Análise da aquisição de medicamentos especializados no Estado da Bahia à luz da teoria de custos de transação

Abstract

The organizations work in a very distant reality from a healthy competition. In practice, there are failures in the Market and in the search for an efficient balance. There are expenses to negotiate and monitor; there are also people’s behaviors to coordinate. This work examines the purchases of medications specialized in the context of Superintendency of Pharmaceutical and Technological Assistance (Saftec), with the objective of analyzing the transaction involved in the acquisition of these drugs in the state of Bahia. To achieve the proposed objective, we analyzed the State Healthy Pan (PES) – 2016 a 2019, the Annual Management Report (RAG) – 2019, medication bidding processes from the Specialized Component of Pharmaceutical Assistance (CEAF) and purchase processes of the drugs, both from 2019. In addition, we applied semi-structured interviews to actors in the process of purchasing specialized medications in the state of Bahia. For the data analysis, we used the content analysis technic, starting from the behavioral dimension and the transactional attributes of the Cost and Transaction Theory (CTT), considered fundamental to the analysis of the problem and to reach the objective of this work. The results show that the transaction costs present themselves in a variety of manners in the acquisition process of specialized medications, involving the various elements of CTT. Thus, the limited rationality is shown by the form in which the questioning about the public notice, medication descriptions, and benchmark price; and considering the behavioral aspect, the public administration recognizes that the contracts are incomplete, thus establishing contractual safeguards. Delays in signing the AFM, suppliers who quote products they do not have in stock, attempts to deliver products with expiring dates below what was established in the auction and with different brands from what was quoted and that do not meet the criteria specified in the auction, companies that require a price closer to the maximum selling price to the government - because they are the only producers/suppliers; those were the situations found related to opportunism. The uncertainty was expressed through the incidence of bidding processes deserted and failed; lack of information about the availability of items in stock by the supplier; lack of feedstock, logistical problems and even problems related to macroeconomic and unpredictable factors. The particularity of the actives was revealed by the requirement of good fabrication practices certificates (CBPF) and medications leaflets, as well as by the composition of batches of just one drug from the bids. In relation to the frequency of transactions, we identified the occurrence of recovery requisitions in a smaller part of companies. It was possible to verify an improvement in the management by the establishment of a flow to the acquisition; on the other hand, we verified the nonexistence of bidding courses specifically for the area of medication. The limitation shown in this research indicate that the interviews did not include medication supplying agents or the auctioneers of the State, just as it did not access the totality of documents required by the researcher. For future studies, besides expanding the number of individuals participating, it is suggested the analysis of the incidence of distortion in price and bidding processes in electronic auctions in relation to waiver, as much as evaluating the impact of the Covid-19 Pandemic on the transaction costs in the acquisition of drugs from CEAF.