Equity and judicialization of medicines: profile of the demands made to the Health Secretariat of Rio Grande do Sul by users in Porto Alegre

The provision of medicines through court orders has led to wide discussions due to its magnitude and its great impact on the management of public resources. The objective of this study was to characterize the judicial demands for obtaining medicines and to compare the socioeconomic quartiles in the judicialization of medicines. A retrospective cross-sectional observational study of judicial demands for medications filed by users in Porto Alegre against the State Health Secretariat of Rio Grande do Sul from March 2017 to February 2018 and granted in favor of the claimants was carried out. Of the cases analyzed, 77.5% were filed by the State Public Defender's Office, but around 60% were from users with better socioeconomic conditions and more access to information about their rights, residing in areas with better Municipal Human Development Indexes. In addition, 72.1% of the users had medical prescriptions originated from private and mixed services; and 72.3% of the requested medications were considered as "off the list". The data revealed that judicialization may contradict the principle of equity foreseen in public health policies related to pharmaceutical care. The creation of a State Pharmacy and Therapeutics Committee and the use of health technology assessment could subsidize court decisions and assist in the elaboration of technical opinions and clinical protocols.