Demandas judiciais relativas ao acesso a medicamentos no âmbito da Secretaria da Saúde do Estado da Bahia.

Abstract

In the scope of health policies, judicialization has been revealed as a search for the guarantee of access to goods and services through lawsuits, assuming a fundamental role in moderation and decision-making on health issues. This phenomenon has been taking great proportions in Brazil since the mid-1990s and has motivated numerous studies in the country, especially in access to medicines. This study aims to analyze the evolution of lawsuits filed against the Department of Health of the State of Bahia regarding access to medicines, from 2007 to 2016. And, as specific objectives, describe the sociodemographic characteristics of the authors of the lawsuits filed against the Secretariat of Health of the State of Bahia, regarding access to medicines and corresponding to the period 2007 to 2016; characterize the lawsuits filed against the Health Secretariat of the State of Bahia regarding access to medicines, regarding procedural, medical-health and political-administrative elements corresponding to the period 2007 to 2016; and discuss possible relations between the lawsuits filed against the Health Secretariat of the State of Bahia and the incorporation of medicines by the Unified Health System-Bahia in the view of managers of pharmaceutical services of the Health Secretariat of the State of Bahia. The research consisted of conducting a case study, focusing on the analysis of lawsuits filed against the Bahia Department of Health for the supply of medicines between 2007 and 2016, Using as data production strategies the transcription of the information present in the judicial processes and interviews with informants that could reveal the existence or not of any influence of lawsuits on the decisions to incorporate medicines. It was found in this study that almost 95% of the actions were individual, that the granting of injunction or anticipation of guardianship occurred in 71.08% of the actions and that the Public Defender was the legal representative responsible for most of the actions (45.4%). The delivery of the drug was one to five days in more than half of the processes (53.3%), with demand for only one drug by the vast majority of the plaintiffs. We identified only 15 (2.7%) actions with off-label use of medicines and mostly medicines that are not part of the official lists. About 227 (45.6%) prescriptions were issued by physicians not linked to the Unified Health System with 57.6% containing additional documents. In the interviews, most managers say that the large number of lawsuits has influenced decision-making regarding the incorporation of the Unified Health System, and some cite that the judicialization of health can contribute to the resolution of individual problems, but not of the collective. Given the results presented, it is concluded that the judicial way has been consolidated as an alternative way of access to medicines in the Unified Health System-Bahia, despite the executive and judicial powers seek strategies to mitigate this phenomenon.