Judicialization of health: lawsuits for access to medicines in Uruguaiana-RS
Main Article Content
Abstract
Introduction: In Brazil, the right to health has a constitutional and universal provision. However, the judicial route has been widely used to access health goods and services. Objective: To analyze the lawsuits of medicines filed by citizens of a Brazilian municipality. Methods: Quantitative and retrospective study evaluating 652 lawsuits filed in 2016 conducted in Uruguaiana, state of Rio Grande do Sul. The information was made available by the State Department of Health. Results: 55.5% of lawsuits filed were related to drugs provided by the public health system Sistema Único de Saúde (SUS). 44.5% did not fit into the guidelines of the Brazilian Policy for Pharmaceutical Services. Most of the lawsuits were filed by women over 60 years old. Regarding the therapeutic classification, the most requested drugs were for the nervous system. The most described pathological condition according to the ICD-10 (International Classification of Diseases) was Diabetes Mellitus. Conclusion: These data corroborate the situation found in other parts of the country, demonstrating the need to reorganize the Pharmaceutical Service Policy to ensure universal and equitable access to medicines, as described in the Federal Constitution.
Downloads
Article Details
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC BY) that allows others to share and adapt the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.References
Brasil. Presidência da República. Constituição da República Federativa do Brasil de 1988. [Cited 2017 Jun 17] Available from: http://www.planalto.gov.br/ccivil_03/Constituicao/Constituicao.htm
Brasil. Presidência da República. Lei Orgânica da Saúde nº 8.080, de 19 de setembro de 1990. [Cited 2017 Jun 17] Available from: http://www.planalto.gov.br/ccivil_03/leis/L8080.htm
Brasil. Ministério da Saúde. Conselho Nacional de Saúde. Política Nacional de Assistência Farmacêutica. [Cited 2017 Jun 17] Available from: http://bvsms.saude.gov.br/bvs/saudelegis/cns/2004/res0338_06_05_2004.html
Nisihara RM, Possebom AC, Borges LMC, Shwetz ACA, Bettes FFB. Judicial demand of medications through the Federal Justice of the State of Paraná. Einstein. 15(1):85-91. http://dx.doi.org/10.1590/s1679-45082017gs3792
Silva MEDL, Almeida ATCD, Araújo Júnior IT. Equity analysis of resource distribution for the Popular Pharmacy Program. Rev Saúde Púbica. 2019;53,50. https://doi.org/10.11606/S1518-8787.2019053000731
Rio Grande do Sul. Secretaria de Estado da Saúde. Portaria /SES/RS Nº 670/2010. [Cited 2017 Jul 15] Available from: https://saude.rs.gov.br/upload/arquivos/201701/1814191320120515135656portaria-ses-rs-n-670-de-31-12-2010.pdf
Provin MP, Leite SN, Amaral RG. Social inequalities in lawsuits for drugs. Braz J Pharm Sci. 2013;49(3):465-74. http://dx.doi.org/10.1590/S1984-82502013000300008
Pepe VLE, Figueiredo TA, Simas L, Osorio-de-Castro CGS, Ventura M. A judicialização da saúde e os novos desafios da gestão da assitência farmacêutica. Ciênc Saúde coletiva. 2010;15(5):2405-14. https://dx.doi.org/10.1590/S1413-81232010000500015
Chieffi AL, Barata RB. Judicialização da política pública de assitência farmacêutica e equidade. Cad Saúde Pública. 2009;25(8):1839-49. https://dx.doi.org/10.1590/S0102-311X2009000800020
Babar ZUD, Gammie T, Seyfoddin A, Hasan SS, Cureley LE. Patient access to medicines in two countries with similar health systems and differing medicines policies: Implications from a comprehensive literature Res Social Adm Pharm. 2019;15(3):231-43. https://dx.doi.org/10.1016/j.sapharm.2018.04.006
Sant’Ana JMB, Pepe VLE, Figueiredo TA, Osorio-de-Castro CGS, Ventura M. Racionalidade terapêutica: elementos médico-sanitários nas demandas judiciais de medicamentos. Rev Saúde Pública. 2011;45(4):714-21. http://dx.doi.org/10.1590/S0034-89102011005000042
Barros SG, Vieira-da-Silva LM. A terapia antirretroviral combinada, a política de controle da Aids e as transformações do Espaço Aids no Brasil dos anos 1990. Saúde Debate. 2017;41(spe3):114-28. http://dx.doi.org/10.1590/0103-11042017s309
Keinert TMM, Paula SHB, Bonfim JRA. As ações judiciais no SUS e a promoção do direito à saúde. São Paulo: Instituto de Saúde, 2009; p. 233.
