Cancer Disparities, Obesity Drugs & Health Updates from Brazil

Research involving 65,500 women with breast cancer in the state of São Paulo has revealed significant disparities between the public and private healthcare systems. Published in the journal Clinical Breast Cancer, the study shows that 38.3% of patients treated through the public system (SUS) are diagnosed at stage 2 of the disease, and 29.5% at stage 3 – when the tumor is more advanced. These findings highlight the critical need for equitable access to timely cancer care.

In the private healthcare sector, the majority (41.4%) are identified at stage 1, the early phase with the highest chance of cure. This difference is reflected in survival rates: after ten years, 81.6% of women in the private system diagnosed at stage 1 remain alive, compared to 77.5% in the SUS. At stage 3, the contrast is even greater: 55.6% survival in the private sector versus 39.6% in the public system.

Gustavo Nader Marta, a physician at Hospital Sírio-Libanês and the study’s author, emphasized in an interview with Folha that early diagnosis is crucial for better outcomes. The researcher cautioned that, given São Paulo’s status as the wealthiest and most developed state in the country, the situation may be even more severe in other regions, where healthcare access barriers are likely to be greater.

Experts say the data underscores the access barriers that patients face within the public oncology system. Daniel Buttros, of the Brazilian Society of Mastology, explained that early-stage tumors have similar treatment approaches in both systems, but “advanced tumors in the public system do not always receive the same treatment as in the private sector. That’s where the disparity begins.”

The Secretary of State for Health of São Paulo, José Luiz Gomes do Amaral, acknowledged that the results reflect structural inequalities and stated, “We need to invest more in the public system. Today, the investment is insufficient.” The Ministry of Health says We see strengthening policies for early diagnosis and equipment acquisition to address this reality.

New Obesity Treatments in the Private Sector and SUS

The number of healthcare claims related to obesity in supplemental health insurance more than doubled in nearly a decade, rising from 40.7 cases per 100,000 beneficiaries in 2015 to 84.5 in 2024, according to a study by IESS based on data from ANS. The growth was more intense among women (132%) and the economically active population aged 20 to 59 (116%), the group that concentrates most beneficiaries and where the disease puts the most pressure on the care network, with direct impacts on medical and hospital costs, work absences, and sector sustainability. Experts warn that obesity cannot be treated as an isolated condition, but as a “comorbidity that generates new comorbidities,” associated with cardiovascular diseases, diabetes, and joint problems.

Addressing the problem, however, goes beyond access to medications, even though the expiration of the semaglutide patent this month opens up new possibilities. The Ministry of Health is evaluating the incorporation of the active ingredient into the SUS for specific groups, such as patients with advanced obesity and comorbidities awaiting bariatric surgery, and is too encouraging national production of synthetic peptides through an Anvisa call for proposals. But Minister Alexandre Padilha emphasizes that responding to the obesity epidemic requires integrated policies: “taxing sugary drinks and reducing taxes on healthy food baskets is very important. As is banning ultra-processed foods from school meals,” he defended.

New Anvisa Director Aims to Accelerate Drug and IFA Analysis

The National Health Surveillance Agency (Anvisa) has a new leader at the helm of its Second Directorate, a strategic area focused on evaluating medicines and foods. Daniela Marreco Cerqueira, who was in the Third Directorate, assumed the position a month ago and has prioritized the creation of tools to speed up the analysis of registration requests. In an interview with JOTA, the director said she intends to strengthen the policy initiated in 2025 to reduce the waiting list, which is considered extensive by both the agency and the pharmaceutical sector.

Among the measures under study is the expansion of the so-called “optimized analysis” – a strategy used since 2017 with biological products, which groups several petitions from the same company for joint evaluation – to synthetic drugs and Active Pharmaceutical Ingredients (IFA). Daniela also intends to expand the employ of regulatory confidence, accepting summaries of opinions from international reference agencies. The director set a goal to analyze, by June, all approximately 200 registration processes from 2023 that are still pending.

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