Drug utilization research in South and Central America

South and Central America includes 20 countries and two territories and stretches from Mexico to the tip of South America. South and Central American health systems have made efforts to manage the rising healthcare costs and attain financial sustainability. This chapter presents case studies on drug utilization research (DUR) in Brazil and Ecuador. DUR has grown considerably in Brazil since the early1990s. Because of the nature of the available data, DUR studies in Brazil revolve mainly around consumption or around provision, as a proxy for consumption, and describe utilization patterns, user profiles, purchases and expenditures, prices, and access. As in many other countries in the region, DUR in Ecuador faces three main challenges: the fragmentation of the healthcare provision between public and private subsystems; the low level of interoperability between healthcare databases; and the low number of trained professionals in DUR, pharmacoepidemiology, and related areas.