Aspectos jurídicos e sanitários condicionantes para o uso da via judicial no acesso aos medicamentos no Brasil

Abstract

The search for having access to health care and medicines right granted through Judicial Courts has increased in Brazil. What has been nominated "health judicialization" is a multidimensional phenomenon, a need for dealing with it in a multidisciplinary way involving legal-judicial, political-institutional and sanitary approaches has raised. The Health is recognized as a fundamental human right in the Brazilian Constitution giving it a different legal protection under the legal-constitutional order and the country guarantees the right to health are not only the Constitution and the law strictly, but mainly in an normative infralegal arc that define the goals and outcomes to be achieved by public policy. The lawsuits by drugs may be a reflection of the difficulty of access to health services, to empty and downgrading of health care. Therefore, this turns out to affect the judicialization of pharmaceutical care in Brazil.

Institutional Strategies as a Mechanism to Rationalize the Negative Effects of the Judicialization of Access to Medicine in Brazil

“…The prevalence of requests for medicines outside the SUS formulary without a therapeutic alternative was not influenced by institutional strategies, proving the need to update policies and incorporate new technologies by the SUS. Legal demands for medicines are justified when the provision in the policies is not guaranteed or when the request involves medicines not covered by the policies and without a therapeutic alternative, reflecting gaps in care [4].…”

“…1 Anatomical Therapeutic Chemical 1 Adjusted Prevalence ratio; 2 Confidence interval of 95%; 3 Model adjusted according to the origin of the prescription, DAMNP and CATS. 4…”

Itinerário dos usuários de medicamentos via judicial no estado do Amazonas, Brasil

“…O Ministério da Saúde repassa o recurso financeiro a titulo de ressarcimento, com base na Autorização de Procedimento de Alto Custo, e tem investido nos estudos para inclusão de novas tecnologias e na publicação e revisão de protocolos clínicos 18 . Os achados deste artigo divergem de outros trabalhos, que apontam cerca de um terço dos medicamentos demandados pela via judicial faziam parte de alguma lista do SUS para o fornecimento gratuito, possivelmente por ter sido realizado antes do fenômeno da judicialização, que acabou estimulando o Ministério da Saúde, e os estados na ausência deste, a ampliar o rol de protocolos para diagnóstico e tratamento de doenças raras e/ou que utilizam terapia de alto custo 5,19 . Os entrevistados ingressaram pedidos judiciais individuais, e não por meio de associações, o que demonstra o investimento apenas no atendimento de suas necessidades particulares e imediatas.…”

Institutional strategies as a mechanism to rationalize the negative effects of judicialization of access to medicine in brazil

“…However, since the 1990s, Brazilian citizens have resorted to the judicial system in order to have access to medications and other health goods and services. This phenomenon is called health judicialization, and drugs are the most requested good [2,3,4]. The flaws in health policies and insufficient funds for the State to meet the growing demands in health care are the attributed causes of this phenomenon [5].…”