Consumption and Lack of Access to Medicines and Associated Factors in the Brazilian Amazon: A Cross-Sectional Study, 2019

Objective: We aimed to investigate the consumption and lack of access to medicines in the adult population of Manaus, Amazonas. Methods: A population-based study was conducted in Manaus in 2019. Individuals aged ≥18 years were selected by probabilistic sampling performed in three stages. Study outcomes included the consumption of medicines in the previous fortnight and the lack of access to treatments in those who used any medicine. We calculated the prevalence ratios (PR) for the outcomes with 95% confidence intervals (CI) by Poisson regression with robust variance, considering the complex sampling design. Results: Out of the 2,321 participants, 53.2% (95%CI 50.7-55.7%) consumed medicines, of which 14.4% (95%CI 11.9-16.8%) could not obtain appropriate treatments. Analgesics were the most used medicines (557/2,702; 21.4%), whereas antibiotics were the most inaccessible treatments (18/228; 7.9%). Lack of financial resources was the main reason for not accessing treatments (104/228; 45.6%). Consumption was significantly associated with older age (≥60 years: PR=1.27; 95%CI 1.09-1.49), lower social class (D/E: PR=0.84; 95%CI 0.72-0.99), lower educational level (p=0.039), poor health status (PR=1.30; 95%CI 1.11-1.52), use of healthcare services (PR=1.37; 95%CI 1.26-1.49), and chronic diseases (PR=1.36; 95%CI 1.22-1.52). Lack of access was higher in people with poor health status (PR=2.46; 95%CI 1.50-4.04) and chronic diseases (PR=1.84; 95%CI 1.16-2.92). Conclusion: Half of Manaus’ population used medicines, which was higher in socially privileged and sicker individuals. Among those, 14 in every 100 could not access drug therapies, which was more frequent in people with poor health and with chronic diseases.