Custos médicos diretos dos tratamentos para diabetes mellitus solicitados por via judicial no município de Juiz de Fora, Minas Gerais

Abstract

Diabetes mellitus is considered a global epidemic by the World Health Organization. Both the prevalence and the incidence of the two main types (1 and 2) have increased each year. In Brazil it is observed a phenomenon called judicialization to achieve drugs and supplies for the treatment of diabetes. There is free material for diabetes treatment in Brazil distributed by the Public Health System and by some assistance programs such as Farmácia Popular and Aqui Tem Farmácia Popular. However, some patients go to court to have access to the treatment prescribed. The study aims to calculate the economic impact and the direct medical costs involved in lawsuits filed by patients against the city of Juiz de Fora, Minas Gerais, to get insulin, drugs, disposable supplies, permanent suppliet and diet goods for the treatment of diabetes mellitus. Copies of granted or granted in part lawsuits filed between 2009 and 2014 against Juiz de Fora City Council have been studied. They were stored in Municipal Health Department and City Attorneys Office. 125 cases were analyzed with an average cost of R$5,944.44 per patient considering direct medical costs. According to the simulation of costs expenditures were R$743,055.57 with these diabetes treatments or 9.29% of R$ 8 million allocated to spending on health judicialization in Juiz de Fora in 2014, having economic impact on the health budget. Disposable supplies and insulin were the highest direct medical costs, respectively R$344,818.09 and R$159,410.88. 54.4% of prescriptions attached to lawsuits were from SUS; 51.2% of the lawsuits had a public defender in charge; 47.2% of the lawsuits required items that are not available free of charge in the public health system; 53.6% of plaintiffs have type 1 diabetes; 60.8% are female; 29.6% are adults; 24.8% aged 0-17; 22.4% are elderly people.