Brazilian Courts as a Pathway to Medicines which Represent Pharmacotherapeutic Gaps

Mércia Pandolfo ProvinSilvana Nair Leite Contezini Rita Goreti Amaral

Health system very excludent and with strong economic

component

1988 Brazilian

Constitution

Universal and integral Health System

Art. 5 [...] right to life

Cap. II - Social Security: Health Art. 196 a 200 Art. 196 – Health is a everyone's right and duty of the State [...]

Art. 198 – The actions and public health services [...] II – Integral care;

(Brasil, 1988)Mércia Pandolfo

Provin

Mércia Pandolfo Provin

Access

Problem

In spite of this, in the last few years an

increasing number of citizens have initiated

court actions to grant their access to

medicines prescribed for their treatments and

it has become a management and financial

problem for the national and local health

systemsMércia Pandolfo

Provin

The judicial way has become a manner of

gaining access to medications, but it is not

known for sure whether they are an

equalitarian way for that access and how

much social and geographical differences

influence in its characteristics.


To characterize the demand for medicines

through judicial way in regions with

different incomes


Transversal descriptive study (2003-2007), carried out in the

Pharmacy School – Federal University of Goiás, approved by the

Ethics Committee of that institution. We analyzed court actions that

demanded for medicines and were accepted and granted in the city of

Goiânia-GO-Brazil.


Methodology

The object of study

Served as object of this study those court actions that; demanded for

medications, were initiated against the city of Goiânia-GO, were accepted

and received by the Unified Health System manager from January 2005 to

December 2007. Thus, among the 1553 process filed, 175 of them

contained no request for medication, 129 the date were incomplete and

were therefore excluded from the study. Were analyzed them 1249 lawsuits.


For characterizing the medicines demand through judicial way in different city regions

After geoprocessing, the court actions were grouped in accordance with the estimated average income of the family breadwinner for the respective TPU, in four groups as follows:

Region type I: set of court actions started in regions where the average householder’s income is from 0 to 3 (included) minimum wages;

Region type II: set of court actions started in regions where the average householder’s income is higher than 3 to 6 (included) minimum wages;

Region type III: set of court actions started in regions where the average householder’s income is higher than 6 to 9 (included) minimum wages;

Region type IV: set of court actions started in regions where the average householder’s income is higher than 9 minimum wages.


For characterizing the medicines demand

Variable:

• Lawsuits: number, year of approval;

• Petitioner: number, gender, age, disease, address;

• Prescription origin: public or private;

• Medicine: drug, cost, access, alternative therapeutic;

• Income: average income of the household head


Picture 1. Number of new lawsuits filed against the Municipal Health Secretariat and the number of corrents processes, 2003-2007, Goiânia – GO



ADHD: Attention Deficit Hypertativity Disorder; IDC: international disease code Picture 2. The most frequent pathologies found in writs against the City Secretary of Health, Goiânia-GO


Picture 3. Medicines distribution in official lists of drugs for public distribution and the existence of therapeutic alternatives


1:4 1:5

The judicial demand profile in intracity regions with different incomes presented

distinct characteristics, and it may represent diverse needs when it comes to

guarantee right to health care, particularly concerning the supply of medicines.

Population segments with higher incomes file lawsuits more frequently to

assure their access to medicines and they also request more expensive

treatments.


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Brazilian Courts as a Pathway to Medicines which Represent Pharmacotherapeutic Gaps

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Transcript of Brazilian Courts as a Pathway to Medicines which Represent Pharmacotherapeutic Gaps