Judicialization for access to antineoplastic drugs in Brazil: a reflection based on the debate on the derivation of the State

Abstract

This essay aims to reflect on the phenomenon of the judicialisation of healthcare, from the perspective of the Marxist theory of state derivation. It specifically examines the medication policy of the Unified Health System (SUS, in Portuguese acronymous), focusing on antineoplastic drugs within the context of the capitalist crisis. By unveiling the complex relationships between the state, market, and civil society, it demonstrates how judicialisation serves as a mechanism for the reproduction of capital. Instead of equitably guaranteeing the right to health, the legal form acts as a tool for capital accumulation. The analysis of medication policy reveals the pharmaceutical industry’s influence on the definition of public policies and the fragility of the SUS when faced with judicial demands. The lack of a clear financing policy for antineoplastic drugs makes patients vulnerable to industry pressure and exposes them to high-cost treatments, often without solid scientific evidence of their efficacy. Judicialisation thus becomes a strategy to ensure the circulation of medicines and the profitability of pharmaceutical corporations. Therefore, while individual legal action represents a struggle for rights, it reflects structural problems within the SUS and the State, reinforcing inequalities and Brazil’s subordination to the global logic of capital.