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Brazilian Courts as a Pathway to Medicines which Represent Pharmacotherapeutic Gaps

Brazilian Courts as a Pathway to Medicines which Represent Pharmacotherapeutic Gaps. Mércia Pandolfo Provin Silvana Nair Leite Contezini Rita Goreti Amaral. Context. Health system very excludent and with strong economic component. Art. 5 [...] right to life. Cap. II - Social Security:

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Brazilian Courts as a Pathway to Medicines which Represent Pharmacotherapeutic Gaps

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  1. Brazilian Courts as a Pathway to Medicines which Represent Pharmacotherapeutic Gaps Mércia Pandolfo Provin Silvana Nair Leite Contezini Rita Goreti Amaral

  2. Context Health system very excludent and with strong economic component Art. 5 [...] right to life Cap. II - Social Security: Health Art. 196 a 200 Art. 196 – Health is a everyone's right and duty of the State [...] Art. 198 – The actions and public health services [...] II – Integral care; 1988 BrazilianConstitution Universal and integral Health System Mércia Pandolfo Provin (Brasil, 1988)

  3. Context Access MérciaPandolfoProvin

  4. Problem In spite of this, in the last few years an increasing number of citizens have initiated court actions to grant their access to medicines prescribed for their treatments and it has become a management and financial problem for the national and local health systems Mércia Pandolfo Provin

  5. Problem The judicial way has become a manner of gaining access to medications, but it is not known for sure whether they are an equalitarian way for that access and how much social and geographical differences influence in its characteristics. Mércia Pandolfo Provin

  6. Aim To characterize the demand for medicines through judicial way in regions with different incomes Mércia Pandolfo Provin

  7. Metodology Transversal descriptive study (2003-2007), carried out in the Pharmacy School – Federal University of Goiás, approved by the Ethics Committee of that institution. We analyzed court actions that demanded for medicines and were accepted and granted in the city of Goiânia-GO-Brazil. Mércia Pandolfo Provin

  8. Methodology The object of study Served as object of this study those court actions that; demanded for medications, were initiated against the city of Goiânia-GO, were accepted and received by the Unified Health System manager from January 2005 to December 2007. Thus, among the 1553 process filed, 175 of them contained no request for medication, 129 the date were incomplete and were therefore excluded from the study. Were analyzed them 1249 lawsuits. Mércia Pandolfo Provin

  9. Methodology For characterizing the medicines demand through judicial way in different city regions After geoprocessing, the court actions were grouped in accordance with the estimated average income of the family breadwinner for the respective TPU, in four groups as follows: Region type I: set of court actions started in regions where the average householder’s income is from 0 to 3 (included) minimum wages; Region type II: set of court actions started in regions where the average householder’s income is higher than 3 to 6 (included) minimum wages; Region type III: set of court actions started in regions where the average householder’s income is higher than 6 to 9 (included) minimum wages; Region type IV: set of court actions started in regions where the average householder’s income is higher than 9 minimum wages. Mércia Pandolfo Provin

  10. Methodology • For characterizing the medicines demand • Variable: • Lawsuits: number, year of approval; • Petitioner: number, gender, age, disease, address; • Prescription origin: public or private; • Medicine: drug, cost, access, alternative therapeutic; • Income: average income of the household head Mércia Pandolfo Provin

  11. Results Picture 1. Number of new lawsuits filed against the Municipal Health Secretariat and the number of corrents processes, 2003-2007, Goiânia – GO Mércia Pandolfo Provin

  12. Results ADHD: Attention Deficit Hypertativity Disorder; IDC: international disease code Picture 2. The most frequent pathologies found in writs against the City Secretary of Health, Goiânia-GO Mércia Pandolfo Provin

  13. Results Picture 3. Medicines distribution in official lists of drugs for public distribution and the existence of therapeutic alternatives Mércia Pandolfo Provin

  14. Results 1:4 1:5 Mércia Pandolfo Provin

  15. Conclusão The judicial demand profile in intracity regions with different incomes presented distinct characteristics, and it may represent diverse needs when it comes to guarantee right to health care, particularly concerning the supply of medicines. Population segments with higher incomes file lawsuits more frequently to assure their access to medicines and they also request more expensive treatments. Mércia Pandolfo Provin

  16. ThankyouMérciaPandolfoProvin merciap@gmail.com

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