Judicial demands and therapeutic assistance in the Brazilian Public Health System

OBJECTIVE: To analyze the qualitative coverage of therapeutic policies at federal level in the Brazilian Public Health System (SUS) for diseases that were the subject of lawsuits. METHODS: An exploratory research was performed, based on a sample of diseases referred to in lawsuits against the city of São Paulo Municipal Office for Health, in 2005. A search of the standards that set forth therapeutic policies, as well as recommended therapeutic resources (surgical procedures and drugs), was performed. The database Diseasedex, part of the Micromedex system, was used as the basis for therapeutic procedures used to treat those diseases. A reference summary table was prepared to facilitate comparison between recommendations in public policies and the Diseasedex database. RESULTS: Therapeutic public policy covers the major part (n = 26) of the diseases analyzed, either by public policies for primary care or public policies for rare diseases and/or high cost treatment diseases. This represents 96% of the sample analyzed (n = 27). Only 3 of the 27 diseases in the sample are contemplated by limited therapeutic policies. This means that public policies do not offer full first-line therapy, which corresponds to 11% of the sample. There was only one disease that was not covered by public therapeutic policies: attention deficit hyperactivity disorder. CONCLUSION: There were limitations in the qualitative coverage of treatment of some diseases from the sample analyzed, which may jeopardize the comprehensiveness of therapeutic assistance and health care in some cases.

Public health policy; Legal decisions; State health care coverage; Right to health

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