DEMANDAS JUDICIAIS DE MEDICAMENTOS NO MUNICÍPIO DE CAMPO GRANDE: ANÁLISE POR MEIO DE INDICADORES

Abstract

Introduction: The knowledge of the “judicialization of health” through the analysis of indicators provides subsidies to government officials and the Judiciary Power for decision-making, as well as for the elaboration and reformulation of public policies. Litigation in the health area can generate a positive social impact, favoring the creation of public policies that promote access to health care and even structural changes, improving the distribution of social goods and public services among society. Objective: This study aims to analyze the lawsuits for medicines in the city of Campo Grande from July 2018 to June 2020. Materials and Method: Observational and cross-sectional study, in which four dimensions were evaluated, including sociodemographic characteristics of the plaintiff, procedural, medical-sanitary and political-administrative characteristics, according to the Manual of Indicators for the Evaluation and Monitoring of Judicial Drug Demands. For the analysis, lawsuits with request for medication and filed by the citizen against the municipality of Campo Grande - MS, between July 2018 and June 2020 were included. Results: 676 processes were analyzed that resulted in 1006 requests with 284 different medications. There was a predominance of requests for patients aged 70 to 79 years (14.20%), retirees or pensioners (43.46%), residing in Campo Grande, with an average income of 1.47 minimum wages. In 92.74% of the lawsuits, the judge initially granted the requested medicines, admitting urgency in 88.8% of the requests. The median times between drug request and decision was 34 days and between decision and drug delivery was 146 days. Most requests had prescriptions as a generic name (54.37%) and the patient sought care from the SUS (56.95%). 241 morbidities were observed in the main diagnoses, being predominant Diabetes Mellitus, coagulation defects, hypertension and chronic obstructive pulmonary diseases. According to the Chemical Therapeutic Anatomical Classification System (CTA), anatomical groups such as the nervous system (22,54%), antineoplastics and immunomodulators (16,20%) were prevalent for the 284 drugs requested. The average monthly cost of medicines purchased to fulfill the actions was R$ 2,183.68. All prescription drugs are registered at Anvisa and three have an “off label” indication according to the diagnosis present in the process and the package insert. Among the 284 prescribed drugs, 179 (63.03%) did not belong to any official list and there was a therapeutic alternative for 166 (90.22%) of them. Ninety-four (33.10%) medicines are part of the Pharmaceutical Assistance financing components, with their own responsibilities and financing for their acquisition. Conclusion: The compromising of income and the lack of guarantee of continuous access to medication, lead many patients to legalization. The lack of knowledge or non-adherence of prescribing professionals to official lists, demonstrated in the research with the predominance of prescriptions originating from the SUS, is another triggering factor.