Access to high-priced medicines: inequalities in the organization and the results among Brazilian states

This case study aimed to characterize the Specialized Component of Pharmaceutical Services (CEAF) organization in four Brazilian states from diverse regions of the country. Data were collected with representatives of CEAF ma-nagement from states in different regions, who answered a 21-question questionnaire on scope, organization, financing, hurdles, and facilita-tors. This information was complemented with data from national health surveys, DataSUS, the applied resources, and socioeconomic indicators. Differences were observed between states on issues such as the proportion of users and the decentrali-zation of services. These characteristics seem to be related to the level of development concerning the socioeconomic indicators used. Advances in access to medicines were highlighted, despite the difficul-ties complying with the CEAF's objectives, such as insufficient resources, the qualification of human resources, and the provision of necessary visits and exams. The results point to advances, diffe-rent forms of organization and highlight the need for more in-depth studies on the clinical and eco-nomic outcomes achieved as a strategy to outline solutions to achieve the comprehensive and equal care for users.