Ações judiciais e direito à saúde: reflexão sobre a observância aos princípios do SUS

Abstract

The paper refl ects upon the legal interpretations of the right to health and its consequences. In order to exemplify the complexity of the theme and its emotional appeal, it analyzes the Supreme Court's decision in a public litigation against the State of Alagoas demanding that medication be supplied. Different interpretations, by both judges and health professionals, of the notion of integral health care, one of the principles of Brazil's Health System, are examined. It is held that scarcity of resources must be taken into consideration when drawing up public policies that aim to allocate funding effi ciently and in a manner that is compatible with the principals of the health system. Finally, the impact of judicial decisions concerning medication not offered by the system and the behavior of the Brazilian judiciary with this respect are discussed.

Ações judiciais: estratégia da indústria farmacêutica para introdução de novos medicamentos

“…c The States have limited funds and misusing them adversely affects the population as a whole; therefore, it is up to the Executive Branch to defi ne the priorities taking into account the population's healthcare needs. 8 Many preliminary injunctions aim at providing highcost prescribed medication, many of which have only recently been launched in other countries and are still not available in Brazil. Lobbying, carried out by the industry and by those who market pharmaceutical products, at associations of chronic disease patients and the intense advertising activities targeted at physicians results in both patients and prescribers believing that the use of new drugs is absolutely indispensable.…”

“…However, there are situations in which therapy for the condition, for which the medication is being sought, is provided for and regulated based on the offer of alternative therapies. 8 In Brazil, a drug can only be marketed after being registered at and receiving the approval of the Agência Nacional de Vigilância Sanitária (Anvisa -National Agency for Public Health Surveillance). However, being approved does not mean a drug will be listed in the SUS pharmaceuticals assistance program.…”

“…Therefore, it is of utmost importance to provide to the population drugs that are safe, effi cient and cost-effective. 8 The principles of universality, comprehensiveness and equity that govern the SUS end up favoring industry strategies of opening up markets for their new products. When a drug is listed in a pharmaceuticals assistance program, it means that it has a permanent market in a country whose majority of the population cannot afford the costs of medical treatment.…”

Trajetória de busca por cuidado na vivência do evento traumático e sua cronificação

“…Para Mariê a necessidade de realizar uma quarta intervenção cirúrgica já foi cogitada pelo médico: A instituição jurídica entende como ação integral o consumo dos bens de saúde (Vieira, 2008). Decorre que, por meio das decisões judiciais, ela tem garantido apenas ofertas recortadas para necessidades de saúde que são amplas (Araújo e col., 2011).…”

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

“…On the other hand, requests related to medicaments belonging to other AF/ SUS programs are motivated by supply-line problems, such as insuffi cient quantity procurement or failure to meet delivery schedule. 5,7,9,10,14 Studies carried out in São Paulo and Minas Gerais in 2006 showed a high number of judicial claims requesting adalimumab and etanercept (then not yet incorporated into the SUS list) from a small group of prescribers and lawyers. Such results suggest inappropriate relationships between these professionals and the pharmaceutical companies, mischaracterizing the guarantee to the right to health as the overriding motivation in these lawsuits.…”