Judicialização do cinacalcete no estado do Rio de Janeiro. Rio de Janeiro
Judicialização do cinacalcete no estado do Rio de Janeiro. Rio de Janeiro
Data
2018
Autores
Mota, Karla Spinoza Coelho
Journal Title
Journal ISSN
Volume Title
Publisher
Instituto Nacional de Cardiologia
Resumo
A doença renal crônica é um problema de saúde que afeta 5 a 10% da população mundial, que causa uma elevada mortalidade e morbidade com consequente aumento dos custos e consumo de recursos da saúde. A insuficiência renal crônica, fase terminal da doença renal, apresenta alta letalidade, apesar dos tratamentos disponíveis. O hiperparatireodismo é uma consequência da insuficiência renal crônica e o medicamento mais indicado para o seu tratamento é o cinacalcete, um dos itens mais solicitados por vias judiciais no Rio de Janeiro. O valor gasto para atender esta demanda não é conhecido e, diante do contexto do crescimento da judicialização, e do impacto econômico que este fenômeno pode causar, a presente dissertação objetivou conhecer a demanda e o impacto no orçamento deste medicamento no Estado do Rio de Janeiro. Para tal, analisaram-se os pareceres emitidos pelo Núcleo de Assessoria Técnica do Tribunal de Justiça deste estado entre os anos de 2009 e 2016 e verificou-se a quantidade de processos. Para descrever o perfil dos autores e o valor gasto foi escolhido o ano de 2015, ano com o maior número de processos para este medicamento. Realizou-se uma busca no banco de licitações da Secretaria de Estado de Saúde do Rio de Janeiro para encontrar o valor pago por este medicamento em 2015. Entre 2009 e 2015 este núcleo elaborou 23.852 pareceres, 1553 relacionados ao cinacalcete, sendo 359 em 2015. Entre os autores 88% residiam na capital deste estado, 50,4% eram mulheres, 46% com renda entre 1 a 3 salários mínimos, sendo a maioria aposentados e 90% foram atendidos em unidades de saúde privada conveniada ao SUS. A decisão judicial foi favorável ao autor em 100 % dos processos; em apenas 29% solicitou-se a atualização semestral dos receituários médicos; não foi possível verificar a decisão de 11% e 2% foram extintos. Os autores solicitaram auxílio da defensoria pública em 95% dos processos. Em 2015 foram gastos cerca de 3.7 milhões de reais para compra deste medicamento, o que equivale a 2,5% dos recursos destinados a assistência farmacêutica do estado do RJ neste ano, caracterizando um elevado impacto no orçamento da saúde.
The chronic kidney disease is a health problem that affects 5 to 10% of the world population, which causes a high mortality and morbidity increasing the costs and consumption of health resources. The kidney failure, the end phase of kidney disease, presents high lethality despite available treatments. Hyperparathyroidism is a consequence of kidney failure and the most suitable drug for its treatment is cinacalcet, one of the most requested items by judicial means in Rio de Janeiro. The expended value to meet this demand is unknown, and due to the increase of judicialization and economic impact that this phenomenon could cause, the current study aimed to define the demand and impact in the budget of this drug in Rio de Janeiro state. In order to achieve these objectives, it was checked the reports issued by the Technical Advisory Core of the Court of Justice in Rio de Janeiro between 2009 and 2016 which was verified through the processes quantities. In order to describe the authors profiles and the amount spent it was chosen the 2015, year with the highest number of processes associated to this drug. It was realized a search in the bids database of Health Secretary of Rio de Janeiro state to define the value spent for this drug in 2015. Between 2009 and 2015, the Core Technical Advisory prepared 23.852 opinions, 1553 related to Cinacalcete, 359 in 2015. Among the authors, 88% was living in the capital of Rio de Janeiro, 50.4% were women, 46% with income between 1 and 3 minimum wages, most of them retired and 90% were attended at private health facilities agreed upon SUS. The court decision was favorable to the author in 100% of the processes; only in 29% was conditioned to the semi-annual update of medical prescriptions; it was no possible to check the decision in 11% of the cases and 2% were extinguished. The authors requested assistance from public defenders in 95% of the cases. In 2015, about R$ 3.7MM were spent, which is equivalent to 2.5% of the resources intended for pharmaceutical assistance in the state of Rio de Janeiro at that year, causing a high impact in the health´s budget.
The chronic kidney disease is a health problem that affects 5 to 10% of the world population, which causes a high mortality and morbidity increasing the costs and consumption of health resources. The kidney failure, the end phase of kidney disease, presents high lethality despite available treatments. Hyperparathyroidism is a consequence of kidney failure and the most suitable drug for its treatment is cinacalcet, one of the most requested items by judicial means in Rio de Janeiro. The expended value to meet this demand is unknown, and due to the increase of judicialization and economic impact that this phenomenon could cause, the current study aimed to define the demand and impact in the budget of this drug in Rio de Janeiro state. In order to achieve these objectives, it was checked the reports issued by the Technical Advisory Core of the Court of Justice in Rio de Janeiro between 2009 and 2016 which was verified through the processes quantities. In order to describe the authors profiles and the amount spent it was chosen the 2015, year with the highest number of processes associated to this drug. It was realized a search in the bids database of Health Secretary of Rio de Janeiro state to define the value spent for this drug in 2015. Between 2009 and 2015, the Core Technical Advisory prepared 23.852 opinions, 1553 related to Cinacalcete, 359 in 2015. Among the authors, 88% was living in the capital of Rio de Janeiro, 50.4% were women, 46% with income between 1 and 3 minimum wages, most of them retired and 90% were attended at private health facilities agreed upon SUS. The court decision was favorable to the author in 100% of the processes; only in 29% was conditioned to the semi-annual update of medical prescriptions; it was no possible to check the decision in 11% of the cases and 2% were extinguished. The authors requested assistance from public defenders in 95% of the cases. In 2015, about R$ 3.7MM were spent, which is equivalent to 2.5% of the resources intended for pharmaceutical assistance in the state of Rio de Janeiro at that year, causing a high impact in the health´s budget.
Description
Palavras-chave
Budget cost of illness, Health care spent, Cinacalcet, Health judicialization, Impacto orçamentário, Gastos em saúde, Cinacalcete, Judicialização da saúde
Citação
Mota KSC. Judicialização do cinacalcete no estado do Rio de Janeiro. Rio de Janeiro. Dissertação [Mestrado Profissional em Avaliação de Tecnologias em Saúde] - Instituto Nacional de Cardiologia; 2018.