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L’introduction des traitements antirétroviraux de 3ème ligne au Brésil : Contexte, Modalités, Enjeux, Perspectives

Abstract : The continuity of the Brazilian HIV / AIDS program faces several challenges: first, it is necessary to count the annual arrival of new patients. Next, we show that the program increases life expectancy and thus patients spend more time in the program. Finally, it should be noted that during the long treatment period, patients are vulnerable to viral mutations, which requires a change in therapeutic treatment. The analysis of the Brazilian case shows that the increasing need to integrate new drugs into therapeutic protocols makes it difficult to budget for patented antiretrovirals. In 2014, expenditures with 3rd line antiretrovirals reached 34.88% of the total antiretroviral budget and served only 3.8% of Brazilian patients in the same year. Brazil admits that investing in innovation is important in order to overcome barriers to access to medicines. In this way, the country imposes its national production policy through the Partnership for Productive Development (PPD) program, intensifying support to the Brazilian industry for the manufacture of medicines. We present a case study of the situation of Brazilian patients treated in a public hospital. According to data from the pharmacy, only 20.7% of the 145 patients have good therapeutic adherence. The Brazilian health system and the protocols to fight HIV suppose the integrality of the health care, that is to say that all the needs for the recovery of the state of health must be filled. The establishment of specific care policies for 2nd and 3rd line patients is imperative to avoid and prevent changes in therapies related to inadequate therapeutic adherence.
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Carla Edialla Figueiredo Zaire. L’introduction des traitements antirétroviraux de 3ème ligne au Brésil : Contexte, Modalités, Enjeux, Perspectives. Economies et finances. Université Sorbonne Paris Cité, 2018. Français. ⟨NNT : 2018USPCD073⟩. ⟨tel-02613288⟩

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