Judicialization of health and public hearing convened by the Supreme Court in 2009: what has changed since then?

Gomes, Dalila Fernandes; Souza, Camila Rufino; Silva, Felipe Luiz da; Pôrto, Julianna Alves; Morais, Indyara de Araújo; Ramos, Maíra Catharina; Silva, Everton Nunes da

doi:10.5935/0103-104.20140008

Cited by 7 publications

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“…The hypothesis that the number of lawsuits increased because of the limited incorporation of new medicines into the SUS is a misconception when we consider that despite the changes in the policy of technological incorporation within the SUS with the creation of Conitec [15], which made the analysis and incorporation of new technologies into the SUS more transparent, responsive, and democratic [14], the number of lawsuits continues to increase in Brazil. Therefore, the argument that the increase in the number of lawsuits is often attributed to the failed or delayed incorporation of new technologies into the SUS is unjustified.…”

Section: Resultsmentioning

confidence: 99%

“…Although this increase follows an increase in the number of lawsuits at the federal level [14, 26], it has not been observed in other states such as Rio Grande do Sul [27]. …”

Section: Discussionmentioning

confidence: 99%

“…In several Brazilian states, there is a strong correlation between high socioeconomic status and the number of lawsuits filed [7, 12, 13]. Currently, the steady increase in the number of lawsuits is attributed to poor management of PA [11], delays in the supply of medications, inaction, and insufficient incorporation of new technologies into the SUS [14]; medicines are the emphasis.…”

Section: Introductionmentioning

confidence: 99%

“…Using this strategy, the process of analysis and incorporation of new technologies into SUS has become more transparent, responsive, and democratic [14]. Despite these changes, the number of lawsuits continues to increase in Brazil.…”

Section: Introductionmentioning

confidence: 99%

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Legal access to medications: a threat to Brazil’s public health system?

Chieffi

Barradas

Golbaum

2017

BMC Health Serv Res

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BackgroundIn Brazil, health is fundamental human right guaranteed by the Constitution of 1988, which created the Brazilian Universal Health System (Sistema Único de Saúde - SUS). The SUS provides medications for outpatient care via policy of pharmaceutical assistance (PA) programmes. Despite the advances in PA policies which include the improvement in access to medications, there has been a significant increase in lawsuits related to health products and services. This study aimed to characterize the medication processes filed between 2010 and 2014 against the Secretary of State for Health of São Paulo (State Health Department of São Paulo - SES/SP), in Brazil, following PA policies.MethodsThis descriptive study used secondary data on medication lawsuits filed against the SES/SP between 2010 and 2014. The data source was the S-Codes computerized system.ResultsIn the period evaluated, the number of lawsuits filed concerning health-related products increased approximately 63%; requests for medications were predominant. Approximately 30% of the medications involved in court proceedings were supplied via PA programmes. With regard to medications supplied via specialized component, 81.3% were prescribed in disagreement with the protocols published by the Ministry of Health. Insulin glargine was the most requested medication (6.3%), followed by insulin aspart (3.3%). Because there is no scientific evidence that either of these medicines is superior for the treatment of diabetes, neither of them has been incorporated into the SUS by the National Commission for Technology Incorporation. The judicial data showed that most of the lawsuits involved normal proceedings (i.e., individual demands), were filed by private lawyers, and named the State of São Paulo as the sole defendant, demonstrating the individual nature of these claims.The data indicate inequality in the distribution between the number of cases and lawyers and the number of lawsuits and prescribers, evidencing the concentration of lawyers and physicians in filing lawsuits.ConclusionThe judicialization of health in the State of São Paulo with the characteristics presented herein is a threat to the SUS.

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Section: Resultsmentioning

confidence: 99%

“…Although this increase follows an increase in the number of lawsuits at the federal level [14, 26], it has not been observed in other states such as Rio Grande do Sul [27]. …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Legal access to medications: a threat to Brazil’s public health system?

