O acesso a medicamentos de alto custo no SUS: desafios contemporâneos

Abstract

Access to high-cost medications through the Brazilian Unified Health System (SUS) is a critical issue involving the intersection of fundamental rights, public administration, and the State’s budgetary limitations. In this context, the State’s civilliability becomes particularly relevant, especially given the rise in health-relatedlawsuits, a growing phenomenon in Brazil. Increasingly, citizens are turning to thejudiciary to secure access to essential treatments, ighlighting the complexity ofenforcing social rights and the judiciary's role in protecting them in the face of systemicconstraints.Extraordinary Appeal No. 566.471/RN, ruled on by the Federal Supreme Court(STF), represents a significant milestone in this debate by stablishing guidelines aimedat balancing the right to health with the State's inancial limitations. This decisionunderscores the need for an approach that econciles the protection of individual rightswith the sustainability of the SUS—a challenge that involves not only legal issues butalso administrative and budgetary considerations.Authors such as Maria Paula Dallari Bucci and Clarice Seixas Duarte (2017)discuss the obstacles faced by the Executive Branch in implementing ffective publicpolicies in light of judicial demands. Giacomoni (2019) omplements this analysis byhighlighting the tension between the right to health, guaranteed by the 1988Constitution, and the financial realities of the State. In this context, understanding theState’s civil liability becomes essential for assessing how to ensure access to high-costmedications without compromising the sustainability of the healthcare system.Therefore, this study seeks to explore these issues by evaluating the legal andadministrative implications of providing high-cost medications, in light of theguidelines established by the STF and the concept of the right to a minimum standard ofliving, as discussed by authors such as Torres (2009), Silva (2011), and Gaspardo(2015). This nalysis aims to ontribute to a deeper understanding of the contemporarychallenges in accessing essential treatments in Brazil