Characteristics of judicialization of health in relation to drugs

Abstract

The aim of this article is to characterize the procedure of judicialization to request drugs in a health plan for public employees in the Province of Santa Fe, corresponding to the south area, which coexists with other two subareas, public and private. These administrative and/or judicial procedures add to the idea that the “judicialization of health” obtains provision of drugs which are not considered by the health system. This research employs a qualitative methodology with analysis of the content of drugs claims which were filed in appeals for protection by members. The sample includes 43 claims, and it was taken from a total of 209 claims for protection filed at the health plan's Legal Department during 2007–2013. Most of the claims for protection are related to high cost drugs. In most of the cases, the plaintiff obtains what they claim. As regards arguments in favor of the plaintiffs, some statements endorse forensic experts’ reports, others highlight the need and urgency of having the requested drug available, and still others present the drug as orphan, unique or novel. In those cases which were favorable to the health plan, similar reasons were observed between the expert witnesses and the defendant party.