Judicialization of access to medicines in Minas Gerais state, Southeastern Brazil
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2011 |
| Outros Autores: | , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | por eng |
| Título da fonte: | Revista de Saúde Pública |
| Texto Completo: | https://www.revistas.usp.br/rsp/article/view/32992 |
Resumo: | OBJECTIVE: To analyze the profile of claimants and medicines demanded in lawsuits. METHODS: Descriptive study that examined 827 lawsuits with 1,777 demands of access to medicines in the period between July 2005 and June 2006 in the state of Minas Gerais, Southeastern Brazil. There were examined the type of health care provided to claimants and their attorneyship. The medicines were described based on the following: drug registration at the National Health Surveillance Agency (Anvisa); wheter they were essential medicines; supply in the Brazilian Health System programs; and evidence of drug efficacy. RESULTS: More than 70% of the claimants were provided care in the private health system and 60.3% hired private lawyers. The most common diagnosis of claimants was rheumatoid arthritis (23.1%) and the immunosuppressant agents were the most frequent demand medicines (mainly adalimumab and etanercept). Approximately 5% of the medicines demanded were not registered at Anvisa, 19.6% were included in the Brazilian List of Essential Medicine, 24.3% were included in the High-Cost Drug Program and 53.9% showed consistent evidence of efficacy. Among the medicines that were not available in Brazilian Health System, 79.0% had therapeutic alternatives in drug programs. CONCLUSIONS: The phenomenon of judicialization of health in Brazil can point out failures in the public health system as some medicines demanded are included in its lists. However, it is a barrier for rational drug use and application of the National Drug Policy guidelines, especially when there are demanded medicines with no evidence of efficacy and that are not included in Brazilian Health System standards. |
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Judicialization of access to medicines in Minas Gerais state, Southeastern Brazil Judicialización del acceso a medicamentos en el Estado de Minas Gerais, Sureste de Brasil Judicialização do acesso a medicamentos no Estado de Minas Gerais, Brasil Assistência FarmacêuticaPolítica Nacional de MedicamentosDireito à saúdeDecisões judiciaisServicios FarmacéuticosPolítica Nacional de MedicamentosDerecho a la SaludDecisiones JudicialesPharmaceutical ServicesNational Drug PolicyRight to HealthJudicial Decisions OBJECTIVE: To analyze the profile of claimants and medicines demanded in lawsuits. METHODS: Descriptive study that examined 827 lawsuits with 1,777 demands of access to medicines in the period between July 2005 and June 2006 in the state of Minas Gerais, Southeastern Brazil. There were examined the type of health care provided to claimants and their attorneyship. The medicines were described based on the following: drug registration at the National Health Surveillance Agency (Anvisa); wheter they were essential medicines; supply in the Brazilian Health System programs; and evidence of drug efficacy. RESULTS: More than 70% of the claimants were provided care in the private health system and 60.3% hired private lawyers. The most common diagnosis of claimants was rheumatoid arthritis (23.1%) and the immunosuppressant agents were the most frequent demand medicines (mainly adalimumab and etanercept). Approximately 5% of the medicines demanded were not registered at Anvisa, 19.6% were included in the Brazilian List of Essential Medicine, 24.3% were included in the High-Cost Drug Program and 53.9% showed consistent evidence of efficacy. Among the medicines that were not available in Brazilian Health System, 79.0% had therapeutic alternatives in drug programs. CONCLUSIONS: The phenomenon of judicialization of health in Brazil can point out failures in the public health system as some medicines demanded are included in its lists. However, it is a barrier for rational drug use and application of the National Drug Policy guidelines, especially when there are demanded medicines with no evidence of efficacy and that are not included in Brazilian Health System standards. OBJETIVO: Analizar el perfil de los requirentes y de los medicamentos pleiteados en acciones judiciales. MÉTODOS: Estudio descriptivo sobre 827 procesos judiciales con 1.777 pedidos de medicamentos de 2005 a 2006 en el Estado de Minas Gerais, Sureste de Brasil. Se evaluaron los tipos de asistencia en el sistema de salud y la representación de los autores junto al Poder Judicial. Los medicamentos fueron descritos según registro en la Agencia Nacional de Vigilancia Sanitaria, esencialidad, inclusión programática en el Sistema Único de Salud y evidencias de eficiencia. RESULTADOS: Más de 70% de los autores fueron atendidos en el sistema privado de salud y 60,3% fueron representados por abogados particulares. El diagnóstico más frecuente fue el