Acesso a medicamentos via poder judiciário no Estado de Minas Gerais

Abstract

The access to medicines through lawsuits has been occurring frequently under the three public management levels of the National Health System (SUS) in Brazil and it is legitimated by the guaranty of the universal right to health and influenced by the great demand ofmedicines observed among the population. It has been causing distortions in the health public policies and deviation of public resources for the execution of the judicial orders. To aim of knowing this phenomenon in the State of Minas Gerais, more specifically the profile ofthe petitioners and of the pled medicines, a descriptive and crosswise study of lawsuits was accomplished with requests of medicines concerning to the period from July 2005 to June 2006. It has been evaluated the gender, age, diagnoses, attendance type in the healthsystem and the petitioners' representation in the Judiciary Power. The medicines were described according to the registration in the National Health Surveillance Agency (Anvisa), essentialness, public financing, the existence of therapeutic alternatives in SUS and evidences of efficacy. It has been analyzed 827 processes that resulted in 1777 requests formedicines. There was a predominance of the female sex (60,2%) and petitioners with 60 years old or more (18,9%). Approximately 45% of the patients were assisted in the private health system and 57,2% were represented by private lawyers. The most frequent diagnoseswere rheumatoid arthritis (22,5%), diabetes mellitus type 1 (6,2%) and systemic arterial hypertension (5,3%). The most requested medicines were adalimumab, etanercept, insulin glargine, omeprazole, aripiprazole, sinvastatine and clopidogrel (20,8%). About 5% of the pled medicines do not have registration under the Anvisa, 19,6% are listed in the NationalEssential Medicines List, 24,3% compose the High Cost Program of Medicines and 54,9% present consistent evidence of efficacy. Among the medicines without public financing, 79,0% have therapeutic alternatives in the SUS. The judicialization in the health field may indicate failures on the public health system, e.g. when medicines included in the SUSprograms are requested, and it is the result from the users' pursuit of a fundamental right. However, it constitutes an obstacle for the practice of the rational use of medicines and losses on the public health policies, since there are requests of medicines without evidence of efficacy and not standardized. Keywords: pharmaceutical assistance, public health policies, health right, judicial decisions.