Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo, Diadema, Brasil.
Cad Saude Publica. 2020 Nov 23;36(11):e00192319. doi: 10.1590/0102-311X00192319. eCollection 2020.
Water pollution has been an increasing concern for the authorities responsible for planning and executing public policies. In this qualitative research, we have discussed the most sold pharmaceuticals in the São Paulo Metropolitan Region, Brazil, and compared public policies focused on pharmaceuticals and environmental issues among countries/regions. For that, data provided by Close-Up International related to the sales of medicines in the São Paulo Metropolitan Region between April/2016 and April/2017 were collected and processed to identify and quantify the pharmaceutical products. The 300 most sold medicines in the São Paulo Metropolitan Region fall in 26 therapeutic classes, which include 159 drugs. The most sold pharmaceutical products group is nonsteroidal anti-inflammatory drugs (NSAIDs) representing approximately 44.3% of the total. The ten most sold pharmaceuticals sum up 1200 tons. Dipyrone is the first place in mass representing around 488 tons, followed by metformin with around 310 tons commercialized. Public policies focused on pharmaceuticals in the environment still need adjustments to improve reinforcement, even in developed countries. There is no international standard on how to conduct the issue, each country adopting the public policy that best matches to the local. Brazil, despite having some legislation that approaches the theme, still lacks effective public policies and stakeholder awareness. In this aspect, the need for improvement of the reverse logistics system, consumer orientation to the adequate disposal of unused/expired medicines, and the adoption of the unit-dose system as a therapeutic strategy is evident.
水污染一直是负责规划和执行公共政策的当局日益关注的问题。在这项定性研究中，我们讨论了巴西圣保罗大都市区最畅销的药品，并比较了各国/地区关注药品和环境问题的公共政策。为此，我们收集并处理了 Close-Up International 提供的有关 2016 年 4 月至 2017 年 4 月期间圣保罗大都市区药品销售的数据，以识别和量化药品。圣保罗大都市区销量最高的 300 种药品属于 26 种治疗类别，其中包括 159 种药物。销量最高的药品是非甾体抗炎药（NSAIDs），约占总数的 44.3%。销量最高的十种药品总计 1200 吨。双氯芬酸的销量最高，约 488 吨，其次是二甲双胍，约 310 吨。环境中的药品公共政策仍需要调整以加强，即使在发达国家也是如此。目前还没有关于如何处理这个问题的国际标准，每个国家都采用最适合本国国情的公共政策。巴西尽管有一些接近这一主题的立法，但仍缺乏有效的公共政策和利益相关者的意识。在这方面，显然需要改进逆向物流系统、消费者对未使用/过期药品的适当处理的意识，以及采用单位剂量系统作为一种治疗策略。
