Pharmaceutical policies for gaining access to high-priced medicines: a comparative analysis between England and Brazil

Even though the National Health Service (NHS) and Unified Health System (SUS) are systems with similar universal principles, they can show different political measure patterns in the pharmaceutical field. The aim was to provide a comparative analysis of pharmaceutical policies highlighting strategies to guarantee sustainability and access to high-price medicines (HPM) between Brazil and England. An integrative literature review was performed in electronic databases between January 2009 and December 2019, supplemented by grey literature searched in governmental platforms (laws, decrees, ordinances, and resolutions). A total of 47 articles and 7 policies were selected for analysis, categorised according to the lifecycle of a pharmaceutical product framework. The results showed that both countries applied distinct policies to guarantee access to HPM, between them, policies to define prices and reimbursements, and actions to regulate the access and use of these medicines in the health systems. Also, these countries apply distinct policies to their own sustainability. While Brazil often uses partnerships for productive development, England uses a collaborative accelerated access program. In conclusion, despite similarities in the normative principles, these countries have been proposing and applying distinct policies to maintain access to HPM and ensure the sustainability of their health systems.