Health Judicialization: A Case Study Involving High-Cost Medication

• Autor(a) principal: de Azevedo Ramos, Marcelo Cristiano
• Data de Publicação: 2023
• Outros Autores: Mello do Amaral Júnior, José Levi
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Revista Direito GV
• Texto Completo: https://periodicos.fgv.br/revdireitogv/article/view/90320
• topic: Unified Health System; Health Law; judicialization of health policies; state of Sao Paulo; eculizumab; Sistema Único de Saúde; direito sanitário; judicialização das políticas de saúde; estado de São Paulo; eculizumab

Currently, there has been a significant number of lawsuits in health area from the perspective of individual conflicts of interest. In this sense, the objective of this paper was to conduct a case study on the content of court decisions involving provision of a high-cost medication called eculizumab. To this end, sentences available on State of Sao Paulo Justice Court website were evaluated. The results showed concentration of demands in district of capital, with the state of Sao Paulo as preferred passive pole. It was observed that a significant proportion of decisions ignored the need to prove adequacy and necessity of the drug, as well as demonstration of ineffectiveness of drugs available at Sistema Único de Saúde (SUS – Brazilian Unified Health System). The results pointed to a greater concern of judges in verifying the existence of sanitary registration of the drug at National Health Surveillance Agency and in recognizing the patient’s financial inability to handle the costs of treatment. Conversely, verification of incorporation of the drug for paying source and diagnosis showed less value among the magistrates. This phenomenon can present perverse contours and potential to modify planning and prioritization processes in health, improperly restricting economic resources.