Demandas judiciais de medicamentos no Rio Grande do Norte: análise do triênio 2020-2022

Abstract

Despite the current health policies, the "judicialization of health" is increasing, with legal actions to obtain medications in the Unified Health System, shifting responsibilities from the Executive to the Judiciary since the 2000s. The study in question, conducted in 2022, is a continuation and comparison with previous research on the judicialization of medications in Rio Grande do Norte. Using data from UNICAT and state and federal courts, it analyzes various variables such as gender, defendant, origin of the process, among others. Exclusion criteria were applied, and the results from 2022 were compared with previous years. From 2020 to 2022, legal proceedings related to health issues were analyzed. There was an increase in the number of cases over time. In 2020, the majority of actions were initiated by women, and most cases were not stratified by region. In 2021 and 2022, a greater impact was observed in the metropolitan areas of Natal and Seridó. Judicialization in the Federal Court increased, with the majority of cases requested by private attorneys. The technical support of decisions also grew over the years, highlighting the role of the Technical Support Center of the Judiciary. Most judicialized medications were purchased by the plaintiffs, blocking public funds. About 40% of the medications were in the National List of Essential Medicines (RENAME), and the most requested ones included aflibercept, enoxaparin sodium, bevacizumab, insulin glargine, and ranibizumab. Ranibizumab was the most judicialized medication in 2022, despite not being on the RENAME for that year. The study revealed an increase in demand for medications, especially biologics and those not listed in the RENAME. The State Judiciary was the main origin of the cases, but the involvement of the Federal Judiciary increased over time. The blocking of public funds to comply with judicial decisions was emphasized, despite constitutional questions. The study suggests the need to reformulate policies for access to medications, considering technical criteria in judicial decisions. Therefore, it is crucial to address this issue collaboratively to ensure fair, efficient, and sustainable access to medications.