"Judicialization" of public health policy for distribution of medicines

Abstract

The supply of medicines in response to court ordersor injunctions has become a common practicein the State of São Paulo, Brazil. This "judicialization"of the health system clashes withbasic principles of the Brazilian Unified NationalHealth System (SUS), such as equal opportunityto access health services. The aim of this paper isto analyze the legal action used to obtain medicinesthrough the São Paulo State Health Department,from two main angles: judicialization ofpublic policies and breach of the equity principle.This is a descriptive study of legal action taken toobtain medicines through the São State HealthDepartment, as listed in the Electronic CourtDocket System for the year 2006. Most cases werefiled through private attorneys; 47% of the patientshad obtained their prescriptions throughprivate care; and 73% of the cases involved patientsfrom the three wealthiest areas in the cityof São Paulo. The data demonstrate that such legalaction violates key principles of the SUS suchas equity, thereby privileging individuals withhigher purchasing power and more access toinformation.