Conflitos e impasses da judicialização na obtenção de medicamentos: as decisões de 1ª instância nas ações individuais contra o Estado do Rio de Janeiro, Brasil, em 2005

Abstract

Partindo-se de uma análise das ações judiciais individuais para o fornecimento de medicamentos propostas por usuários do Sistema Único de Saúde (SUS) contra o Estado do Rio de Janeiro, Brasil, no ano de 2005, este estudo tem como objetivo discutir a atuação e o comportamento do Poder Judiciário no julgamento dos referidos processos judiciais. O estudo corresponde a uma pesquisa documental exploratória, de caráter quali-quantitativo, na qual foram analisados alguns aspectos relacionados às ações judiciais, tais como, o tipo de medicamento pleiteado, o teor das decisões proferidas e os fundamentos mais freqüentes utilizados pelos magistrados no julgamento das ações. Com base no resultado da análise das ações, do conceito de judicialização e da padronização oficial em matéria de medicamentos, concluiu-se que, ao decidir sobre o fornecimento de medicamentos, o Poder Judiciário concede os pedidos formulados sem considerar a padronização de medicamentos adotada pelo Ministério da Saúde, exercendo assim uma excessiva intervenção na política de saúde.

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 .…”

“…Four studies 2,5,6,12 (23,5%) analyzed the plaintiffs' allegations in the lawsuits, or the grounds for the suit. The main claims involved urgency in the patient's health condition, imminent risk of death, and prescriptions and/or medical and laboratory reports proving the need for the product.…”

“…In a study in the state of Rio Grande do Sul, 29% of the lawsuits claimed delay or denial of the drug when requested through normal administrative channels 2 . The fundamental right to health ensured by the Federal Constitution was cited as a justification for claims in at least articles 2,6,12 .…”

“…Two articles dealt specifically with lawsuits for rare diseases 6,18 , and one focused on claims filed by cancer patients 17 . Of the five studies that examined more than 2,000 lawsuits, only one verified whether the origin of the supply was from the public or private sector, and whether the drugs were registered with the Brazilian National Health Surveillance Agency (ANVISA) 14 , and three studies analyzed whether the drugs claimed through lawsuits were part of official government lists 12,14,19 .…”

“…In these same studies with the most lawsuits, one studied a period of more than ten years 7 and the others covered from one to three years 12,14,16,19 . Two of these studies were by the same research group and published analyses from the same sample in different time periods and with different analyses 14,16 .…”