O direito à saúde no Brasil: entre a judicialização e a desjudicialização

Figueiredo, Iara Veloso Oliveira; Costa, Nílson do Rosário

doi:10.17566/ciads.v11i4.785

Cad. Ibero Am. Direito Sanit.

2022

DOI: 10.17566/ciads.v11i4.785

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O direito à saúde no Brasil: entre a judicialização e a desjudicialização

Iara Veloso Oliveira Figueiredo¹,

Nílson do Rosário Costa

Abstract: Objetivo: demonstrar as configurações da judicialização da saúde e refletir sobre os impasses e possibilidades dessa experiência singular no Brasil. Metodologia: foi realizada uma revisão da literatura em 113 textos, encontrados em bases de dados de literatura científica, que embasou uma proposta de teoria que estratifica a judicialização da saúde no Brasil em quatro faces: judicialização positiva; judicialização negativa; assessorias técnicas; e desjudicialização. Resultados e discussão: na judicialização pos… Show more

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Cited by 2 publications

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Health litigation and cancer survival in patients treated in the public health system in a large Brazilian city, 2014–2019

et al. 2023

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Background Litigation for health care, also known as health judicialization, is frequent in Brazil. It involves recourse to the court system to access health services. The study aimed to evaluate whether cancer patients in Belo Horizonte, Minas Gerais, Brazil, increased their overall survival by increasing access to certain drugs or treatments through litigation, controlling for the effect of demographic and disease-related variables. Methods A retrospective cohort study was conducted. Patients with breast, prostate, brain, lung, or colon cancers from 2014 to 2019 were included. Survival analysis was performed using the Cox proportional hazards model. Results In the multivariate analysis, litigation was significantly associated with increased survival in cancers of breast (HR = 0.51, 95%CI 0.33–0.80), prostate (HR = 0.50, 95%CI 0.30–0.85), colon (HR = 0.59, 95%CI 0.38–0.93), and lung (HR = 0.36, 95%CI 0.22–0.60). Five-year survival rates of patients who sued for treatment were 97.8%, 88.7%, 59.3%, and 26.0%, compared to median survival of 95.7%, 78.7%, 41.2%, and 2.4%, respectively, among patient that did not resort to court action. The study suggests that litigation for access to cancer treatment may represent a step forward in obtaining more effective treatment. This study´s main limitations are the lack of patients´ clinical information for use as control variables and the lack of variables to assess patients´ quality of life. The study also found that many cases involved claims that could have been solved by administrative rather than legal action. Some claims thus reflect the lack of adequate administrative procedures. Conclusion When based on scientific evidence, access to new therapies, combined with other technologies already available, can favor patient survival. Access to new therapies through litigation may increase health inequalities since low-income patients have limited access to legal recourse against the State to meet their needs. The timely approval of new effective therapies can mitigate the judicialization of cancer treatment.

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Health litigation and cancer survival in patients treated in the public health system in a large Brazilian city, 2014–2019

et al. 2023

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Desjudicialização da saúde e diálogos interinstitucionais em Minas Gerais: a análise do Acordo de Cooperação Técnica para a gestão dos medicamentos Ranibizumabe e Aflibercept

Castro,

Netto,

dos Santos

et al. 2024

Cad. Ibero Am. Direito Sanit.

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Objective: to understand the judicialization of health in Brazil and analyze, from the perspective of health de-judicialization, the Technical Cooperation Agreement signed on December 2, 2021, between the State Health Departmentof Minas Gerais , the State Attorney General's Office of Minas Gerais, and the State Public Defender's Office of Minas Gerais for the management of the medications Ranibizumab and Aflibercept. Method: a narrative review of the literature on the judicialization of health and an exploratory study based on documentary analysis of the antecedents of the Technical Cooperation Agreement were carried out. Results and discussions: Self-composition and consensual resolution of conflicts by the Public Administration has broad legal support and, in the current legal and administrative scenario, is the most effective and efficient means of realizing the underlying public interest, notably the right to health, promoting its dejudicialization. This scenario points to the potential for new solutions, including the implementation of interinstitutional dialogues, such as the Technical Cooperation Agreement studied, which is expected to serve as the embryo for a permanent trend in the management of the judicialization of health within the scope of State Health Departmentof Minas Gerais. Final considerations: ahe cooperation agreement studied has great potential for the dejudicialization of actions with requests for ophthalmological medicines, in addition to others whose incorporations are proposed within it. It also promotes synergistic and convergent action by actors involved in judicialization. The perspective is that, from this milestone, these legal actions will decrease and patients will begin to be served through the United Health System administrative supply route. Submission: 03/19/24| Review: 08/16/24| Approval: 09/01/24

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O direito à saúde no Brasil: entre a judicialização e a desjudicialização

Cited by 2 publications

References 26 publications

Health litigation and cancer survival in patients treated in the public health system in a large Brazilian city, 2014–2019

Health litigation and cancer survival in patients treated in the public health system in a large Brazilian city, 2014–2019

Desjudicialização da saúde e diálogos interinstitucionais em Minas Gerais: a análise do Acordo de Cooperação Técnica para a gestão dos medicamentos Ranibizumabe e Aflibercept

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