OBJECTIVES: The Brazilian public health system ensures universal, equitable and comprehensive access to health technologies, including medicines. The high-cost medicines are offered through Specialized Pharmaceutical Services Component (SPSC). The clinical conditions treated in the SPSC are defined in the Guidelines in the form of lines of care. To describe the experience and results of the SPSC with its particular strategies in the quest for the comprehensive health care.  METHODS: Focused on the SPSC’s issues, we did a retrospective data analysis related to its management strategies for the pharmaceutical services in the public health system in the period 2010 to 2013. Data were obtained from documents of the Ministry of Health in 2013 (current values; exchange rate: US$ 1 = R$ 2.30). RESULTS: As a strategy to increase medicines access and optimization of resource allocation, the MoH expanded the amount of centralized procurement medicines, from 13 to 51 products. This deed was focused on those medicines with a concentrated market. As a consequence, this action allowed a saving of U$ 403.8 million in four years, compared to the price in 2010. The medicines that most contributed to the economy were adalimumabe (U$120 million), etanercepte (U$100 million) and infliximab (U$44 million). Betainterferona (52%), etanercepte (48%), imiglucerase (48%), adalimumabe (37%) e Alfapeginterferona (37%) were the products with a greater reduction in the unit price, considering the accumulated value at period. The increase in the number of units distributed was 263%. CONCLUSIONS: The SPSC was designed in 2010 for the budgetary resources optimization and to expand access to medicines for diseases that require complex health services or high-cost medicines. The purchasing power of the MoH is a strategy that allowed expansion of access to medicines, with optimization of budgetary resources in the Brazilian public health system.