Universidade de Sorocaba, Sorocaba, SP, Brasil.
Rev Saude Publica. 2011 Aug;45(4):706-13. doi: 10.1590/s0034-89102011005000044. Epub 2011 Jul 1.
To analyze judicial requests for medications that are covered by the pharmaceutical assistance components of the Sistema Único de Saúde (SUS - Brazilian Unified Health System).
We analyzed 81 judicial requests for medications in the State of São Paulo between 2005 and 2009. The details of these cases were obtained electronically from the Court of Justice of the State of São Paulo. Directives that regulate pharmaceutical assistance were consulted to identify judicially requested medications that are covered by the SUS. To assess the level of evidence supporting the use of these medications to treat the clinical indications described, we consulted the Thomson Micromedex® database.
The number of individual medications requested in each case ranged from 1 to 7; in total, 77 different pharmaceuticals agents were identified. Of the medications requested, 14.3% should have been available through SUS primary care, 19.5% were classified under the exceptionally dispensed medications component of the SUS, and 66.2% were not on any official list. Medications of the exceptionally dispensed medications component showed better clinical evidence when indicated for the treatment of medical conditions covered by the Clinical Protocols and Therapeutic Guidelines of Brazil's Ministry of Health.
The judicial process has been used to ensure access to medications that are covered by the SUS and to request access to those that are not covered. Our assessment of the level of available evidence reinforces the need for technical analysis in the decision-making process in cases of judicially requested medications.
分析司法请求的药物，这些药物覆盖了巴西统一医疗系统（SUS）的药品援助部分。
我们分析了 2005 年至 2009 年期间在圣保罗州的 81 份药物司法请求。这些案件的详细信息是从圣保罗州法院电子获取的。咨询了规范药品援助的指令，以确定 SUS 覆盖的司法请求药物。为了评估支持使用这些药物治疗描述的临床适应症的证据水平，我们查阅了 Thomson Micromedex®数据库。
每份案件中请求的个别药物数量从 1 到 7 不等；总共确定了 77 种不同的药物制剂。在请求的药物中，14.3%应该通过 SUS 初级保健获得，19.5%属于 SUS 特殊配给药物部分，66.2%不在任何官方名单上。当特殊配给药物部分的药物被指示用于治疗巴西卫生部临床方案和治疗指南涵盖的医疗状况时，其具有更好的临床证据。
司法程序已被用于确保获得 SUS 覆盖的药物，并请求获得未覆盖的药物。我们对现有证据水平的评估加强了在司法请求药物的决策过程中进行技术分析的必要性。
