Experts consulted by the Health Committee of the Chamber of Deputies denounced that efficient medicines against breast cancer are not being made available in time by the Unified Health System (SUS). According to statements, sick women are unassisted and can die due to lack of these medications. Representatives from the state and federal governments say that a new policy is under analysis and should improve the situation.

The president of the Oncoguia Institute, an NGO dedicated to the quality of life of cancer patients, Luciana Holtz, stated that technologies incorporated by the SUS should be available in all hospitals, but what happens is just a recommendation, which creates differences in the provision of SUS across the country.

The National Commission for the Incorporation of Technologies into the SUS (Conitec) approved new clinical protocols for breast cancer in April. In the case of cyclin inhibitors, the delay exceeded 745 days between authorization for use in the SUS, made in December 2021, and the provision of care. Another medication, called trastuzumab emtansine, was incorporated in September 2022, but has already been waiting for 470 days without being offered in the SUS.

“This year alone, in 2024, more than 2 thousand women are missing the chance to take the most effective treatment for their case. We already know, it is a less toxic, safe treatment, they are losing the chance of not experiencing a recurrence of cancer, they are losing the chance of being cured”, said Luciana Holtz.

Outdated value
Another problem reported is that the incorporation of medicines is not followed by an update in the value of these medicines in the Ambulatory Procedures Authorization (Apac) and hospitals are unable to bear the new costs and new clinical protocols and therapeutic guidelines (PCDT), such as warns the representative of the Brazilian Federation of Philanthropic Institutions to Support Breast Health (Femama), Joana Jeker.

“These medicines are currently covered by Apac, which reimburses hospitals with just R$2,378.00. The value of this APAC is negligible. And the cost of this medicine is around R$12 thousand. The account does not close. Many patients do not have access to the medicine because the Apac value is outdated,” he said.

Joana Jeker asked for the approval of a complementary bill ( PLP 65/24 ), by deputy Weliton Prado (Solidariedade-MG), which allocates 4% of health resources to actions to combat cancer, a disease that is the second most kills in Brazil and is expected to become the main cause of death by 2030.

The representative of the Brazilian Society of Clinical Oncology, Romualdo Barroso, remembers that 80% of Brazilian patients depend on the SUS.

Expenditure and results
The technical advisor of the National Council of Health Secretaries (Conass), Henrique Vogado, considered the interval between the Conitec report and the incorporation of medicines, because in addition to resources, it is necessary to have technology and structure in the hospital network .

“We have access to data from DataSUS and the Todos Contra o Câncer movement, which demonstrate that, throughout 2022, considering chemotherapy, including medicines, expenditure on medicines, radiotherapy, hospitalizations and surgeries, was spent in the SUS on the treatment of breast cancer. breast R$ 1.1 billion, considering the entire process, from diagnosis to the final outcome of the person undergoing treatment”, he said. For him, there is a divergence between the amount spent and the result.

But the resources could be smaller, according to the deputy head of the Federal Audit Court ( TCU ), Vinícius Augusto Guimarães, if there were no delays in diagnosing and carrying out exams.

“The result of this is that a huge percentage of patients arrive and begin treatment with staging levels 3 and 4. So, as was said by colleagues before me, as a result, the cost of treatment increases significantly and the chance of cure is greatly reduced. ”, he noted.

New protocol
The general coordinator of the National Cancer Prevention and Control Policy of the Ministry of Health, Patricia Gonçalves Freire dos Santos, stated that the new breast cancer clinical protocol is about to be published. According to her, the ministry works together with the TCU to put together an action plan for oncology.

The Oncoguia Institute defends the regulation of the law that establishes the National Cancer Prevention and Control Policy within the scope of the SUS and the National Navigation Program for People Diagnosed with Cancer ( Law 14,758/23 ). The law is from December 2023 and came into force 180 days after its publication, that is, this month.

The debate on access to cancer medicines in the SUS was requested by deputies Doutor Luizinho (PP-RJ) and Dr. Frederico (PRD-MG), who made a comparison with the Covid-19 pandemic.

“The Covid pandemic killed around 700 thousand Brazilians. In the same period, cancer, this silent disease that people pretend doesn’t exist, that no one sees notice of in the newspapers, no one talks about the problems, killed 750,000 people in the same period. So we see the size of the impact of cancer and how little relevance it needs and deserves to have”, said Dr. Frederico.

Source: Agência Câmara de Notícias

Photo: Bruno Spada / Câmara dos Deputados