The Brazilian Society of Diabetes (SBD) is concerned about the possibility of a lack of fast-acting insulin analogues in the Unified Health System (SUS). A report by the Federal Court of Auditors (TCU) identified that the current stock should last only until the month of May.
The Ministry of Health held two auctions to acquire the drug, in August 2022 and in January of this year, but failed to attract the interest of manufacturing companies. Unsuccessfully, the Federal Government opened, on January 31, an emergency purchase process to acquire, by waiver of bidding, 1.3 million 3 ml insulin tubes to serve the SUS, with a capacity for 180 days.
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In an interview with metropolises, the president of the SBD, Levimar Araújo, pointed out some failures of the Ministry of Health when dealing with the purchase of the medicine. “The bids do not cover a diversity of insulin categories, but very specific products; Brazil does not have insulin production independence, that is, there is no Brazilian manufacture, despite being the fifth country with the highest incidence of diabetes in the world; and the process is very bureaucratic, both for doctors and for patients who depend on the SUS to obtain medication”, says Araújo.
health risks
Brazil is the fifth country with the highest number of diabetics, behind only China, India, United States and Pakistan. There are approximately 16.8 million sick adults, aged between 20 and 79 years. The Diabetes Atlas of the International Diabetes Federation (IDF) estimates that the incidence of the disease in 2030 will be 21.5 million people.
The lack of medication or the discontinuation of treatment aggravate the condition and can lead to coronary complications, in the eyes – with loss of vision -, in the kidneys and in the nerves. In more severe cases, diabetes can lead to death.
“The triggering of these other diseases results in more medical consultations and hospitalizations, which end up burdening the health system. It is worth remembering that type 2 diabetes has increased a lot due to the pandemic, as people have changed their lifestyle, reduced physical activity and obesity has increased”, says Araújo.
emergency purchase
Approximately one million rapid-acting insulin pens were discarded by the Ministry of Health during the government of Jair Bolsonaro (PL) because they were expired. The damage was estimated at R$ 15 million.
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The process for the acquisition of new units, opened on an emergency basis in January, included companies registered with international agencies and certified by the World Health Organization (WHO), which were able to participate along with those registered in Brazil.
In a note sent to metropolises, the Ministry of Health informs that it carries out, in partnership with the states, a survey of stocks of fast-acting insulin analogues and current purchasing processes in order to monitor the entire process with transparency. “The folder can even reimburse the states through decentralized purchases”, says the text.
“The Ministry of Health has a strategy to support the local production of essential products for the SUS, which is the only way to permanently reduce dependence on the volatility of the international market”, he says.
The folder also explains that the most consumed regular insulins are in adequate stock and the case of the fast-acting analogue insulin is being treated with the highest priority with international suppliers to guarantee the population’s service.
The president of SBD says that analogue insulin has the most advanced technology and offers better results to patients. “It is used during meals, with fast action. The previous version remains longer in the body, which makes it difficult to control and can cause late hypoglycemia in the patient”, explains Araújo.
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