Navegando por Palavras-chave "Decisões judiciais"
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- ItemSomente MetadadadosAs ações judiciais e suas impliações para a assistência farmacêutiva e a locação de recursos do SUS(Universidade Federal de São Paulo (UNIFESP), 2006) Vieira, Fabiola Sulpino [UNIFESP]; Zucchi, Paola [UNIFESP]Objetivo: Descrever os efeitos das ações judiciais que requerem da Secretaria Municipal da Saúde de São Paulo (SMS-SP) o fornecimento de medicamentos, em relação a aspectos da Política Nacional de Medicamentos e diretrizes do SUS. Métodos: A unidade de análise do estudo é o processo movido pelo cidadão contra a SMS-SP e o período estudado foi de janeiro a dezembro de 2005. Foi padronizado um formulário para a coleta de dados. Resultados: Em 2005 foram impetradas 170 ações contra a SMS-SP requerendo o fornecimento de medicamentos. Os serviços do SUS originaram 59 por cento das prescrições (26 por cento municipais e 33 por cento os demais). Câncer e diabetes foram as doenças mais referidas (59 por cento). Fazem parte de listas do SUS 62 por cento dos itens solicitados. O gasto total foi de 876 mil reais, efetuado somente para itens não¬selecionados (que não fazem parte da Relação Municipal de Medicamentos Essenciais). A disponibilidade de alternativa terapêutica para esses itens mostrou que 73 por cento poderiam ser substituídos. Do gasto total, 75 por cento foram destinados à aquisição de antineoplásicos. Desses, 2 não estão registrados no Brasil e a maioria carece de mais estudos que fundamentem sua eficácia. Conclusões: A maioria das demandas por medicamentos geradas por ações judiciais poderia ser evitada se a organização do SUS e suas diretrizes tivessem sido consideradas, tanto para o atendimento em oncologia quanto em relação à observância das relações de medicamentos essenciais. Quando estas questões não são observadas, esfacela-se a Política Nacional de Medicamentos, comprometendo o acesso e o uso racional de medicamentos no SUS, além da eqüidade no acesso.
- ItemAcesso aberto (Open Access)Demandas judiciais e assistência terapêutica no Sistema Único de Saúde(Associação Médica Brasileira, 2009-01-01) Vieira, Fabiola Sulpino [UNIFESP]; Zucchi, Paola [UNIFESP]; Ministério da Saúde Gestão Governamental; Universidade Federal de São Paulo (UNIFESP)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.
- ItemAcesso aberto (Open Access)Distorções causadas pelas ações judiciais à política de medicamentos no Brasil(Faculdade de Saúde Pública da Universidade de São Paulo, 2007-04-01) Vieira, Fabiola Sulpino [UNIFESP]; Zucchi, Paola [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To describe how lawsuits, which demand the supply of drugs, impact on elements of the national drug policy. METHODS: This is a desk-based study using qualitative and quantitative methods. All legal proceedings brought by citizens against the Municipal Secretary of State of São Paulo, relating to the supply of drugs in 2005 were analyzed. A standardized form was used to collect data, with a view to carrying out an exploratory analysis. RESULTS: A total of 170 cases relating to the supply of drugs were brought against the Municipal Secretary of State. The National Health System (SUS) was the source for 59% of the prescriptions: 26% from the municipal level, 33% from other levels. Cancer and diabetes were the diseases most commonly involved (59%). About 62% of drugs requested are on the lists of SUS services. Total expenditure was R$876,000 (Brazilian Reais), covering only non-selected items (i.e. those which are not included in the Municipal Register of Essential Medicines), 73% of which could be substituted. Of the total expenditure, 75% was spent on purchasing anticancer drugs, for which further clinical trials are required to prove their effectiveness. Two of these medicines were not registered in Brazil. CONCLUSIONS: The majority of demands for drugs that have led to legal proceedings could be avoided if two SUS directives were followed, namely the organization of oncology services and the observance of reporting on essential medicines. Failure to do so causes a breakdown in the National Drug Policy, in equality of access and in the rational use of drugs within the National Health System.