Garantia do direito social à assistência farmacêutica no Estado de São Paulo

Marqués, Silvia Badim; Dallari, Sueli Gandolfi

doi:10.1590/s0034-89102007000100014

Cited by 64 publications

(54 citation statements)

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“…c Currently, there are fi ve classes of drugs: analgesics, nonsteroidal anti-infl ammatory drugs (NSAIDs), corticosteroids, disease-modifying Private lawyers prevailed in lawsuits fi led in Minas Gerais, a situation observed in different parts of the cuntry. 5,8,10,13 However, the Public Defender's Offi ce of Minas Gerais was responsible for most cases related to four of the 18 drugs most in demand, which is similar to the fi ndings by Messeder et al (2005) and Sant'ana (2011). 9,11,d A low frequency of legal proceedings fi led by free legal assistance centers linked to law faculties was observed.…”

Section: Discussionsupporting

confidence: 74%

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Médicos, advogados e indústria farmacêutica na judicialização da saúde em Minas Gerais, Brasil

et al. 2012

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OBJECTIVE: To describe the relationship between the prescribing physician, lawyer and pharmaceutical industry in lawsuits against the state. METHODS:Retrospective descriptive study based on data from administrative fi les, relating to lawsuits involving medicine demands, in the State of Minas Gerais, from October 1999 to October 2009. The variables studied were: gender, age, benefi ciaries' illness, type of medical care (public or private), prescriber, type of legal representation and requested medication. A descriptive analysis of the variables with the distribution of frequencies was carried out. RESULTS:A total of 2,412 lawsuits were analyzed with 2,880 medicine requests, including 18 different drugs, 12 of them provided through Pharmaceutical Policies of the Brazilian National Health System (SUS). The most frequent medicines requested were adalimumab, etanercept, infl iximab, insulin glargine and tiotropium bromide. The main diseases were rheumatoid arthritis, ankylosing spondylitis, diabetes mellitus and chronic obstructive pulmonary disease. Private lawyers and doctors were predominant. The results revealed the association between doctors and law offi ces on drug requests. Among the lawsuits fi led by the offi ce A, 43.6% had a single prescriber of adalimumab, while 29 doctors were responsible for 40.2% of the same drug prescriptions. A single doctor was responsible for 16.5% of the adalimumab prescriptions, being requested through lawsuits fi led by a single private law offi ce in 44.8% of legal proceedings. CONCLUSIONS:A greater representation of doctors and lawyers from the private sector can hinder equity in health. The results revealed the association between doctors and law offi ces on drug requests. This is an indication that justice and medical practice have been used, at certain times, to serve the interests of the pharmaceutical industry. DESCRIPTORS:Health lawsuits and access to health . Equity in health. Pharmaceutical industry. Incorporation of medicines. Lawsuit offi cials. Doctors.

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Section: Discussionsupporting

confidence: 74%

“…Long waiting lines are often common and a reason for discouraging those needing the free assistance. [8][9][10] The lawsuits represent a diversion of substantial resources for the fulfi llment of court injunctions, to the detriment of (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Médicos, advogados e indústria farmacêutica na judicialização da saúde em Minas Gerais, Brasil

et al. 2012

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“…5 The technique of collective subject discourse, similar to what was described in the study of Marques & Dallari, 12 was used to organize and tabulate the qualitative data. The main arguments mentioned by the magistrates were transcribed from each interlocutory decision.…”

