Reducing Public Healthcare Costs in Brazil Through Effective Innovation

Brazil’s public healthcare system faces one of the greatest challenges of its recent history: ensuring universal, comprehensive, and equitable access to care in a context of limited financial resources, population growth, an aging society, and a significant rise in chronic diseases. The Unified Health System (SUS), internationally recognized for its scale and complexity, operates under constant pressure to deliver efficiency, budget predictability, and improved clinical outcomes.

In this context, reducing costs does not mean cutting investments or restricting access. It means investing more effectively, based on scientific evidence, economic evaluation, and results-oriented innovation. The sustainability of public healthcare in Brazil necessarily depends on how the system addresses diseases with high economic and social impact—particularly mental health disorders and substance use.

The Structural Challenge of Public Healthcare in Brazil

Public healthcare in Brazil operates under permanent budget constraints. Healthcare spending grows at a faster pace than economic growth, while demand for services continues to rise. Chronic diseases, long-term treatment conditions, and illnesses requiring recurrent follow-up consume a significant share of public health budgets.

Beyond direct costs—such as consultations, hospitalizations, medications, and procedures—there are substantial indirect costs, including work absenteeism, productivity losses, caregiver burden, and healthcare-related litigation. These factors amplify the financial impact on states and municipalities and increase the system’s vulnerability to budgetary imbalances.

Mental Health as a Critical Cost Driver in the Public System

Among the main sources of pressure on public healthcare in Brazil, mental health disorders stand out. Depression, anxiety, substance dependence, and other psychiatric conditions are associated with high rates of rehospitalization, continuous medication use, emergency care visits, and prolonged specialized follow-up.

Under the current model, many patients repeatedly cycle through primary care, psychosocial care centers (CAPS), emergency units (UPAs), and hospitals without achieving sustained clinical improvement. This creates a recurring cost cycle that directly undermines system efficiency. Low adherence to conventional treatments and side effects related to polypharmacy further increase the complexity of care.

Why the Traditional Therapeutic Model Generates High Costs and Low Systemic Returns

A large proportion of treatments currently used in Brazil’s public healthcare system were designed primarily to suppress symptoms, requiring continuous and long-term medication use. In many cases, therapeutic effects take weeks to emerge, while adverse effects appear early, leading to treatment discontinuation.

This model results in:

• low treatment adherence;

• frequent medication adjustments;

• combination of multiple drugs;

• increased demand for new consultations and hospitalizations.

From an economic standpoint, this translates into accumulated costs over time, without a proportional reduction in the care burden on the public system.

What Effective Innovation Means in Public Healthcare

Innovation, in the context of public healthcare in Brazil, should not be confused with expensive technology or experimental solutions. Effective innovation is innovation that demonstrates, in measurable terms, the ability to improve clinical outcomes while reducing total system costs over time.

Modern health evaluations consider factors such as:

• reductions in hospital admissions and readmissions;

• shorter overall treatment duration;

• sustained improvements in quality of life;

• reduced dependence on continuous care;

• positive impacts on healthcare network organization.

This perspective shifts the focus from immediate cost to long-term value—an approach widely adopted in more mature healthcare systems.

Cost Is Not Price: Foundations of Economic Evaluation in Healthcare

In Brazil’s public healthcare system, decisions based solely on the unit price of medications or therapies often lead to distortions. Modern economic evaluations distinguish price from total cost, incorporating concepts such as cost-effectiveness, cost-utility, and cost-benefit.

A treatment may have a higher initial cost but significantly reduce:

• future hospitalizations;

• continuous use of multiple medications;

• emergency care visits;

• prolonged work absences.

When analyzed from this perspective, the initial investment can result in net savings for the public healthcare system.

Sustained-Effect Therapies as a Cost-Reduction Strategy

One of the most promising pathways to the sustainability of public healthcare in Brazil is the adoption of therapies capable of producing long-lasting clinical effects. Treatments that deliver sustained improvement reduce the need for repeated interventions and relieve pressure on healthcare services.

In mental health, scientific evidence indicates that approaches with prolonged impact can decrease relapse rates, rehospitalizations, and dependence on continuous treatment. This leads to more efficient use of healthcare resources and greater budget predictability.

Regulated Natural-Based Medicines: Science Applied to Public Healthcare

It is essential to distinguish empirical use of natural substances from regulated medicines developed under rigorous scientific standards. For an innovation to be incorporated into Brazil’s public healthcare system, it must meet clear criteria for safety, efficacy, standardization, and quality control.

Regulated medicines enable:

• precise dose control;

• production traceability;

• predictable effects;

• integration into clinical protocols;

• reduction of legal and health-related risks.

This is the only viable path for the responsible adoption of new therapies in the public system.

Healthcare Litigation and the Role of Regulated Innovation

Healthcare litigation has become a growing source of unpredictable expenditure in Brazil’s public healthcare system. Many legal actions arise from the absence of effective therapies incorporated into the system or from the pursuit of treatments outside official protocols.

Incorporating regulated innovations, assessed under technical and economic criteria, helps reduce litigation, increase budget predictability, and strengthen healthcare governance.

National Science, Public Partnerships, and Health Sovereignty

Another strategic dimension for public healthcare in Brazil is strengthening national science and partnerships between the public sector, universities, and research centers. Developing solutions domestically reduces external dependence, shortens supply chains, and enhances system responsiveness.

Well-structured public–private partnerships also allow risk sharing, resource optimization, and faster incorporation of innovations with real impact on population health.

Sustainability, Ethics, and Long-Term Impact

The sustainability of public healthcare in Brazil is also linked to how natural resources and traditional knowledge are used. Sustainable production, raw material traceability, and adherence to ethical principles reduce environmental, legal, and reputational risks.

Models that integrate modern science, social responsibility, and sustainability tend to produce more stable, safer solutions aligned with contemporary public health demands.

Pathways for Incorporating Innovation into the SUS

The incorporation of new technologies into Brazil’s public healthcare system requires rigorous technical evaluation, including clinical studies, pharmacoeconomic analyses, and real-world outcomes monitoring. Transparent, evidence-based processes enable more accurate and sustainable decision-making.

Pilot projects, multicenter studies, and continuous outcome monitoring are essential tools to ensure that innovation delivers real value to the system.

Conclusion: Efficiency as the Foundation of Sustainable Public Healthcare in Brazil

Securing the future of public healthcare in Brazil requires a paradigm shift—from short-term cost logic to decisions based on value, long-term impact, and scientific evidence. Reducing costs does not mean restricting care, but adopting solutions that are more effective, safer, and more sustainable.

Effective innovation, solid regulation, national science, and ethical responsibility form the pathway toward a more resilient public healthcare system, capable of meeting the population’s needs today and in the future.

Connecting Scientific Innovation to Public Healthcare

The discussion around cost reduction and efficiency in Brazil’s public healthcare system reinforces the importance of scientific initiatives that combine regulated innovation, economic evaluation, and social impact. It is within this context that Ayamed operates—developing prescription medicines grounded in rigorous science, focused on sustained clinical outcomes and responsible integration into the public healthcare system.