Judicialização no acesso a medicamentos: análise das demandas judiciais no Estado do Rio Grande do Norte, Brasil

Abstract

Este trabalho objetivou analisar os processos judiciais que solicitavam medicamentos ao Estado do Rio Grande do Norte, Brasil, no período de 2013 a 2017, descrevendo suas características sociodemográficas, jurídicas e médico-sanitárias. Trata-se de um estudo descritivo, cuja unidade de análise foi o processo judicial individual de solicitação de medicamentos, em que o estado é réu. Os dados foram obtidos por meio de consulta ao sítio eletrônico do Tribunal de Justiça do Estado do Rio Grande do Norte. Foram analisados 987 processos em que a maioria dos autores é do sexo feminino (58,8%), com idade média de 48,3 anos e residentes no interior do estado (56,9%). Houve predomínio de assistência jurídica pública (52,8%) e origem da prescrição no setor privado (38,1%). Em 68% dos casos, houve acesso ao medicamento, sendo o autor responsável pela compra em 56,1% deles, via bloqueio de verbas públicas. As doenças crônicas predominaram, bem como a solicitação de medicamentos não disponibilizados pelo Sistema Único de Saúde (SUS). Foram solicitados 1.517 medicamentos, dos quais 936 (61,7%) não estavam na Relação Nacional de Medicamentos Essenciais (Rename). O medicamento mais solicitado foi a insulina glargina (74 pedidos). Dos 10 medicamentos com maior número de ações judiciais, 4 foram posteriormente incorporados ao SUS, com destaque para as insulinas análogas. Os resultados mostraram que a via judicial tem se consolidado como forma de acesso a medicamentos ainda não incorporados ao SUS, o que pode contribuir como forma de pressão para a incorporação. O bloqueio de verbas públicas para o cumprimento das decisões é preocupante para o gestor do SUS, pois compromete a execução das políticas de assistência farmacêutica programadas.

Profile of The Judicialization In Pharmaceutical Assistance And Expenses With Antineoplastics: A Cross-Sectional, Descriptive Study Based On A Set of All The Lawsuits Filed Between The Years 2016 To 2018 In of A State In Northeastern Brazil

“…With an understanding that this was a convenience sample, it was not possible to address any trends that may have increased or reduced the impacts of these lawsuits on the state's health management, although it was possible to describe the characteristics and behavior of expenditure on medications and the relevance of antineoplastic drugs in a Northeastern Brazilian state that ranks as one of the richest (GDP) in the region. The following comparisons with other ndings in the literature have limitations, since the studies present different methodologies for collecting and describing the pro le characteristics of judicialization, as recently cited by Oliveira et al [22] (2021).…”

Profile of judicialization in access to antineoplastic drugs and their costs: a cross-sectional, descriptive study based on a set of all lawsuits filed between 2016 and 2018 in a state in the Northeast Region of Brazil

“…It was possible, however, to describe the characteristics and trends relating to expense on medication and the proportion of this associated with antineoplastic drugs in a Northeastern Brazilian state that is one of the wealthiest (in terms of GDP) in the region. Attention should be drawn to a few shortcomings regarding the following comparison of our findings with those of other studies in the literature, in view of the variety of methodologies that have been used to collect and describe the characteristics of lawsuits, as recently noted by Oliveira et al (2021) [21]. Our description of the profile of litigation relating to healthcare in the State of Pernambuco found that the proportion of lawsuits was similar for both sexes, thereby corroborating the findings of Diniz et al [22], who found that 51% of such lawsuits in the Federal District (DF) were filed by men.…”

“…It was possible, however, to describe the characteristics and trends relating to expense on medication and the proportion of this associated with antineoplastic drugs in a Northeastern Brazilian state that is one of the wealthiest (in terms of GDP) in the region. Attention should be drawn to a few shortcomings regarding the following comparison of our findings with those of other studies in the literature, in view of the variety of methodologies that have been used to collect and describe the characteristics of lawsuits, as recently noted by Oliveira et al (2021) [ 21 ].…”

Hospital-based health technology assessment in Brazil: current experiences and challenges

“…It is not clear how much these legal demands put pressure on the adoption of drugs by the CONITEC. In Rio Grande do Norte, four of the ten most demanded drugs between 2013 and 2017 were later adopted by the CONITEC (25), suggesting an association between the demands and the adoption. Souza et al (26), on the other hand, found no direct relationship between lawsuits for biological drugs and their adoption by the CONITEC.…”