Section: Methodsmentioning

confidence: 99%

Decisões judiciais sobre acesso aos medicamentos em Pernambuco

Stamford

Cavalcanti²

2012

Rev. Saúde Pública

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OBJECTIVE:To analyze decisions from the legal system concerning the population's access to medicines within the Brazilian Public Health System through judicial channels, with regard to decision-making criteria and possible political and economic pressure. METHODS:This was a descriptive retrospective study on documents with a quantitative and qualitative approach. Data were gathered from the State of Pernambuco Superintendency for Pharmaceutical Care, and the data sources used were 105 lawsuits and administrative reports between January and June 2009. It was ascertained which medications have a patent or patent request in the database of the Brazilian Patent Offi ce (INPI), in order to identify the frequency with which patents feature in lawsuits. The data obtained were classifi ed according to Anatomical and Therapeutic Chemical System. To analyze the judicial decisions, the theory of autopoietic social systems was used. RESULTS:There were lawsuits involving 134 medications, with an estimated value of R$ 4.5 million for attending the treatments requested. 70.9% of the medications had a patent or a patent request and they were concentrated in three therapeutic classes: antineoplastic and immunomodulating agents; digestive tract and metabolism; and sensory organs. Six central ideas within judges' decision-making criteria were identifi ed (the federal constitution and medical prescriptions), along with pressure between the legal, economic and political systems concerning access to medications. CONCLUSIONS:The analysis on judicial decisions based on the theory of autopoietic social systems made it possible to identify mutual stimulation (dependency) between the legal system and other social systems in relation to the issue of citizens' access to medications. This dependency was represented by the federal constitution and intellectual property. The federal constitution and medical prescription were identifi ed as decision-making criteria in lawsuits. Intellectual property represented possible political and economic pressure, especially in cases of launching medications into the market.

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“…Ações judiciais contendo prescrições de medicamentos sem registro no país têm levantado discussão sobre o que os mesmos podem acarretar sobre a segurança dos pacientes/usuários (MARQUES; DALLARI, 2007;PEREIRA, 2006;ROMERO, 2008;SARTÓRIO, 2005;PEREIRA et al, 2007).…”

Section: Segurança Sanitáriaunclassified

“…Alguns estudos que caracterizam as ações judiciais referem ser a existência do receituário médico o principal respaldo para a decisão do julgador (VIEIRA; ZUCCHI, 2007;MARQUES;DALLARI, 2007;SARTÓRIO, 2005;MESSEDER et al, 2005;BORGES, 2007;ROMERO, 2008). Segundo Pepe et al (2008), em uma amostra de 185 ações de medicamentos julgadas na segunda instância do Tribunal de Justiça do Rio de Janeiro, de janeiro a dezembro de 2007, a prescrição de medicamento não foi questionada.…”

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Um enfoque sanitário sobre a demanda judicial de medicamentos

Figueiredo

Pepe

Osório-de-Castro³

2010

Physis

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No Brasil, apesar dos avanços da assistência farmacêutica, permanecem falhas na garantia do acesso dos cidadãos aos medicamentos pelo Estado. Nos últimos anos, vem crescendo a reivindicação de medicamentos por parte do cidadão via sistema judiciário. Os objetos dessas solicitações são tanto os medicamentos em falta na rede pública como aqueles ainda não incorporados pelo Sistema Único de Saúde. Este fenômeno pode ser analisado sob diferentes perspectivas, inclusive a sanitária, entendida aqui como os desfechos sobre a saúde dos indivíduos que demandam estes medicamentos. O presente texto busca discutir as principais características das demandas judiciais frente aos seguintes aspectos: o uso racional de medicamentos, o uso de evidências científicas para a indicação terapêutica proposta e o quanto as demandas se justificam diante do conceito de acesso adotado pelo campo da assistência farmacêutica. Ponderações podem ser feitas no sentido de minimizar os riscos à saúde dos demandantes de medicamentos por via judicial, sobretudo quando o objeto da ação são medicamentos não pertencentes às listas de fornecimento público, ou com uso off label, ou desprovidos de registro no país. Considera-se que o Judiciário, a partir do fornecimento de medicamentos, busca garantir a saúde dos demandantes, e assim a dignidade da pessoa humana. Cabe ressaltar que este objetivo só será atingido quando a garantia da saúde estiver associada aos aspectos que certificam a segurança do paciente, inclusive no uso de medicamentos.

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Garantia do direito social à assistência farmacêutica no Estado de São Paulo

Cited by 64 publications

References 0 publications

Médicos, advogados e indústria farmacêutica na judicialização da saúde em Minas Gerais, Brasil

Médicos, advogados e indústria farmacêutica na judicialização da saúde em Minas Gerais, Brasil

Decisões judiciais sobre acesso aos medicamentos em Pernambuco

Um enfoque sanitário sobre a demanda judicial de medicamentos

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