What the Brasíndice table is and how it affects billing

Medications account for a significant share of a hospital’s expenses. In medium- and high-complexity hospital stays, the value of the drugs administered can make up 30% or more of the total claim. When that cost is billed based on the wrong price or an outdated edition of the reference table, the payer can deny the claim. The loss hits the balance sheet without anyone noticing in time to correct the error.

The Brasíndice table is the main drug pricing reference used in hospital contracts in Brazil. Knowing how it works, what its prices represent and how to apply it correctly in billing is an essential part of hospital financial management.

What the Brasíndice table is

Brasíndice is a specialized publication that compiles the prices of drugs sold in Brazil, including enteral diets and some hospital materials. Its origins date back to 1965, when Editora Andrei, a São Paulo publisher, began publishing Revista Brasíndice to give the healthcare industry a consolidated reference for pharmaceutical prices.

The publication comes out every two weeks and is available both in print and on an online portal, by subscription. Frequent updates are necessary because drug prices can change at any time, whether because of industry price adjustments, the addition of new products or regulatory changes. Working with an outdated edition is therefore a billing risk.

For each drug listed, Brasíndice provides two main values: the Manufacturer Price (PF) and the Maximum Consumer Price (PMC). These two numbers serve different purposes, and confusing them is among the most frequent errors in hospital billing.

PF and PMC: which to use in hospital billing

PF and PMC are the two pillars of Brasíndice pricing, but each serves a different context. Using the wrong value in billing leads to an administrative denial due to a pricing discrepancy.

Manufacturer Price (PF)

The PF is the price at which the pharmaceutical industry sells the drug to hospitals, clinics and distributors. It is the price charged within the hospital supply chain, which is why it is the correct reference value for billing claims to health plans.

When the contract between the hospital and the payer specifies Brasíndice as the reference table for drugs, the PF is understood to be the basis for calculation. Billing based on the PMC in this situation results in a higher amount than the contracted one, which leads to an immediate denial.

Maximum Consumer Price (PMC)

The PMC is the price ceiling allowed for selling drugs at retail pharmacies, regulated by Anvisa (National Health Surveillance Agency) through CMED (Drug Market Regulation Chamber). It is calculated from the PF by adding a distribution margin and taxes.

In the hospital setting, the PMC appears as a reference in some specific contract negotiations, usually with a discount percentage applied to it. When the contract uses the PMC as its basis, this will be stated explicitly. Without that specification, the market standard is the PF.

How Brasíndice relates to CMED

Brasíndice and CMED are often confused because both deal with drug prices. The distinction between them, however, is fundamental for anyone who works in hospital billing.

CMED is the Drug Market Regulation Chamber, an interministerial body linked to Anvisa, responsible for setting the maximum prices that can be charged in the Brazilian market. Based on Law No. 10,742/2003 and CMED Resolution No. 3/2003, which establish the rules for setting and adjusting prices, CMED periodically publishes the official lists of regulated prices. This data is publicly available and carries regulatory force: no drug can be sold above the limits set by the chamber.

Brasíndice, in turn, is an independent publication. It collects the prices reported by pharmaceutical companies after approval by the Ministry of Finance and republishes them in an organized way, every two weeks, in a format suited to operational use in hospitals. In practical terms, Brasíndice translates CMED’s regulatory data into a quick-reference tool for billing specialists, buyers and auditors.

The essential difference lies in the audience and purpose of each:

From a billing standpoint, what matters is that Brasíndice neither replaces CMED nor conflicts with it. Brasíndice operates within the regulatory limits set by CMED and provides the data in a practical format for day-to-day hospital use. When a contract cites “Brasíndice” as a reference, it recognizes this publication as the operational instrument for looking up drug prices.

How Brasíndice is used in hospital billing

Brasíndice enters hospital operations at two distinct moments: in contract negotiations with the payer and in the day-to-day execution of billing.

In the contract phase, the hospital and the payer define which reference table will be used to price the drugs administered during care. When Brasíndice is chosen, the contract specifies which value will be applied, PF or PMC, and whether there will be an adjustment percentage on top of it. This contractual agreement is what the billing specialist needs to check before any charge.

