Caracterização de demandas judiciais de fornecimento de medicamentos "essenciais" no Estado do Rio de Janeiro, Brasil

Abstract

Recognition of the right to health raises two practical issues IntroduçãoAs leis e recomendações internacionais reconhecem o direito à saúde como um direito humano, estando ele incluso nas leis constitucionais de alguns países. O acesso aos medicamentos essenciais é considerado por alguns autores como integrante deste direito 1,2,3 .No Brasil, o direito à saúde está disposto nos artigos 6 o , 196 o a 200 o da Constituição Federal brasileira, como um direito social, a ser garantido por meio de políticas, que, dentre outras tarefas, devem promover e garantir o acesso universal e igualitário às ações e serviços para promoção, proteção e recuperação da saúde dos cidadãos. A Lei Orgânica da Saúde (Lei Federal nº. 8.080/90) 4 , em seus artigos 6 o e 7 o , regulamenta o sistema público de saúde, estabelecido constitucionalmente, e atribuiu ao Sistema Único de Saúde (SUS) a execução de ações de assistência terapêutica integral, inclusive farmacêutica. Desta forma, o reconhecimento da saúde como um direito possui duas importantes repercussões prá-ticas: a responsabilidade ética e legal do poder público de formular e implementar ações que assegurem o acesso da população aos serviços de atenção à saúde; e a possibilidade do cidadão reivindicar judicialmente, de forma individual ou coletiva, o cumprimento desta obrigação estatal. Os chefes dos executivos da saúde têm formulado e implementado políticas e ações de saúde, inclusive de assistência farmacêutica, por meio ARTIGO ARTICLE

Studies published in indexed journals on lawsuits for medicines in Brazil: a systematic review

“…The first year of the publications included in the review was 2005, and there was a peak in the years 2010 and 2011. The data refer to studies done in the states of Pernambuco 5 , Rio Grande do Sul 2,6 , Minas Gerais 7,8 , Rio de Janeiro 9,10,11,12 , and São Paulo 13,14,15,16,17 , besides one article that collected data directly from the Ministry of Health in Brasilia 18 . The studies that examined the most lawsuits (between 2,000 and 2,927 cases) were done in the states of São Paulo, Rio de Janeiro, and Santa Catarina 7,12,14,16,19 .…”

“…Three articles 2,6,10 (17.6%) examined petitions for advance relief or other types of court injunctions, and the results were the following: two studies showed 100% of such petitions 6,10 and one 98% 2 . The majority of the studies (76.5%; n = 13) collected specific data to determine whether there was more than one defendant in the suits, four conducted this analysis 2,6,9,10 , in two of them the defendants were states and municipalities 9,13 and in the others the defendants were states, municipalities, and the Federal Government 2,6 .…”

“…Ten studies analyzed the plaintiffs' legal representation 2,6,7,8,9,10,14,16,17,20 , of which three 7,14,16 examined more than two thousand lawsuits, whose plaintiffs were represented predominantly by private attorneys. These studies were done in São Paulo, Rio de Janeiro, and Minas Gerais, states with large populations, and two of the three Table 2 Characterization of types of documents and agencies used as data sources.…”

“…In some states, such as Rio Grande do Sul and São Paulo, in order to receive legal aid from the Office of the Public Defender, there is a limit on the plaintiff's income (three times the minimum wage) 2 , while in other states such as Rio de Janeiro and the Federal District it is necessary to prove insufficient economic means with documents and an affidavit signed by the plaintiff 10 . In this case, one might infer that, in principle, individuals filing claims through the Office of the Public Defender have the lowest socioeconomic status.…”

“…Another factor to consider in relation to the prevalence of chronic diseases is the change in the population's epidemiological profile related to aging and socioeconomic conditions 14 . Data on the therapeutic indications for the medicines were analyzed by nine of the 17 articles included in the review 2,6,7,10,11,15,17,18,20 and show that in most cases the prescribed drugs can be classified as medium to high cost, while four studies were designed to clarify points on rare diseases. Thus, it is not possible to infer that the high cost of lawsuits is due to the lack of organization in primary care.…”