Bermudez JAZ, Esher A, Osorio-de-Castro CGS, Vasconselos DMM, Chaves GC, Oliveira MA, et al. Assistência Farmacêutica nos 30 anos do SUS na perspectiva da integralidade. Ciênc Saúde Coletiva. 2018;23(6):1937-49. https://doi.org/10.1590/1413-81232018236.09022018
Brasil. Presidência da República. Lei Nº 8666, de 21 de junho de 1993. [Cited 2017 Jul 15] Available from: http://www.planalto.gov.br/ccivil_03/leis/l8666cons.htm
Biehl J, Socal MP, Amon JJ. The judicialization of health and the quest for state accountability: Evidence from 1,262 lawsuits for access to medicines in Southern Brazil. Health Hum Rights. 2016;18(1):209-20.
Conselho Federal de Farmácia (CFF). Farmacêuticos atuantes na judicialização se reúnem em Brasília. [Cited 2017 Jun 17] Available from: https://www.cff.org.br/noticia.php?id=4479&titulo=+Farmac%C3% AAuticos+atuantes+na+judicializa%C3%A7%C3%A3o+se+re%C3%BAnem+em+Bras%C3%ADlia.
Sindicato Médico do Rio Grande do Sul [Internet]. Rio Grande do Sul lidera judicialização na saúde. [Cited 2017 Mar 29] Available from: http://www.simers.org.br/2015/11/rio-grande-do-sul-lidera-judicializacao-na-saude.
Defensoria Pública do estado do Rio Grande do Sul [Internet]. Farmacêutica auxilia defensores públicos nos atendimentos da área da saúde. [Cited 2017 Jun 17] Available from: http://www.defensoria.rs.def.br/farmaceutica-auxilia-defensores-publicos-nos-atendimentos-da-area-da-saude.
Corte FD, Zanatta BR, Pizutti PL, Colet CF. Identificação dos medicamentos solicitados à SES/RS judicial e via administrativa no município de Ijuí-RS. Rev Interdiscipl Ensino Pesq Extensão. 2014;2(1).
Ucker JM, Oliveira KR, Bandeira VAC, Flores VB. Profile of medicines supplied via judicial process in the pharmaceutical assistance in the city of Santa Rosa/RS. Tempus Actas Saúde Coletiva. 2016;10(1):127-42. http://dx.doi.org/10.18569/tempus.v10i1.1717
Cardoso CS. Análise das demandas judiciais de medicamentos: uma abordagem da realidade atual do Distrito Federal. Cad Ibero-Amer Dir Sanit. 2017;6(1):228-46. http://dx.doi.org/10.17566/ciads.v6i1.351
Bertoldi AD, Barros AJD, Hallal PC, Lima RC. Drug utilization in adults: prevalence and individuals determinants. Rev Saúde Pública. 2004;38(2):228-38. http://dx.doi.org/10.1590/S0034-89102004000200012
Miranda GMD, Mendes ACG, Silva ALA. Population aging in Brazil: current and future social challenges and consequences. Rev Bras Geriatar Gerontol. 2016;19(3):507-19. http://dx.doi.org/10.1590/1809-98232016019.150140
Foly SLF, Matta LG, Shimoda E. Judicialização do acesso a medicamentos no Município de Itaperuna-RJ: perfil das demandas. Saúde Transf Social. 2016;7(2):51-68.
Sant’Ana JMB, Pepe VLE, Osorio-de-Castro CGS, Ventura M. Essencialidade e assistência farmacêutica: considerações sobre o acesso a medicamentos mediante ações judiciais no Brasil. Rev Panam Salud Publica. 2011:29(2):138-44.
Catanheide ID, Lisboa ES, Souza LEPF. Características da judicialização do acesso a medicamentos no Brasil: uma revisão sistemática. Physis. 2016;26(4):1335-56. https://doi.org/10.1590/S0103-73312016000400014
Batistella PMF, Aroni P, Fagundes AL, Haddad MCFL. Ações judiciais em saúde: revisão integrativa. Rev Bras Enferm. 2019;72(3):809-17. http://dx.doi.org/10.1590/0034-7167-2018-0551
Bittencourt RA, Silveira MPT, Guttier MC, Miranda FF, Bertoldi AD. Avaliação da Assistência Farmacêutica em um município no Sul do Brasil. Rev Bras Epidemiol. 2017;20(2):310-23. https://doi.org/10.1590/1980-5497201700020011
Strand MA, Tellers J, Patterson A, Ross A, Palombi L. The achievement of public health services in pharmacy practice: a literature review. Res Social Adm Pharm. 2016;12(2):247-56. https://doi.org/10.1016/j.sapharm.2015.06.004
Veber AP, Diehl E, Leite SN, Prospero ENS. Pharmaceutical assistance in local public health services in Santa Catarina (Brazil): characteristics of its organization. Braz J Pharmaceutical Sci. 2011;47(1):75-80. http://dx.doi.org/10.1590/S1984-82502011000100009