Preparação individualizada de Medicação – avaliação de necessidades e custos de implementação

Abstract

Background: Individualized Medication Preparation (IMP) systems organize therapy by dose and by day and aim to improve adherence and simplify complex regimens, especially in polymedicated patients [1]. Adherence can have a greater impact on public health than many recent innovations, with non-adherence being one of the main causes of avoidable expenses [2–5].
Objectives: To assess public perceptions of IMP, identify factors associated with willingness to pay (WTP), and estimate the implementation and operation costs of an IMP system in a community pharmacy.

Methods: Observational, cross-sectional, descriptive study using a structured online questionnaire (n=263; 261 valid responses). Simple binary logistic regression was applied to analyze associations between WTP and sociodemographic and behavioral variables. An economic analysis with fixed and variable costs (2024/2025 euros) was also performed, considering 238 annual preparation days.
Results: The majority of participants were female (75.5%), aged between 19 and 83 years. Although 84% reported no difficulties taking the medication, 59% did not consider the PIM useful for them; only 6% considered it of little use to family members or acquaintances. Overall, 76% expressed PPD and 67% would agree to pay up to €10/month. Female gender showed a lower probability of PPD (-43%), while identifying as a relative (+126%) and recognizing usefulness for others (+190%) increased this probability. The total cost in the first year was €70,171.68 (R$ 9,120.00 initial investment; €21,579.00 in supplies; €39,472.68 in human resources). The daily cost was €233.91, with labor being the main component. Sustainability is estimated with approximately 700 users at €10/month.
Conclusions: The PIM is perceived as beneficial, especially for third parties. Gender, respondent, and perceived usefulness influence the DPP. Despite the significant initial investment, the service can become financially viable through appropriate reimbursement models.