Custos de doenças crônicas não transmissíveis para o sistema único de saúde: revisão narrativa da literatura

Abstract

Chronic noncommunicable diseases (NCDs) are responsible for more than half of deaths worldwide; specifically in Brazil, for approximately 70% of deaths. Despite the various policies aimed at reducing its prevalence, the number of individuals affected by such diseases is still high; and considering a country like Brazil, where most of the population depends on the Unified Health System (SUS), NCDs generate high costs for the country. Thus, this study aimed to carry out a narrative review of the literature, analyzing works that evaluated the costs of NCDs for the country in recent years, as well as evaluating some of the existing public policies aimed at reducing them. For that, recent scientific works were searched in the databases: MEDLINE, LILACS BIREME, SCIELO, PUBMED and Google Scholar. Being considered for this study the direct and indirect costs, when available, of the treatments of diabetes mellitus, systemic arterial hypertension, cardiovascular diseases, obesity, and cancers; main chronic diseases that affect the Brazilian population. Cost data from eleven studies were analyzed. Such studies demonstrate that in recent years there has been an increase in the direct costs of NCDs for the SUS, especially regarding hospitalizations, emphasizing the need to act more efficiently in primary care. Several public policies aim at reducing the prevalence of NCDs and, consequently, their costs to the State; such as Family Health Strategy , the HIPERDIA program – developed by it –, the National Immunization Program, the development of the Food Guide for the Brazilian Population, the resolutions of the National Health Surveillance Agency aimed at controlling advertising food and drink for children and teenagers; in addition to the formalized agreements with the Brazilian Food Industry Association to reducing sodium levels in food; the new measures to be adapted in food labeling, the development of the Health Academy Program and the establishment of the National Tobacco Control Program. However, despite the various policies created, the budget allocated to monitoring these actions must be increased, identifying their failures, and optimizing them. Essentially, action must be taken to reduce health inequalities and ensure access to care for the entire population, especially for the most vulnerable groups, given the higher concentration of NCDs and their risk factors in the population with low income and education.