In billing execution, the process follows a straightforward sequence. After the patient is seen, the billing specialist identifies each drug the patient used, finds the item in Brasíndice by its product code, checks the current value in the most recent edition of the table and applies the contractual percentage agreed with that payer. The resulting amount goes into the billing form submitted under the TISS standard.

Two practical points of attention for this routine:

• Current edition. Brasíndice is updated every fifteen days. A drug’s price in this week’s edition may differ from the previous one. Billing must always use the edition in force on the date of service, not the date the claim is submitted.

• Correct code. Each drug has a specific code in Brasíndice. Billing one product under another’s code, even at a similar price, is a technical discrepancy and can lead the payer to deny the claim for an incorrect code.

An outdated Brasíndice leads to denials

Incorrect use of Brasíndice in billing is a source of administrative denials that many institutions underestimate. Unlike clinical denials, which require analysis of the medical record and a technical discussion with the payer, denials for pricing discrepancies tend to be objective: the amount billed does not match the amount in the contracted table. The payer rejects it, and the hospital loses.

The most frequent errors in this category follow a recognizable pattern:

• Outdated edition. The billing system is configured with an old edition of Brasíndice. The industry has adjusted the drug’s price, the current table already reflects the new value, but the hospital still bills the previous price. Depending on the direction of the adjustment, the hospital bills less than it could receive, leaving revenue on the table, or more than the payer accepts, leading to a denial.

• Confusing PF and PMC.The contract specifies PF, but the system applies PMC. Since the PMC is always higher than the PF, the amount billed exceeds the contractual limit and the payer denies the difference.

Prevention requires automatic biweekly updates of Brasíndice in the billing systems and correct configuration of the price type for each contract. Manual processes at this step are slow, prone to being forgotten and hard to audit.

An up-to-date Brasíndice is protected revenue

The right drug, with the right code, at the right price from the current edition: that is the equation hospital billing has to solve with every claim. Brasíndice provides the reference, but making sure it is applied correctly, for every patient, under every contract, is an operational challenge that scales with the volume of care.

Hospitals that rely on manual processes to keep Brasíndice up to date in their systems are always one step behind: the edition changes every 15 days, contracts vary by payer and any mismatch turns into a denial. Automating this control, with automatic application of the current values for each contract, is what turns Brasíndice from a source of risk into a tool for protecting revenue.

Many institutions are already adopting artificial intelligence tools to automate the revenue cycle and reduce denials. Rivio uses AI to manage this entire cycle, automatically updating Brasíndice and other pricing tables, applying the current rules and values for each contract and identifying discrepancies before the claim is submitted. From audit to payment, our technology takes care of every step so that the hospital receives everything it is entitled to.

Frequently asked questions about the Brasíndice table

How often is the Brasíndice table updated?

Brasíndice is published every two weeks, both in print and on an online portal. Billing must always use the edition in force on the date of service.

What is the difference between Brasíndice and CMED?

CMED is the regulatory body linked to Anvisa, responsible for setting maximum drug prices in Brazil. Brasíndice is an independent publication that republishes this data in an operational format for use by hospitals and payers. CMED carries regulatory force; Brasíndice is the industry’s practical reference tool.

What are PF and PMC in Brasíndice?

The PF (Manufacturer Price) is the price charged in transactions between the pharmaceutical industry and hospitals. The PMC (Maximum Consumer Price) is the ceiling for retail pharmacies. In hospital billing, the PF is the standard reference. The PMC should only be used when the contract with the payer explicitly provides for it.

Is Brasíndice an official government table?

Brasíndice is an independent publication by Editora Andrei, with no ties to government bodies. Its wide adoption by the market, as a reference in contracts between hospitals and payers, stems from its consistency and regular publication, not from a legal requirement.

For drugs, should I use Brasíndice or SIMPRO?

Brasíndice is the specific reference for drugs registered with Anvisa. SIMPRO covers medical and hospital supplies, equipment and devices. For a hospital stay involving both drugs and surgical materials, the two tables are used together, each for its own scope.