Supreme Court reaches agreement on funding for high-cost medicines

Brazil’s Federal Supreme Court has finalized an agreement with the federal government, states, and municipalities to establish parameters for supplying high-cost medicines, grounded in the constitutional right to health.

The measure stipulates that lawsuits regarding medicines not incorporated into the country’s public healthcare network, the SUS, but already registered with the national drug regulator Anvisa, must be handled by the Federal Court. In such cases, the Brazilian state is required to cover the cost of medicines with an annual value of 210 minimum wages or more. This year, the national minimum wage is set at BRL 1,412.00, approximately $248.77.

When the annual cost of a medicine falls between seven and 210 minimum wages, these cases will be heard by state courts. In such instances, the federal government is obligated to reimburse 65 percent of the expenses incurred by states and municipalities for purchasing the medicines. For cancer drugs, the reimbursement rate increases to 80 percent.

There are also plans to establish a national platform to centralize all legal requests for medicines. This platform will enable the sharing of data from drug requisition processes with the judiciary to streamline case analysis.

Ceremony

The Federal Supreme Court held a ceremony on Thursday (Oct. 17) to finalize the agreement. According to the Court's president, Justice Luís Roberto Barroso, this agreement is the first step toward rationalizing the judicial health system.

“The judicialization of health has emerged as one of the Brazilian Judiciary's most significant challenges, likely one of the most complex, as it presents issues that lack straightforward legal or morally affordable solutions,” he stated.

Health Minister Nísia Trindade also participated in the event, stating that the agreement marks a significant milestone for public health in the country. She emphasized that the constitutional right to health must be implemented sustainably to ensure that the SUS benefits the entire population.

“The cases decided by the Federal Supreme Court are emblematic and set criteria for the judicial approval of medicines and other health supplies. They also clarify the responsibilities and burdens shared among the the federal government, states, and municipalities,” she stated.

Federal Attorney General Jorge Messias stated, “From this understanding, we were able to establish a clear outline of the competencies and responsibilities within the SUS, delineating the roles of the federal governemnt, states, the Federal District, and municipalities.”