ANDRE LUIZ BIGAL

Doutorando em Saúde Coletiva pelo programa de Pós-graduação em Saúde Coletiva da Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM/UNIFESP). Pesquisador do Laboratório de Saúde Coletiva (LASCOL): Política, Planejamento e Gestão em Saúde. Sanitarista do Departamento Medicina Preventiva da Escola Paulista de Medicina na Universidade Federal de São Paulo (DMP/EPM/UNIFESP). Mestre em Ciências (Saúde Coletiva) pela Escola Paulista de Medicina/UNIFESP. Especialista em Saúde da Família pelo Programa de Residência em Saúde da Família da Faculdade Santa Marcelina (FASM/SP). Graduação em Farmácia (UNIESP/SP).

EDUCATION

PhD student, master of sciences from the Escola Paulista de Medicina at the Federal University of São Paulo.
Family Health Specialist. Degree in Pharmacy.

RESEARCH, TEACHING, or OTHER INTERESTS

Medicine, Public Health, Environmental and Occupational Health, Health Policy, Pharmaceutical Science

Scopus Publications

Technological arrangements for regulating access to healthcare: experience in the state of São Paulo
Revista De Saude Publica, 2026
National Pharmaceutical Care Policy and COVID-19: analysis of the pandemic response in the state of São Paulo
André Luiz Bigal, Luís Fernando Nogueira Tofani, Rosemarie Andreazza, Fernando Tureck, Mariana Prado Freire, et al.
Ciencia E Saude Coletiva, 2026
The National Pharmaceutical Care Policy (Política Nacional de Assistência Farmacêutica - PNAF) is defined by the National Health Council as essential to the realization of the constitutional right to health. It is a cross-cutting and intersectoral policy that coordinates state and municipal managers at different levels of care in the Unified Health System (SUS). The objective was to identify and analyze the aspects of Pharmaceutical Care (PC) in the fight against COVID-19 in the state of São Paulo from the perspective of local and regional SUS managers, based on the PNAF. This is a mixed-method, multiple-case study with structured quantitative questionnaires and semi-structured qualitative interviews. Responses were obtained from 255 municipal managers (39.5%), representing 29,039,968 inhabitants (65.4% of the state population), and 14 regional health directors (82% of the Health Regions). This study identifies and analyzes ‘What are the contributions of the PNAF to addressing the COVID-19 pandemic in the state of São Paulo?’ The results revealed: joint action by federal entities, decentralization of PC, access to and rational use of medicines, irrational use of medicines from the COVID kit, tensions between managers, prescribers, pharmaceutical professionals and users, and supply difficulties.
Resilience and technological care arrangements in hospital settings during the COVID-19 pandemic: an integrative literature review
Larissa Maria Bragagnolo, Camila Aleixo de Campos Avarca, Luís Fernando Nogueira Tofani, André Luiz Bigal, Greice Herédia dos Santos Moura, et al.
Ciencia E Saude Coletiva, 2026
Resumo A presente revisão integrativa objetiva analisar a literatura científica para identificar arranjos tecnológicos hospitalares de gestão do cuidado (AT) utilizados durante a pandemia de COVID-19, com vistas a compreender se e como esses arranjos contribuíram para a resiliência dos serviços e sistemas. A busca na literatura científica foi feita em três bases de dados, compreendendo o período de 1º de janeiro de 2020 a 10 de maio de 2023. A análise de dados se deu a partir da classificação dos AT de acordo com as dimensões familiar, profissional e organizacional do cuidado de Cecílio (2011). Os AT que operaram na dimensão familiar do cuidado sugerem estratégias relacionais como potencializadoras da resiliência dos hospitais. As experimentações no campo das dimensões profissional e organizacional apontam a importância do compartilhamento de decisões e o diálogo entre tecnologias na resiliência e na integralidade do cuidado. As TIC apoiaram a reorganização hospitalar na superação dos desafios pandêmicos sem prescindir de tecnologias leves, com potência para transformar o hospital contemporâneo. Assim, sistemas de saúde como o SUS, ao conectar TIC aos AT, podem potencializar a articulação entre familiares e profissionais, a ampliação da clínica e das capacidades institucionais.
Pharmaceutical prescription and health judicialization: Healthcare access restriction implemented by corporations
André Luiz Bigal
Physis, 2025
Fentanyl: A threat to Brazilian society or an opioid drug of great importance in pain management?
