{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T11:23:08Z","timestamp":1791372188371,"version":"4.3.1"},"reference-count":39,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T00:00:00Z","timestamp":1787356800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T00:00:00Z","timestamp":1787356800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      The World Health Organization (\n                      <jats:styled-content style=\"fixed-case\">WHO<\/jats:styled-content>\n                      ) began recognizing drug shortages as a global issue in 2014, impacting health systems and patient care. Shortages arise from supply chain disruptions, production issues, and mismatches between supply and demand, aggravated by insufficient mechanisms for forecasting and communication.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The study analyzed medicine discontinuation notifications in Brazil from 2014 to 2024 from a public secondary database. Data was downloaded, organized, and cleaned using Excel, incorporating\n                      <jats:styled-content style=\"fixed-case\">ATC<\/jats:styled-content>\n                      classification and verification of medicines listed on the National Essential Medicines List (\n                      <jats:styled-content style=\"fixed-case\">NEML<\/jats:styled-content>\n                      \/\n                      <jats:styled-content style=\"fixed-case\">RENAME<\/jats:styled-content>\n                      ). Statistical analyses included descriptive statistics and association tests (Pearson's\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      , Fisher's exact test) examining discontinuation types, registration categories, reasons, and\n                      <jats:styled-content style=\"fixed-case\">NEML<\/jats:styled-content>\n                      presence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Between 2014 and 2024, Brazil had 23,\u2009110 discontinuation notifications, of which 15,\u2009599 (67.5%) were temporary, and 7,511 (32.5%) were definitive discontinuation. The annual distribution was not homogeneous. Generic had the highest proportion of discontinuations (37.2%), surpassing branded generics (33.2%) and originator brands (15.9%). In contrast, biological products, herbal medicines, dynamized medicines, and specific medicines together accounted for only 13.73% of the total. Regarding the reasons for discontinuation, commercial reasons predominated, accounting for 73.4% of notifications. Finally, it was found that the majority of discontinued drugs were not included in\n                      <jats:styled-content style=\"fixed-case\">NEML<\/jats:styled-content>\n                      (73.9%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Medicine discontinuation in Brazil from 2014 to 2024 is mainly temporary and occurs for generics and branded\u2010generics due to commercial decisions. The findings highlight the complexity of supply continuity and the importance of strategies that include diversifying supply sources, strengthening regulatory oversight, and improving monitoring and communication systems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pds.70458","type":"journal-article","created":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T07:31:42Z","timestamp":1787383902000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Trends in Medicines Discontinuation and Implications for Access in Brazil (2014\u20132024)"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8528-7379","authenticated-orcid":false,"given":"Raphaella Oliveira Martins","family":"de Lima","sequence":"first","affiliation":[{"name":"Centro Multidisciplinar UFRJ\/Maca\u00e9 Federal University of Rio de Janeiro  Maca\u00e9 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9595-1656","authenticated-orcid":false,"given":"Esther Ramos","family":"Silva","sequence":"additional","affiliation":[{"name":"Centro Multidisciplinar UFRJ\/Maca\u00e9 Federal University of Rio de Janeiro  Maca\u00e9 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0383-2465","authenticated-orcid":false,"given":"Isabel C. M.","family":"Emmerick","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Department of Surgery University of Massachusetts Medical School  Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9814-8526","authenticated-orcid":false,"given":"Danielle Maria","family":"de Souza Serio dos Santos","sequence":"additional","affiliation":[{"name":"Centro Multidisciplinar UFRJ\/Maca\u00e9 Federal University of Rio de Janeiro  Maca\u00e9 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0568-6625","authenticated-orcid":false,"given":"Isabella Piassi Dias","family":"God\u00f3i","sequence":"additional","affiliation":[{"name":"Centro Multidisciplinar UFRJ\/Maca\u00e9 Federal University of Rio de Janeiro  Maca\u00e9 Brazil"},{"name":"Centro Multidisciplinar UFRJ\/Maca\u00e9, N\u00facleo de Avalia\u00e7\u00e3o de Tecnologia em Sa\u00fade\u2014Gest\u00e3o, Economia, Educa\u00e7\u00e3o em Sa\u00fade e Servi\u00e7os Farmac\u00eauticos (GEESFAR\/NATS\/UFRJ) Federal University of Rio de Janeiro  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0596-6632","authenticated-orcid":false,"given":"Ana Cristina Viana","family":"Campos","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio e Observat\u00f3rio em Vigil\u00e2ncia &amp; Epidemiologia Social Universidade Federal do Sul e Sudeste do Par\u00e1 (LOVES\/Unifesspa)  Par\u00e1 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9597-3651","authenticated-orcid":false,"given":"Luisa Arueira","family":"Chaves","sequence":"additional","affiliation":[{"name":"Centro Multidisciplinar UFRJ\/Maca\u00e9 Federal University of Rio de Janeiro  Maca\u00e9 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,22]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"World Health Organization \u201cExecutive Board 134th Session Resolutions and Decisions Annexes \u201daccessed January 20 2014 https:\/\/apps.who.int\/gb\/ebwha\/pdf_files\/EB134\u2010REC1\/B134_2014_REC1\u2010en.pdf?utm_source=.com."},{"key":"e_1_2_10_3_1","unstructured":"World Health Organization \u201cEB140\/2017\/REC\/1 \u201daccessed December 14 2018 http:\/\/apps.who.int\/gb\/ebwha\/pdf_files\/EB140\u2010REC1\/B140_REC1\u2010en.pdf#page=1."},{"key":"e_1_2_10_4_1","unstructured":"L. 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