Análise da judicialização de medicamentos na assistência farmacêutica do Distrito Federal e desenvolvimento de material educativo

Abstract

Introduction: In the Brazilian legal system, health is among the fundamental rights and guarantees, as a social right guaranteed by the constitution that requires a provisional activity on the part of the state. In view of this, the Federal District has been the defendant in several lawsuits that require drug treatment through the Judiciary, which has led to a significant cost in terms of the health budget. Objectives: To analyze the prevalence and typification of judicial decisions regarding the supply of medicines not available in the Unified Health System of the Federal District (SUS/DF) in the period from 2016 to 2019. To elaborate instructional material (booklet) to guide managers and health professionals about the characteristics of these lawsuits addressing the organization of pharmaceutical care, as well as the financial impact caused by compliance with court decisions on the health budget. Research line: Quality of Care in adult health. Methods: This is a cross-sectional, descriptive and analytical study about judicialization of medicines at State Health Secretariat of the Federal District (SES/DF) from 01/01/2016 to 12/31/2019. Data from court cases were collected at the Núcleo de Farmácia Ambulatorial Judicial. Information on amounts spent was taken from the control module of consumables and pharmacy of the Secretariat's Integrated Health System. Judicial demands for non-standardized drugs in the SES/DF were included in the study, as well as judicial decisions regarding drugs prescribed outside the institutionalized clinical protocol. The elaboration of the booklet followed the following steps: definition of the central theme, definition of the topics/theme of the booklet, bibliographical research and script elaboration (detailing of each page, illustrations and textual content). Finally, the graphic design was produced on the CANVA platform. Results: It was found that the judicialization is caused by individuals over 50 years old (54.7%), diagnosed with neoplasms (39.9%). The public defender's office (92.2%) conducted most of the cases. Most lawsuits come from public health system prescribers. Costs related to complying with court decisions increased by 70% in 4 years, reaching R$ 38.5 million in 2019, exceeding 15% of the budget spent on the purchase of medicines at SES/DF. Products developed: Article entitled “The profile and financial impact of the judicialization of medicines in the Unified Health System of the Federal District” and Instructional material “Guidance booklet entitled: “Organization of Pharmaceutical Assistance in SUS/DF - Profile and impact on the Budget of prescription medicines not listed in REME/DF”. Conclusion: This research allowed demonstrating the profile of the judicial demand for non-standardized drugs in the Federal District, as well as elucidating the budgetary impact generated by compliance with court decisions. In addition to providing the creation of an easily accessible and readable instructional material for managers and health professionals seeking to inform about the organization of pharmaceutical assistance at SES/DF and publicizing the existence of the list of medicines available to the population. The research results corroborate most of the findings in the national literature.