title: Judicialization of access to medicines in Minas Gerais state, Southeastern Brazil.
abstract: OBJECTIVE
  To analyze the profile of claimants and medicines demanded in lawsuits.
  
  
  METHODS
  Descriptive study that examined 827 lawsuits with 1,777 demands of access to medicines in the period between July 2005 and June 2006 in the state of Minas Gerais, Southeastern Brazil. There were examined the type of health care provided to claimants and their attorneyship. The medicines were described based on the following: drug registration at the National Health Surveillance Agency (Anvisa); wheter they were essential medicines; supply in the Brazilian Health System programs; and evidence of drug efficacy.
  
  
  RESULTS
  More than 70% of the claimants were provided care in the private health system and 60.3% hired private lawyers. The most common diagnosis of claimants was rheumatoid arthritis (23.1%) and the immunosuppressant agents were the most frequent demand medicines (mainly adalimumab and etanercept). Approximately 5% of the medicines demanded were not registered at Anvisa, 19.6% were included in the Brazilian List of Essential Medicine, 24.3% were included in the High-Cost Drug Program and 53.9% showed consistent evidence of efficacy. Among the medicines that were not available in Brazilian Health System, 79.0% had therapeutic alternatives in drug programs.
  
  
  CONCLUSIONS
  The phenomenon of judicialization of health in Brazil can point out failures in the public health system as some medicines demanded are included in its lists. However, it is a barrier for rational drug use and application of the National Drug Policy guidelines, especially when there are demanded medicines with no evidence of efficacy and that are not included in Brazilian Health System standards.
authors: Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil. marinamaam@yahoo.com.br
authors: Marina Amaral de Ávila
authors: MA
authors: Machado
authors: Francisco de Assis
authors: Fde A
authors: Acurcio
authors: Cristina Mariano Ruas
authors: CM
authors: Brandão
authors: Daniel Resende
authors: DR
authors: Faleiros
authors: Augusto Afonso
authors: AA
authors: Guerra
authors: Mariângela Leal
authors: ML
authors: Cherchiglia
authors: Eli Iola Gurgel
authors: EI
authors: Andrade
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D018954:Drugs, Essential / Q000600:supply & distribution*; D005260:Female; D006291:Health Policy / Q000331:legislation & jurisprudence; D006297:Health Services Accessibility / Q000331:legislation & jurisprudence*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D033222:Judicial Role; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000331:legislation & jurisprudence; D028701:Patient Rights / Q000331:legislation & jurisprudence*; D017150:Public Sector
chemical_list: D018954:Drugs, Essential