Chieffi

Barradas

Golbaum

2017

BMC Health Serv Res

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“…Gomes et al 37 alertam para um emaranhado de interesses que podem ter motivado os discursos de atores representantes de diferentes segmentos durante a audiência. Mesmo assim, houve consenso no debate de alguns pontos, a destacar: a R. Dir.…”

Section: A Audiência Pública N 4 De 2009unclassified

Judicialização e jurisprudência: utilização da STA 175/CE em acórdãos em saúde no Estado de Minas Gerais

et al. 2019

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Após audiência pública em 2009, o Supremo Tribunal Federal consolidou conclusões no julgamento da Suspensão de Tutela Antecipada 175/CE, estabelecendo parâmetros que orientariam o Judiciário e racionalizariam o fenômeno da judicialização da saúde no Brasil. Desconhece-se, contudo, em que medida tal jurisprudência tem influenciado as decisões judiciais. O presente trabalho tem como objetivo investigar o uso da suspensão como referência a embasar as decisões finais colegiadas em saúde do Tribunal de Justiça do Estado de Minas Gerais. Trata-se de estudo de caso baseado em dados secundários obtidos nos acórdãos com citação da Suspensão de Tutela Antecipada 175/CE na ementa. Identificou-se 106 acórdãos. A suspensão foi citada em todos os anos desde 2009 [..]. A distribuição das citações entre relatores e órgãos julgadores foi heterogênea, e o principal contexto de uso da jurisprudência foi para declarar a necessidade de priorização dos tratamentos ofertados pelo Sistema Único de Saúde e comprovação da excepcionalidade dos casos inadequados a eles. Estimou-se que os 106 acórdãos representaram 0,1% do universo de acórdãos sobre o direito à saúde proferidos no período. Concluiu-se que a Suspensão não foi referência fortemente utilizada nos acórdãos do Tribunal de Justiça do Estado de Minas Gerais. Embora a literatura indique uma tendência à racionalidade na jurisprudência brasileira em relação ao deferimento de demandas judiciais em saúde, o frágil uso da jurisprudência do Supremo Tribunal Federal pela corte mineira não confirma, na prática, tal tendência, pondo em questão a efetividade de tal recurso na intervenção sobre o fenômeno da judicialização da saúde.

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Infusão subcutânea contínua de insulina: cenário nacional e internacional

et al. 2016

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Fonte de financiamento: nenhuma. Conflito de interesses: nada a declarar. ResumoIntrodução: O sistema de bomba de infusão contínua de insulina (SIC) é uma alternativa à aplicação múltipla diária de insulina por pacientes diabéticos. Embora apresente inúmeras vantagens, a sua disponibilidade no sistema público de saúde ainda é muito baixa. Esse trabalho objetivou identificar práticas e experiências de secretarias e organizações de saúde quanto à utilização do SIC. Método: Foram aplicados questionários às secretarias de saúde dos Estados brasileiros (SES) e às organizações internacionais de avaliação de tecnologias em saúde (ATS). Resultados: A maioria das SES (83%) tem recebido demandas judiciais, com um aumento de uso do SIC nos últimos cinco anos. As organizações internacionais informaram que, em 47% dos países pesquisados, o SIC é disponibilizado à população pelo governo por meio do sistema de saúde público. Conclusão: O uso do SIC resulta em vários benefícios, contudo está atrelado a um custo adicional anual de cerca de R$9.500,00 por paciente. Portanto é evidente a necessidade de se realizar estudos para avaliar a incorporação do SIC e seu impacto orçamentário no sistema de saúde brasileiro, além de definir em quais circunstâncias ele será disponibilizado à população. Palavras-chave: sistemas de infusão de insulina; diabetes mellitus; insulina; avaliação da tecnologia biomédica; decisões judiciais. Abstract Introduction:The Continuous Subcutaneous Insulin Infusion pump system (CSII) is an alternative to multiple daily administration of insulin in diabetic patients. Although it has many advantages, its availability in the public health system is still very low. This study aimed to identify practices and experiences of health departments and organizations on the use of CSII. Method: Questionnaires were applied to Brazilian Health Departments of the States (SES) and international organizations for health technologies evaluation. Results: Most of the SES (83%) have received lawsuits and the use of CSII has increased in the last 5 years. International organizations reported that in 47% of countries, the CSII is available to patients through the public health system. Conclusion: The use of CSII brings several benefits, but also a high annual additional cost of approximately R$ 9,500 per patient. Therefore, there is an evident need to conduct studies assessing the incorporation of CSII, its budgetary impact in the Brazilian health system, and the definition of which circumstances this will be made available to the population.

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Judicialization of health and public hearing convened by the Supreme Court in 2009: what has changed since then?

Cited by 7 publications

References 0 publications

Legal access to medications: a threat to Brazil’s public health system?

Legal access to medications: a threat to Brazil’s public health system?

Judicialização e jurisprudência: utilização da STA 175/CE em acórdãos em saúde no Estado de Minas Gerais

Infusão subcutânea contínua de insulina: cenário nacional e internacional

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