• Isabela Vaz Leite Pinto, Marina Guimarães Lima, Laís Lessa Neiva Pantuzza, Maria das Graças Braga Ceccato, Micheline Rosa Silveira, and Adriano Max Moreira Reis.
• Municipal Health Department, Municipal Government of Belo Horizonte, Belo Horizonte, MG, Brazil.
• Sao Paulo Med J. 2020 Jun 1; 138 (3): 235243235-243.

BackgroundAccess to medicines is an important indicator of healthcare system quality and capacity to resolve problems. The healthcare system needs to ensure free access to medicines for elderly people, in order to provide greater effectiveness of disease control, thus reducing morbidity and mortality, and improving health and quality of life.ObjectivesTo analyze the frequency of free access to medication among older adults within primary care and determine the factors associated with free access.Design And SettingCross-sectional study at two primary care units.MethodsFree access was defined as provision of all medicines through pharmacies within the Brazilian National Health System and through the Brazilian program for free medicines in private pharmacies. We investigated the sociodemographic, clinical, functional and pharmacotherapeutic characteristics of older adults. Multivariate logistic regression was performed to identify factors associated with free access to medicines.ResultsThis study included 227 older adults, among whom 91 (40.1%) had free full access to prescription drugs. A direct association with age ≤ 70 years and indirect associations with polypharmacy and multimorbidity (P < 0.05) were found.ConclusionsAge ≤ 70 years increases the likelihood of having free full access to medicines, and older adults with multimorbidity and polypharmacy use have a lower likelihood of access. Identification of factors associated with free access to medicines among elderly people provides elements to guide the Brazilian National Health System in implementing access improvement actions.

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