de artritis reumatoidea (23,1%) y los inmunosupresores fueron los más solicitados (principalmente adalimumabe y etanercepte). Aproximadamente 5% de los medicamentos pleiteados no eran registrados en la Agencia, 19,6% estaban presentes en la Relación Nacional de Medicamentos Esenciales, 24,3% componían el Programa de Medicamentos de Alto Costo y 53,9% presentaban evidencia consistente de eficiencia. Entre los medicamentos no disponibles en el sistema público, 79,0% presentaban alternativa terapéutica en los programas de asistencia farmacéutica. CONCLUSIONES: El fenómeno de la judicialización en la salud puede indicar fallas del sistema público de salud, dado que hay solicitudes de medicamentos constantes de sus listas. Aún constituye un obstáculo para la práctica del uso racional de medicamentos y para la consolidación de las premisas de la Política Nacional de Medicamentos, principalmente cuando son solicitados medicamentos sin comprobación de eficiencia y no estandarizados por el Sistema Único de Salud. OBJETIVO: Analisar o perfil dos requerentes e dos medicamentos pleiteados em ações judiciais. MÉTODOS: Estudo descritivo sobre 827 processos judiciais com 1.777 pedidos de medicamentos de 2005 a 2006 no Estado de Minas Gerais. Avaliaram-se os tipos de atendimento no sistema de saúde e a representação dos autores junto ao Poder Judiciário. Os medicamentos foram descritos segundo registro na Agência Nacional de Vigilância Sanitária, essencialidade, inclusão programática no Sistema Único de Saúde e evidências de eficácia. RESULTADOS: Mais de 70% dos autores foram atendidos no sistema privado de saúde e 60,3% foram representados por advogados particulares. O diagnóstico mais freqüente foi o de artrite reumatóide (23,1%) e os imunossupressores foram os medicamentos mais solicitados (principalmente adalimumabe e etanercepte). Aproximadamente 5% dos medicamentos pleiteados não eram registrados na Agência, 19,6% estavam presentes na Relação Nacional de Medicamentos Essenciais, 24,3% compunham o Programa de Medicamentos de Alto Custo e 53,9% apresentavam evidência consistente de eficácia. Dentre os medicamentos não disponíveis no sistema público, 79,0% apresentavam alternativa terapêutica nos programas de assistência farmacêutica. CONCLUSÕES: O fenômeno da judicialização na saúde pode indicar falhas do sistema público de saúde, uma vez que há solicitações de medicamentos constantes de suas listas. Todavia, constitui um obstáculo para a prática do uso racional de medicamentos e para a consolidação das premissas da Política Nacional de Medicamentos, principalmente quando são solicitados medicamentos sem comprovação de eficácia e não padronizados pelo Sistema Único de Saúde. Universidade de São Paulo. Faculdade de Saúde Pública2011-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/3299210.1590/S0034-89102011005000015Revista de Saúde Pública; Vol. 45 No. 3 (2011); 590-598 Revista de Saúde Pública; Vol. 45 Núm. 3 (2011); 590-598 Revista de Saúde Pública; v. 45 n. 3 (2011); 590-598 1518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPporenghttps://www.revistas.usp.br/rsp/article/view/32992/35620https://www.revistas.usp.br/rsp/article/view/32992/35621Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessMachado, Marina Amaral de ÁvilaAcurcio, Francisco de AssisBrandão, Cristina Mariano RuasFaleiros, Daniel ResendeGuerra Jr, Augusto AfonsoCherchiglia, Mariângela LealAndrade, Eli Iola Gurgel2012-07-11T22:42:56Zoai:revistas.usp.br:article/32992Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2012-07-11T22:42:56Revista de Saúde Pública - Universidade de São Paulo (USP)false |
| dc.title.none.fl_str_mv |
Judicialization of access to medicines in Minas Gerais state, Southeastern Brazil Judicialización del acceso a medicamentos en el Estado de Minas Gerais, Sureste de Brasil Judicialização do acesso a medicamentos no Estado de Minas Gerais, Brasil |
| title |
Judicialization of access to medicines in Minas Gerais state, Southeastern Brazil |
| spellingShingle |
Judicialization of access to medicines in Minas Gerais state, Southeastern Brazil Machado, Marina Amaral de Ávila Assistência Farmacêutica Política Nacional de Medicamentos Direito à saúde Decisões judiciais Servicios Farmacéuticos Política Nacional de Medicamentos Derecho a la Salud Decisiones Judiciales Pharmaceutical Services National Drug Policy Right to Health Judicial Decisions |
| title_short |
Judicialization of access to medicines in Minas Gerais state, Southeastern Brazil |
| title_full |
Judicialization of access to medicines in Minas Gerais state, Southeastern Brazil |
| title_fullStr |
Judicialization of access to medicines in Minas Gerais state, Southeastern Brazil |
| title_full_unstemmed |
Judicialization of access to medicines in Minas Gerais state, Southeastern Brazil |
| title_sort |
Judicialization of access to medicines in Minas Gerais state, Southeastern Brazil |
| author |
Machado, Marina Amaral de Ávila |
| author_facet |
