Is the Brazilian pharmaceutical policy ensuring population access to essential medicines?

Data on prices and availability of 50 medicines were collected in 56 pharmacies across six cities in Southern Brazil using the World Health Organization / Health Action International methodology. Median prices obtained were divided by international reference prices to derive the median price ratio (MPR).In the private sector, prices were 8.6 MPR for similar medicines, 11.3 MRP for generics and 18.7 MRP for originator brands, respectively. Mean availability was 65%, 74% and 48% for originator brands, generics and similar medicines, respectively. In the public sector, mean availability of similar medicines was 2–7 times higher than that of generics. Mean overall availability in the public sector ranged from 68.8% to 81.7%. In “popular pharmacies”, mean availability was greater than 90% in all cities.Availability of medicines in the public sector does not meet the challenge of supplying essential medicines to the entire population, as stated in the Brazilian constitution. This has unavoidable repercussions for affordability, particularly amongst the lower socio-economic strata.The Brazilian Universal Health System (SUS) is committed to offer high-quality health care to the entire population, including the distribution free of charge of a list of essential medicines aimed at treating the most prevalent diseases in the population. Also, the government provides expensive medicines for treating rare diseases or medicines targeting small groups (e.g. Crohn’s disease, hepatitis B and C) free of charge, based on clinical protocols and therapeutic guidelines from the Ministry of Health [1]. Charging patients for medicines is strictly prohibited in the public system. In real life, however, medicines are often not available when needed. Studies carried out in Brazil have shown that, on average, 40% of the medicines prescribed in public primary health care were not available when needed [2,3]. Although access to medicines in Brazil is high [4,5], socioeconomic inequities are obse