In Brazil, in spite of advances in the field of pharmaceutical care, problems in assurance, by the State, of access to medicines persist. Since the early 1990s, the judicial demand of medicines by citizens has increased. The lawsuits demand medicines that are out-of-stock in the public sector as well as medicines that have not yet been incorporated by the Brazilian Health System. This phenomenon may be analyzed under different perspectives, including the health perspective, which is basically related to health outcomes for these individuals. This paper discusses the main characteristics of judicial demands, especially regarding the rational use of medicines, the use of scientific evidence to examine and substantiate the intended therapeutic use, and the justification of litigation as a means of access to medicines, in light of the concepts of access adopted by the field of pharmaceutical services in Brazil. Health risks to individuals demanding medicines through the Judiciary must be scrutinized when the demanded medicines do not belong to essential medicines lists, when their indication may be viewed as off-label, or if they have not obtained market approval in the country. The assumption is that the Judicial System aims to warrant the health of plaintiffs and in this ultimately the dignity of the individual. But this objective will only be met if in guaranteeing health all aspects of safety for the individual are involved, including the use of medicines.
pharmaceutical care; lawsuit; Unified Health System; access to medicines
