Comprehensiveness and universality of the pharmaceutical assistance in times of judicialization of health care

Lopes, Luciana de Melo Nunes; Coelho, Tiago Lopes; Diniz, Semíramis Domingues; Andrade, Eli Iola Gurgel de

doi:10.1590/S0104-12902019180642

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ARTICLES • Saude soc. 28 (2) • Apr-Jun 2019 • https://doi.org/10.1590/S0104-12902019180642 copy

Comprehensiveness and universality of the pharmaceutical assistance in times of judicialization of health care

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Law no. 12,401/2011 and Decree no. 7,508/2011 are celebrated, among other reasons, for introducing new rules for the pharmaceutical assistance policy that would have the potential to streamline the judicialization of health care in Brazil. This study aims to analyze the effects of the universal access to the comprehensive pharmaceutical assistance established by these legislations considering the judicialization of medicines in the state of Minas Gerais from 1999 to 2009. This is a retrospective study that analyzes the legal disputes deferred against Minas Gerais during the period. If the criteria established in 2011 were normalized and respected by the Judiciary in this interval, between 68.84% and 85.77% of the medicines judicialized in Minas Gerais would have been rejected. However, despite having the potential to streamline the judicialization, the legislations do not seem to have influenced the judicial decisions permanently.

Keywords:
Judicialization of Health; Pharmaceutical Assistance; Brazilian National Health System; Health Policy

Classification	Criterion I - the patient must be assisted by health actions and services of SUS	Criterion II - the medicine must have been prescribed by health professionals in the regular exercise of their functions in SUS	Criterion III - the prescription must be in accordance with PCDT and/or Rename
Adequate (1)	Organization of public, non-informed or private nature	Prescription with logo of SUS	Medicine included in Rename
Adequate (2)	Organization of public nature	No information about the logo of SUS or prescription without logo of SUS	Medicine included in Rename
Impossible to classify	Organization of non-informed or private nature	No information about the logo of SUS	Medicine included in Rename
Inadequate (1)	Organization of non-informed or private nature	Prescription with logo of SUS	Medicine included in Rename
Inadequate (2)	Organization of public, non-informed or private nature	Prescription without or with the logo of SUS or without information about its existence	Medicine NOT included in Rename

Classification	Number of medicines	Percentage (%)
Adequate (1)	406	7.69
Adequate (2)	367	7.69
Impossible to classify	2,359	23.47
Inadequate (1)	1,985	68.84
Inadequate (2)	4,934	68.84
TOTAL	10,051	100.00

Year	Quantity of judicialized medicines	Proportion of medicines adequate to the criteria (%)	Proportion of medicines impossible to classify (%)	Proportion of medicines inadequate to the criteria (%)
1999	2	50.00	0.00	50.00
2000	15	20.00	33.33	46.67
2001	3	33.33	66.67	0.00
2002	54	1.85	59.26	38.89
2003	113	2.65	37.17	60.18
2004	315	3.81	35.87	60.32
2005	835	7.90	25.75	66.35
2006	1,614	6.38	26.83	66.79
2007	2,489	6.39	24.59	69.02
2008	2,929	10.07	20.76	69.17
2009	1,682	7.67	17.66	74.67

Faculdade de Saúde Pública, Universidade de São Paulo. Associação Paulista de Saúde Pública. Av. dr. Arnaldo, 715, Prédio da Biblioteca, 2º andar sala 2, 01246-904 São Paulo - SP - Brasil, Tel./Fax: +55 11 3061-7880 - São Paulo - SP - Brazil
E-mail: saudesoc@usp.br

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[1] Correspondence Luciana de Melo Nunes Lopes Universidade Federal de Minas Gerais. Av. Alfredo Balena, 190, 7º andar, Santa Efigênia. Belo Horizonte, MG, Brasil. CEP 30130-100.