Distorções causadas pelas ações judiciais à política de medicamentos no Brasil

Vieira, Fabíola Sulpino; Zucchi, Paola

doi:10.1590/s0034-89102007000200007

Cited by 152 publications

(192 citation statements)

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“…c Currently, there are fi ve classes of drugs: analgesics, nonsteroidal anti-infl ammatory drugs (NSAIDs), corticosteroids, disease-modifying Private lawyers prevailed in lawsuits fi led in Minas Gerais, a situation observed in different parts of the cuntry. 5,8,10,13 However, the Public Defender's Offi ce of Minas Gerais was responsible for most cases related to four of the 18 drugs most in demand, which is similar to the fi ndings by Messeder et al (2005) and Sant'ana (2011). 9,11,d A low frequency of legal proceedings fi led by free legal assistance centers linked to law faculties was observed.…”

Section: Discussionsupporting

confidence: 75%

Médicos, advogados e indústria farmacêutica na judicialização da saúde em Minas Gerais, Brasil

et al. 2012

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OBJECTIVE: To describe the relationship between the prescribing physician, lawyer and pharmaceutical industry in lawsuits against the state. METHODS:Retrospective descriptive study based on data from administrative fi les, relating to lawsuits involving medicine demands, in the State of Minas Gerais, from October 1999 to October 2009. The variables studied were: gender, age, benefi ciaries' illness, type of medical care (public or private), prescriber, type of legal representation and requested medication. A descriptive analysis of the variables with the distribution of frequencies was carried out. RESULTS:A total of 2,412 lawsuits were analyzed with 2,880 medicine requests, including 18 different drugs, 12 of them provided through Pharmaceutical Policies of the Brazilian National Health System (SUS). The most frequent medicines requested were adalimumab, etanercept, infl iximab, insulin glargine and tiotropium bromide. The main diseases were rheumatoid arthritis, ankylosing spondylitis, diabetes mellitus and chronic obstructive pulmonary disease. Private lawyers and doctors were predominant. The results revealed the association between doctors and law offi ces on drug requests. Among the lawsuits fi led by the offi ce A, 43.6% had a single prescriber of adalimumab, while 29 doctors were responsible for 40.2% of the same drug prescriptions. A single doctor was responsible for 16.5% of the adalimumab prescriptions, being requested through lawsuits fi led by a single private law offi ce in 44.8% of legal proceedings. CONCLUSIONS:A greater representation of doctors and lawyers from the private sector can hinder equity in health. The results revealed the association between doctors and law offi ces on drug requests. This is an indication that justice and medical practice have been used, at certain times, to serve the interests of the pharmaceutical industry. DESCRIPTORS:Health lawsuits and access to health . Equity in health. Pharmaceutical industry. Incorporation of medicines. Lawsuit offi cials. Doctors.

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Section: Discussionsupporting

confidence: 75%

Médicos, advogados e indústria farmacêutica na judicialização da saúde em Minas Gerais, Brasil

et al. 2012

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“…O predomínio da atuação da Defensoria Pública neste âmbito também foi observado por Messeder et al 16 , no Estado do Rio de Janeiro, e por Romero 17 , no Distrito Federal. Estudos realizados em outros estados -Vieira & Zucchi 18 , no Município de São Paulo; Marques & Dallari 19 , no Estado de São Paulo e Pereira et al 20 , no Estado de Santa Catarina -referiram ser a maior parte das ações conduzidas por advogados particulares. Há dois aspectos que devem ser aprofundados para entendermos este dado.…”

Section: Discussionunclassified

Caracterização de demandas judiciais de fornecimento de medicamentos "essenciais" no Estado do Rio de Janeiro, Brasil

et al. 2010

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Recognition of the right to health raises two practical issues IntroduçãoAs leis e recomendações internacionais reconhecem o direito à saúde como um direito humano, estando ele incluso nas leis constitucionais de alguns países. O acesso aos medicamentos essenciais é considerado por alguns autores como integrante deste direito 1,2,3 .No Brasil, o direito à saúde está disposto nos artigos 6 o , 196 o a 200 o da Constituição Federal brasileira, como um direito social, a ser garantido por meio de políticas, que, dentre outras tarefas, devem promover e garantir o acesso universal e igualitário às ações e serviços para promoção, proteção e recuperação da saúde dos cidadãos. A Lei Orgânica da Saúde (Lei Federal nº. 8.080/90) 4 , em seus artigos 6 o e 7 o , regulamenta o sistema público de saúde, estabelecido constitucionalmente, e atribuiu ao Sistema Único de Saúde (SUS) a execução de ações de assistência terapêutica integral, inclusive farmacêutica. Desta forma, o reconhecimento da saúde como um direito possui duas importantes repercussões prá-ticas: a responsabilidade ética e legal do poder público de formular e implementar ações que assegurem o acesso da população aos serviços de atenção à saúde; e a possibilidade do cidadão reivindicar judicialmente, de forma individual ou coletiva, o cumprimento desta obrigação estatal. Os chefes dos executivos da saúde têm formulado e implementado políticas e ações de saúde, inclusive de assistência farmacêutica, por meio ARTIGO ARTICLE