Gabriela Pereira Kuhn, André Luiz Bigal, Solange Aparecida Nappo
Saude E Sociedade, 2025
Introduction: About 450,000 Americans died from opioid overdoses from 1999 to 2018, characterizing one of the worst public health problems ever faced by the U.S. Methods: We conducted a narrative literature review by searching the central databases. We selected 101 studies. After analysis, they were reduced to 77 articles that allowed a comprehensive view of fentanyl in the U.S., the factors that triggered its high-risk consumption, and its consequences in Brazil. Results and Discussion: We identified three phases that have contributed to the opioid crisis in the U.S.: (1) Increased prescribing; (2) Heroin use associated with other drugs, especially fentanyl and (3) Illicit fentanyl use. In Brazil, in contrast to an opiophobia history, we have observed growing opioid prescriptions and illicit fentanyl-derived seizures. The impact of this increase is unknown regarding the high-risk/addiction consumption outlook. Final considerations: Fentanyl is a valuable tool in pain management and cannot be excluded from clinical practice. This is justified by the social and bioethical responsibility associated with pain control. Establishing control mechanisms and prevention measures is essential to ensure access to medicines while preventing illegal circulation.
Use of WhatsApp® aplicattion in health manegement, work, and care in fighting the COVID-19 pandemic
Ciencia E Saude Coletiva, 2025
Regulatory technology arrangements for hospital bed access during the COVID-19 pandemic: scope review
Cadernos De Saude Publica, 2025
Mental health care measures and innovations to cope with COVID-19: an integrative review
Amanda Seraphico Carvalho Pereira da Silva, Lumena Almeida Castro Furtado, Luís Fernando Nogueira Tofani, André Luiz Bigal, Larissa Maria Bragagnolo, et al.
Ciencia E Saude Coletiva, 2024
Resumo A presente revisão integrativa tem por objetivo identificar os arranjos de cuidado em saúde mental que foram implementados no enfrentamento à pandemia de COVID-19. Realizou-se busca em três bases de dados (SciELO, PubMed e LILACS), em português, inglês e espanhol, com os descritores “SAÚDE MENTAL” or “SALUD MENTAL” or “MENTAL HEALTH” AND “COVID-19”, no período de 2020 a 2021. Foram encontrados 3.451 artigos, sendo 43 selecionados para análise. Em relação ao cuidado em saúde mental, os principais arranjos identificados foram os digitais, de natureza pública, desenvolvidos na esfera municipal e com integração com a rede de saúde. Os modelos de cuidado em saúde mental para o enfrentamento da pandemia são discutidos a partir dos tipos de arranjo produzidos nesse contexto sanitário emergencial e crítico. Apresenta-se, ainda, um recorte da realidade encontrada no Sistema Único de Saúde (SUS), reiterando sua resiliência. Concluiu-se que os arranjos digitais foram os mais usados e que há necessidade de investigar a acessibilidade deste modelo para populações com maior vulnerabilidade social. Reafirma-se a importância do SUS para o enfrentamento da COVID-19 e no acesso a informações de saúde.
Urgent and emergency care networks in Brazil: an integrative review
Luís Fernando Nogueira Tofani, Lumena Almeida Castro Furtado, Rosemarie Andreazza, André Luiz Bigal, Deize Graziele Conceição Ferreira Feliciano, et al.
Saude E Sociedade, 2023
The Urgent and Emergency Care Network (RUE) was proposed in Brazil as a public policy to articulate and integrate the health services of the Brazilian National Health System (SUS), expanding and qualifying the access of users in e emergency health situations in an efficient and timely manner. This study analyzes the scientific production on the RUE in Brazil and elaborates summaries showing the limits and challenges of this health policy. An integrative literature review was used as a method, based on the search for articles in the LILACS, SciELO, and MEDLINE databases and for dissertations and theses on the virtual platform of the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES). The investigation enabled the analysis of 34 studies in the field of collective health, focused on the different emergency services and the integration between them, including possible changes in the health care process and different evaluation strategies, by using different approaches, mainly qualitative. Weaknesses are observed in the network articulation, maintaining the centrality of hospital services and the power of its symbolic capital, with primary care being relegated to the discursive field.