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Impact of a public health policy on accessibility to levodopa for people with Parkinson's disease in Brazil

Duarte, J. d. S.; Pedrosa, L. R. R.; Gomes, R. S. G.; Santos-Lobato, B. L.

2025-10-24 neurology
10.1101/2025.10.23.25338676 medRxiv
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BackgroundAccess to levodopa remains limited in many low- and middle-income countries. Brazils Popular Pharmacy Program dispenses subsidized levodopa nationwide. ObjectivesTo assess levodopa dispensing and geographic coverage of Popular Pharmacy units in Brazil. MethodsNationwide ecological study. We extracted numbers of levodopa/benserazide and carbidopa/levodopa tablets dispensed from 2020 to 2024, and derived absolute/percent change, annualized growth, and 2024 patient-equivalents of people with PD. Popular Pharmacy coverage was mapped. ResultsIn 2024, the Popular Pharmacy Program dispensed levodopa to approximately 15% of Brazilians with PD. There is a North-South gradient for levodopa dispensing through the program, with higher concentrations in the South/Southeast regions and a significant number of municipalities not dispensing levodopa in the North. ConclusionsThe Popular Pharmacy Program is consistent with increased accessibility to levodopa, yet coverage is limited and uneven. These results may guide other countries to elaborate similar health policies to increase accessibility to levodopa.

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