Prices paid for primary health care medicines by Brazilian municipalities.

OBJECTIVE: The study analyzes the prices paid by Brazilian municipalities for medicines in 2016, 2018, and 2020, comparing municipal human development index, size, region, and purchase modality. METHODS: Economic Ratio indicator, adapted from that proposed for international analyses by the World Health Organization, was used and analyses were performed using data provided by municipalities to the National Database of Pharmaceutical Assistance Actions and Services. RESULTS: The study reveals that the most socially and economically vulnerable municipalities pay more for these medicines, especially in the North and Northeast regions, which can compromise access to and the efficiency of the Unified Health System. Moreover, the article shows that municipalities that purchased in association tend to pay lower prices, suggesting that consortia may be a strategy to mitigate price inequalities. CONCLUSIONS: Based on the results obtained, we propose the adoption of regulatory, economic, and negotiation strategies to reduce these differences and ensure a more equitable distribution of medicines in Brazil.