Machado, Marina Amaral de Ávila Acurcio, Francisco de Assis Brandão, Cristina Mariano Ruas Faleiros, Daniel Resende Guerra Jr, Augusto Afonso Cherchiglia, Mariângela Leal Andrade, Eli Iola Gurgel |
| author_role |
author |
| author2 |
Acurcio, Francisco de Assis Brandão, Cristina Mariano Ruas Faleiros, Daniel Resende Guerra Jr, Augusto Afonso Cherchiglia, Mariângela Leal Andrade, Eli Iola Gurgel |
| author2_role |
author author author author author author |
| dc.contributor.author.fl_str_mv |
Machado, Marina Amaral de Ávila Acurcio, Francisco de Assis Brandão, Cristina Mariano Ruas Faleiros, Daniel Resende Guerra Jr, Augusto Afonso Cherchiglia, Mariângela Leal Andrade, Eli Iola Gurgel |
| dc.subject.por.fl_str_mv |
Assistência Farmacêutica Política Nacional de Medicamentos Direito à saúde Decisões judiciais Servicios Farmacéuticos Política Nacional de Medicamentos Derecho a la Salud Decisiones Judiciales Pharmaceutical Services National Drug Policy Right to Health Judicial Decisions |
| topic |
Assistência Farmacêutica Política Nacional de Medicamentos Direito à saúde Decisões judiciais Servicios Farmacéuticos Política Nacional de Medicamentos Derecho a la Salud Decisiones Judiciales Pharmaceutical Services National Drug Policy Right to Health Judicial Decisions |
| description |
OBJECTIVE: To analyze the profile of claimants and medicines demanded in lawsuits. METHODS: Descriptive study that examined 827 lawsuits with 1,777 demands of access to medicines in the period between July 2005 and June 2006 in the state of Minas Gerais, Southeastern Brazil. There were examined the type of health care provided to claimants and their attorneyship. The medicines were described based on the following: drug registration at the National Health Surveillance Agency (Anvisa); wheter they were essential medicines; supply in the Brazilian Health System programs; and evidence of drug efficacy. RESULTS: More than 70% of the claimants were provided care in the private health system and 60.3% hired private lawyers. The most common diagnosis of claimants was rheumatoid arthritis (23.1%) and the immunosuppressant agents were the most frequent demand medicines (mainly adalimumab and etanercept). Approximately 5% of the medicines demanded were not registered at Anvisa, 19.6% were included in the Brazilian List of Essential Medicine, 24.3% were included in the High-Cost Drug Program and 53.9% showed consistent evidence of efficacy. Among the medicines that were not available in Brazilian Health System, 79.0% had therapeutic alternatives in drug programs. CONCLUSIONS: The phenomenon of judicialization of health in Brazil can point out failures in the public health system as some medicines demanded are included in its lists. However, it is a barrier for rational drug use and application of the National Drug Policy guidelines, especially when there are demanded medicines with no evidence of efficacy and that are not included in Brazilian Health System standards. |
| publishDate |
2011 |
| dc.date.none.fl_str_mv |
2011-06-01 |
| dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
| format |
article |
| status_str |
publishedVersion |
| dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/32992 10.1590/S0034-89102011005000015 |
| url |
https://www.revistas.usp.br/rsp/article/view/32992 |
| identifier_str_mv |
10.1590/S0034-89102011005000015 |
| dc.language.iso.fl_str_mv |
por eng |
| language |
por eng |
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https://www.revistas.usp.br/rsp/article/view/32992/35620 https://www.revistas.usp.br/rsp/article/view/32992/35621 |
| dc.rights.driver.fl_str_mv |
Copyright (c) 2017 Revista de Saúde Pública info:eu-repo/semantics/openAccess |
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Copyright (c) 2017 Revista de Saúde Pública |
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openAccess |
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application/pdf application/pdf |
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Universidade de São Paulo. Faculdade de Saúde Pública |
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Universidade de São Paulo. Faculdade de Saúde Pública |
| dc.source.none.fl_str_mv |
Revista de Saúde Pública; Vol. 45 No. 3 (2011); 590-598 Revista de Saúde Pública; Vol. 45 Núm. 3 (2011); 590-598 Revista de Saúde Pública; v. 45 n. 3 (2011); 590-598 1518-8787 0034-8910 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
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Universidade de São Paulo (USP) |
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USP |
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USP |
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Revista de Saúde Pública |
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Revista de Saúde Pública |
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Revista de Saúde Pública - Universidade de São Paulo (USP) |
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revsp@org.usp.br||revsp1@usp.br |
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1800221791923208192 |