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“…11,21 The estimated values of the annual treatments of the therapeutic classes most demanded judicially were burdensome. Comparison between these values and the gross domestic product (GDP) per capita of Brazil (almost R$ 17,500 in 2010) d and the average monthly income of Brazilian families (R$ 2,763.47), e corroborates the arguments of the legal decisions concerning the insuffi ciency of purchasing power among the population for buying these medications.…”

Section: Discussionmentioning

confidence: 99%

“…7 The number of lawsuits against local governments can reach close to seven thousand per year in Brazil, representing annual expenditures of up to R$ 60.4 million ($ 60.4 million). 3,4,11,21 Concession of medications is considered to be a means of judicialization of healthcare policy. 5 Researchers have suggested that judicial decisions do not take into account the possibility that there may be infl uences external to the political system capable of interfering in the incorporation of therapeutic innovations within the Brazilian National Health System (Sistema Único de Saúde, SUS), such as pressure from the pharmaceutical industry or from doctor and patient associations.…”

mentioning

confidence: 99%

“…5 Researchers have suggested that judicial decisions do not take into account the possibility that there may be infl uences external to the political system capable of interfering in the incorporation of therapeutic innovations within the Brazilian National Health System (Sistema Único de Saúde, SUS), such as pressure from the pharmaceutical industry or from doctor and patient associations. 5,13,21 The objective of this study was to analyze decisions from the legal system concerning the population's access to medications within SUS through judicial channels, with regard to decision-making criteria and possible political and economic pressure.…”

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confidence: 99%

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Decisões judiciais sobre acesso aos medicamentos em Pernambuco

Stamford

Cavalcanti²

2012

Rev. Saúde Pública

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OBJECTIVE:To analyze decisions from the legal system concerning the population's access to medicines within the Brazilian Public Health System through judicial channels, with regard to decision-making criteria and possible political and economic pressure. METHODS:This was a descriptive retrospective study on documents with a quantitative and qualitative approach. Data were gathered from the State of Pernambuco Superintendency for Pharmaceutical Care, and the data sources used were 105 lawsuits and administrative reports between January and June 2009. It was ascertained which medications have a patent or patent request in the database of the Brazilian Patent Offi ce (INPI), in order to identify the frequency with which patents feature in lawsuits. The data obtained were classifi ed according to Anatomical and Therapeutic Chemical System. To analyze the judicial decisions, the theory of autopoietic social systems was used. RESULTS:There were lawsuits involving 134 medications, with an estimated value of R$ 4.5 million for attending the treatments requested. 70.9% of the medications had a patent or a patent request and they were concentrated in three therapeutic classes: antineoplastic and immunomodulating agents; digestive tract and metabolism; and sensory organs. Six central ideas within judges' decision-making criteria were identifi ed (the federal constitution and medical prescriptions), along with pressure between the legal, economic and political systems concerning access to medications. CONCLUSIONS:The analysis on judicial decisions based on the theory of autopoietic social systems made it possible to identify mutual stimulation (dependency) between the legal system and other social systems in relation to the issue of citizens' access to medications. This dependency was represented by the federal constitution and intellectual property. The federal constitution and medical prescription were identifi ed as decision-making criteria in lawsuits. Intellectual property represented possible political and economic pressure, especially in cases of launching medications into the market.

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Distorções causadas pelas ações judiciais à política de medicamentos no Brasil

Cited by 152 publications

References 11 publications

Médicos, advogados e indústria farmacêutica na judicialização da saúde em Minas Gerais, Brasil

Médicos, advogados e indústria farmacêutica na judicialização da saúde em Minas Gerais, Brasil

Caracterização de demandas judiciais de fornecimento de medicamentos "essenciais" no Estado do Rio de Janeiro, Brasil

Decisões judiciais sobre acesso aos medicamentos em Pernambuco

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