A influência da judicialização na incorporação de medicamentos no sistema único de saúde (SUS).

Abstract

The judicialization of health concerns the recourse to the legal field for the acquisition of medicines, treatments, and supplies. This study analyzed requests for the incorporation of medications with the highest number of judicial demands into the Unified Health System (SUS) and their possible relation to the actual incorporations into the system. To identify the most judicialized medications, a two­stage study was conducted: Initially, a literature review was performed using the databases Medline, Scielo, and Lilacs, with the keywords "judicial action," "incorporation of medicines," and "judicialization of health." Articles presenting quantitative data, in English or Portuguese, were selected, and duplicates in the same search were excluded. At the end of this process, 8 articles published between 2019 and 2023 were included, which listed medications with judicial access requests within this time frame: Insulin Glargine, Ranibizumab, Bevacizumab, Methylphenidate, Tiotropium Bromide, and Enoxaparin Sodium.Based on the results obtained from the literature review, a descriptive and exploratory document analysis was conducted on the website of the National Committee for Health Technology Incorporation (CONITEC) to characterize the issued recommendation reports. It was found that most analysis requests originate from CONITEC members themselves. All recommendation reports undergo public consultation, most analyzed technologies are complementary to others available in the system, and most reports include an estimate of budget impact. Finally, it was observed that the majority of the analyzed reports had unfavorable recommendations for incorporation. However, upon analyzing these data and the literature, it is noted that medications targeted by a high number of judicial demands are more frequently incorporated into the system.