As faces da judicialização de medicamentos à luz da literatura e da percepção do sistema de justiça e da gestão do sistema de saúde

• Autor(a) principal: Lyra, Pollyanna Farias Castro Pereira de
• Data de Publicação: 2021
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UFS
• Texto Completo: http://ri.ufs.br/jspui/handle/riufs/16843
• topic: Direito à saúde; Gestão de serviços de saúde; Judicialização; Medicamentos; Percepção; Sistema de justiça; Right to health; Health services management; Judicialization; Medicines; Perception; Justice system; CIENCIAS DA SAUDE

Introduction. In recent years, access to medicines in Brazil has grown through lawsuits, which has increased scientific production in this area. The ambivalence of the phenomenon of “Judicialization of Medicines” has brought benefits and harms to global health, influenced by philosophical, political and socioeconomic issues. However, few studies show the opposite faces of this phenomenon, not going into what individual benefits to the citizen, as well as the harm to the health system and the community. Objective. To understand the two sides of the judicialization of medicines in the light of the literature and the perception of the justice system and the management of health system management. Methods. The thesis consists of two steps. In the first one, a systematic literature review was conducted characterizing in the literature the aspects that influence the judicalization of medicines, in the LILACS, PubMed/ Medline, Scopus and Web of Science databases. Two reviewers identified articles that met the inclusion criteria. In the second stage, a qualitative research was carried out through identification with key informants using as a collection instrument a script of questions through which it was possible to characterize and understand the perceptions of actors involved in the process judicialization of medicines in Brazil, from the perspective of the justice system and the management of the health system. The project was approved by the Ethics Committee of the Federal University of Sergipe, under opinion number 977.043. Results. Results. In step 1, the selection of studies resulted in a final sample of 45 articles. The high level of heterogeneity between the studies made it difficult to compare and generate evidence capable of supporting the judges' decisions based on technical-scientific criteria. In the second stage, 12 interviews were conducted with actors from the justice system and the management of the health system. The data obtained originated five categories: “citizen's right”; “public health policies”; “communication between the justice system and the management of the health system”; “standardization of medicines” and “financial impact”. The categories presented the two faces of judicialization different: “benefits” and “harms”. According to the informants, despite the efforts made in recent years, the relationships between the justice system and the management of the health system are still distant, with no effective communication and optimization of health resources. Conclusion. This thesis showed that the studies had low methodological quality and did not propose viable solutions for health managers and formulators in dealing with the problems caused by the judicialization of medicines, requiring further research in the area. The qualitative study, which is pioneering, presents different perceptions of national actors about the process of judicialization of medicines. Such high reports that the managers of the justice system and the management of the health system need to meet the collective needs and act in a socially zealous and thoughtful manner, based on clinical evidence and cost-effectiveness principles, under penalty of taking the system to health to collapse. Thus, this study can enable the construction of bridges from collaborative interprofessional actions, solving probable conflicts between the two systems.