Políticas sociais no SUS e a gestão da assistência farmacêutica na rede local/regional : o caso da judicialização na 17ª Coordenadoria Regional de Saúde - RS.

Abstract

This doctoral thesis presents the results that face the dynamics of the National Drug Policy, notably as regards the supply management of the public good "medicines", through the National Pharmaceutical Assistance Policy and the game of actor‘s interests through this policy. The organization of policy management by the Brazilian Ministry of Health is introduced to the reader regarding its diversity and territorial extension, to ensure access to this public good and its final destination, which is the citizen. At the same time, the analysis of the game scenery shows the political interests acting specially related to the individual's grant about the right to health in the courts. The selection of the17th Regional Coordination of Health micro region aimed to offer the reader a mapped specific diagnosis in order to identify the critical nodes that affect policy results, both in its internal management aspects, and in its external developments, due to interests conflicts of public and private order. This type of public choice via regional court decision making implies even greater complexity of management. The study shows that this scenery compels public administration to retrigger public debate on conflicts between individual and public rights, since the Public Health System must ensure the public good drug access as a grant to reproduction over time and its character of inexhaustibility. The methodology used to facilitate the study of qualitative research consists of theoretical empirical character, which is used in bibliographical, documentary resources, as well as analysis of secondary data collected from the Accounts Court of the State of Rio Grande do Sul and the tabulation of data together with reports from the public supply of drugs extracted from the medication Administration System of the State Department of Health State of Rio Grande do Sul, which reveal the supply of this input through legal decision in each of the dates of consultation. These two reports generated in October 2013 and January 2014 show a sampling of the situation of the 17th CRS region and were classified according to the criteria of simplicity and rationality, that result in each of the categorical components of the pharmaceutical PNAF (basic, special, exceptional and strategic), is quantitatively calculated how many active court orders involving such components contained in RENAME. It was also determined the number of requests for medications that are unrelated to clipping of institutional policy. The qualitative analysis of this calculation, associated to the arguments used in the discussion of the individual right to health by the Court of Justice of the State of Rio Grande do Sul allow to highlight several detours on offer of this public good.