Pharmaceutical access in Brazil: challenges and opportunities

BACKGROUND: Brazil faces challenges in ensuring equitable access to prescription drugs for its population. Socioeconomic disparities contribute to health inequalities, impacting access to health care services, including medicines. Brazil's Unified Health System aims to provide universal health care coverage, but only 30·5% of people obtain all of their prescribed medications through public channels free of charge. The objective is to characterize the Brazilian pharmaceutical market to better understand the underlying factors affecting medicine accessibility. METHODS: We conducted a literature review to assess the current state of the pharmaceutical market and prescription drug access in Brazil. FINDINGS: The Brazilian pharmaceutical market is extensive but highly concentrated, characterized by low investment in original research and development (R&D) and a heavy reliance on imported active pharmaceutical ingredients. Challenges include vulnerability to economic and external factors. Additionally, high medicine prices, prioritization of production of expensive new medicines over those for prevalent diseases, and shortages contribute to inequalities in access. Regulatory issues, underfunding of health care, and legal discrepancies exacerbate these challenges but also present opportunities for reform. INTERPRETATION: The policymakers should prioritize enhancing R&D investment, reducing dependency on international markets, strengthening regulatory frameworks, and improving health care system efficiency to ensure reliable access to essential medicines.