Why do people appeal to the courts for access to medication? The case of insulin analogues in Bahia (Brazil). / Por que as pessoas recorrem ao Judiciário para obter o acesso aos medicamentos? O caso das insulinas análogas na Bahia.

Insulin analogues have been the object of controversy concerning their therapeutic superiority to human insulin. Perhaps, in part, because of this, insulin analogues are frequently the subject of lawsuits. The judicialization of health has been well studied, but little is known about the reasons that lead people to go to the courts to obtain access to medicines on SUS (the Brazilian National Health System). Therefore, this study aims to analyze the reasons that led people to appeal to the courts to obtain access to insulins analogues in the state of Bahia. This is a case study based on documentary sources. Between 2010 and 2013, 149 lawsuits requiring insulin analogues from the state health authority were filed in the courts. The main reasons for the appeal to the courts, cited in the cases, can be grouped into four categories: the users' lack of finances, an essential need for insulin analogue, the duty and obligation of the state to provide them and bureaucratic difficulties. People turned to the courts, mostly, because doctors who accompany their patients have shifted from the official policy, believing that insulin analogues are better than human insulins. They also recognize that the public health system does not distribute them nor does it give doctors the wherewithal to purchase them with their own resources.

Por que as pessoas recorrem ao Judiciário para obter o acesso aos medicamentos? O caso das insulinas análogas na Bahia / Why do people appeal to the courts for access to medication? The case of insulin analogues in Bahia (Brazil)

Resumo As insulinas análogas são alvo de controvérsias quanto à sua superioridade terapêutica em relação às humanas. Talvez, em parte, devido a isso, são objetos frequentes de ações judicias. A judicialização da saúde tem sido muito estudada, mas pouco se sabe sobre os motivos que levam as pessoas a recorrerem ao Judiciário para obter acesso a medicamentos no SUS. Sendo assim, o presente estudo tem por objetivo analisar os motivos que levaram as pessoas a recorrerem ao Judiciário para obter o acesso às insulinas análogas no estado da Bahia, tratando-se de um estudo de caso apoiado em fonte documental. Foram analisadas, entre 2010 e 2013, 149 ações judiciais que solicitaram o fornecimento de análogas pela secretaria estadual da saúde. Os motivos do recurso à Justiça, citados nos autos, podem ser classificados em: hipossuficiência financeira do usuário, necessidade de insulina análoga, dever e obrigação do Estado em fornecê-las e dificuldades burocráticas. Majoritariamente, as pessoas recorreram ao Judiciário, porque os médicos que as acompanham, divergindo das políticas oficiais, acreditam que as insulinas análogas são melhores do que às humanas e o sistema público de saúde não as dispensa, não dispondo elas de condições financeiras que lhes permitam adquiri-las com recursos próprios.

Abstract Insulin analogues have been the object of controversy concerning their therapeutic superiority to human insulin. Perhaps, in part, because of this, insulin analogues are frequently the subject of lawsuits. The judicialization of health has been well studied, but little is known about the reasons that lead people to go to the courts to obtain access to medicines on SUS (the Brazilian National Health System). Therefore, this study aims to analyze the reasons that led people to appeal to the courts to obtain access to insulins analogues in the state of Bahia. This is a case study based on documentary sources. Between 2010 and 2013, 149 lawsuits requiring insulin analogues from the state health authority were filed in the courts. The main reasons for the appeal to the courts, cited in the cases, can be grouped into four categories: the users’ lack of finances, an essential need for insulin analogue, the duty and obligation of the state to provide them and bureaucratic difficulties. People turned to the courts, mostly, because doctors who accompany their patients have shifted from the official policy, believing that insulin analogues are better than human insulins. They also recognize that the public health system does not distribute them nor does it give doctors the wherewithal to purchase them with their own resources.