating rules (05/2017), and the FPP inflection point that was reached in the 2015 economic crisis was extended both by the reduced service network and the subsidized costs paid by the Brazilian Federal Government (739/2018).

CONCLUSIONS: The FPP represented a political, non-technical decision, and all regulatory changes over time reflected uncertainty and political disruption, as well as epistemic ambiguity in Brazilian public policymaking. Despite the problems of ease of access, the difficulty of promoting rational drug use and the problems of health corruption, the FPP made achievements with regard to expanding access to drugs and reducing mortality and hospitalizations for chronic diseases.