Análise das demandas judiciais para aquisição de medicamentos no estado da Paraíba

Abstract

This study aimed to describe the medical, scientific, and sanitary aspects of lawsuits for drug supply filed with the Court of Paraíba (TJ-PB) against public officials in the state of Paraíba, Brazil. It was a descriptive and cross-sectional study, which had as source the Information System of the Paraíba Court. Drug processes judged at the second instance between the years 2009 and 2010 with a final decision already made at the time of consultation were analyzed. About the scientific evidences of efficacy and safety, drugs were evaluated through systematic reviews in the Brazilian Cochrane Centre database. The groups of drugs most frequently requested were the antineoplastic agents, followed by insulin and angiotensin II antagonists. The antineoplastic agents' costs accounted for 76% of the total spent on litigation, representing an approximate cost of R$ 343,000 per month, of which an item had no record in Brazilian sanitary organ. The results pointed to a high number of lawsuits with prevalence of requests for drugs standardized by the Brazilian Unified Health System (SUS), of which the antineoplastic agents are noteworthy and reinforce the need for revision of the National Pharmaceutical Assistance Policy, both regarding deployment strategies as the urgency to expand the list of drugs available through SUS.

A judicialização da saúde em Manaus: análise das demandas judiciais entre 2013 e 2017

“…The system's logic is to plan coverage based on epidemiological criteria, and these responsibilities are defined in ministerial ordinances. Similar result was found by Nunes and Ramos Junior (2016), in which 84.7% of the lawsuits were filed against the state department (the study included the Federal government), and by Leitão et al (2016), in which 79.3% of the lawsuits were filed against the state. The legal representation, for the most part, comes from assistance agencies to people who declare themselves unable to afford judicial costs, such as the Federal Public Defender's Office, State Public Defender's Office, Public Prosecution Office and Federal Prosecution Office, which corresponds to 75.47% of the suits.…”

“…The study of Pinto and Osório-de-Castro (2015) also highlights that most of the actions were filed by public defenders (62%). There is divergence with the studies of Vieira and Zucchi (2007), Nunes and Ramos Junior (2016), Leitão et al (2016) and Machado et al (2011), in which the number of representations made by private lawyers prevailed (54%, 68.4%, 55.17% and 60.3%, respectively). The study by Nunes and Ramos Junior (2016) found greater use of the judicialization strategy in upper classes.…”

“…Stamford and Cavalcanti (2012), in Pernambuco, showed that eight pharmaceutical companies manufactured 80% of the requested drugs and that 90% of the Health Department resources for their acquisition were related to seven pharmaceutical laboratories. Leitão et al (2016), when studying judicialization in Paraíba, focus on identifying the profile of medicine demands and show the high number of lawsuits filed for standardized drugs by SUS, especially antineoplasics. In Bahia, Lisboa and Souza (2017) tried to identify the reasons that led citizens to petition for insulin in court and found: (1) economic weakness; (2) need to use the medicine; (3) duty and obligation of the State to provide it; (4) difficulties in medicine access caused by administrative and bureaucratic issues.…”

“…Regarding the request for anticipatory relief, a similar result was found by Nunes and Ramos Júnior (2016), who verified a request for it in 99.8% of the cases. About the sentences given, the study bears similarity with Leitão et al (2016), in which 77.6% of the actions were considered upheld. Regarding the situation of suits, 50.94% had already been finalized ("remanded," "unappealable judgment" or "transfer of venue"), and 11.32%, although already judged, may still receive an appeal.…”

“…In Leitão et al (2016), the average time between the entry of the case and its sentence was 206 days. The other data were not collected by the parameters studied.…”