Health judicialization in the Brazilian state of Pernambuco: The antineoplastics at the top again?

Abstract

The medicines are among the most judicially demanded health resources. Antineoplastic drugs are among the therapeutic class with the higher number of lawsuits in some Brazilian states and compliance with these actions confers a certain financial impact to the Brazilian National Health System, since it entails excessive and unplanned expenditures. The objective of this article was to analyze the lawsuits for the acquisition of  antineoplastic drugs in the Health Department of the State of Pernambuco, in the year 2015. A retrospective descriptive study analyzed all the lawsuits related to antineoplastic drugs, issued from January to December 2015, at the Health Secretariat of the State of Pernambuco. This comprised a total of 347 lawsuits concerning a variety of 26 different antineoplastic drugs. The therapeutic subgroup of protein kinase inhibitors (25.9%) comprised the highest proportion, followed by monoclonal antibodies (22.2%). The expenditure on anti-neoplastic drugs of the Health Department of the State of Pernambuco’s for the year 2015 was over R$ 14 million. Regarding the origin of prescriptions, the highest percentage (57%) came from non-profit entities. A total of 58 different pathologies were indicated to justify legal actions. The issue became relevant because of the exponential expansion of neoplasms in the world and in Brazil because of (i) the accelerated pace of technological innovations of the pharmaceutical industry, in particular; (ii) the magnitude acquired by the access to treatments through judicialization in the State, and (iii) the consequent repercussion on public expenditure.