Evaluation of the impact of the 'there's a people's pharmacy here' program on asthma morbidity and mortality in Brazil
1
Federal University of Bahia, Salvador, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A3824
ABSTRACT
BACKGROUND:
Access to essential medicines is a central component of universal health systems and a key determinant of population health outcomes. In Brazil, the Popular Pharmacy Program, through its ‘There’s a People’s Pharmacy Here’ Program (Programa Aqui Tem Farmácia Popular: ATFP) component, was implemented to expand access to essential medicines via private pharmacies. Since 2011, asthma medicines have been provided free of charge under this program. Asthma remains a leading cause of avoidable hospitalizations, making it a relevant condition for monitoring the performance of pharmaceutical access policies.
METHODS:
A longitudinal, municipality-level cohort study was conducted covering the period from 2008 to 2019. Data were aggregated by municipality, age group, and sex using national administrative health information systems. Program impact was estimated using a quasi-experimental difference-in-differences approach with staggered treatment adoption, event-study analysis, and inverse probability weighting to account for observable municipal characteristics. Outcomes included asthma-related hospitalizations, days hospitalized, intensive care unit admissions, and mortality rates per 100,000 inhabitants.
RESULTS:
The expansion of the ATFP program with asthma medicine dispensing was associated with a statistically significant reduction of 10.97 asthma-related hospitalizations per 100,000 inhabitants, corresponding to an approximate 7% decrease from baseline levels. Significant reductions were also observed in total days hospitalized (9%) and urgent admissions (6.2%). No statistically significant effects were identified for intensive care unit admissions or asthma-related mortality, outcomes characterized by low baseline frequency. Program effects varied across age groups and regions, with greater reductions observed among adults and older populations.
CONCLUSIONS:
The findings demonstrate that systematic monitoring and evaluation of pharmaceutical access policies can identify meaningful reductions in avoidable hospitalizations. The ATFP program contributed to improved asthma control and reduced healthcare utilization, reinforcing its relevance as a population-level strategy to strengthen access to essential medicines within the Brazilian Unified Health System.
Access to essential medicines is a central component of universal health systems and a key determinant of population health outcomes. In Brazil, the Popular Pharmacy Program, through its ‘There’s a People’s Pharmacy Here’ Program (Programa Aqui Tem Farmácia Popular: ATFP) component, was implemented to expand access to essential medicines via private pharmacies. Since 2011, asthma medicines have been provided free of charge under this program. Asthma remains a leading cause of avoidable hospitalizations, making it a relevant condition for monitoring the performance of pharmaceutical access policies.
METHODS:
A longitudinal, municipality-level cohort study was conducted covering the period from 2008 to 2019. Data were aggregated by municipality, age group, and sex using national administrative health information systems. Program impact was estimated using a quasi-experimental difference-in-differences approach with staggered treatment adoption, event-study analysis, and inverse probability weighting to account for observable municipal characteristics. Outcomes included asthma-related hospitalizations, days hospitalized, intensive care unit admissions, and mortality rates per 100,000 inhabitants.
RESULTS:
The expansion of the ATFP program with asthma medicine dispensing was associated with a statistically significant reduction of 10.97 asthma-related hospitalizations per 100,000 inhabitants, corresponding to an approximate 7% decrease from baseline levels. Significant reductions were also observed in total days hospitalized (9%) and urgent admissions (6.2%). No statistically significant effects were identified for intensive care unit admissions or asthma-related mortality, outcomes characterized by low baseline frequency. Program effects varied across age groups and regions, with greater reductions observed among adults and older populations.
CONCLUSIONS:
The findings demonstrate that systematic monitoring and evaluation of pharmaceutical access policies can identify meaningful reductions in avoidable hospitalizations. The ATFP program contributed to improved asthma control and reduced healthcare utilization, reinforcing its relevance as a population-level strategy to strengthen access to essential medicines within the Brazilian Unified Health System.
| eISSN: | 2654-1459 |
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