Abstract
Patients without access to medicines often resort to the judicial system. However, no systematic review has discussed the quality of studies and the factors that may influence the access to medicines from judicialization. This study aimed to characterize the quality of research on access to judicialized medicines and their influence on public policies in Brazil. A search was conducted in the LILACS, PubMed/Medline, Scopus, and Web of Science databases using the terms "judicialization" and "medication". Two reviewers identified articles that met the inclusion criteria. Only studies written in English, Portuguese, or Spanish published from 1990 to 2018 were included. The study selection resulted in a final sample of 45 articles. The retrospective descriptive design was the most common methods, based on reports and lawsuits. A high level of heterogeneity among the studies hindered the comparison and generation of evidence capable of supporting judges' decisions based on technical-scientific criteria. This review showed that studies were heterogeneous and had low methodological quality. Moreover, they did not propose viable solutions for health managers and formulators to face the problem.
Highlights
MethodsFrom the late 1980s, many countries in Latin America introduced universal health coverage[1]
No systematic review has discussed the quality of studies and the factors that may influence the access to medicines from judicialization
This review showed that studies were heterogeneous and had low methodological quality
Summary
MethodsFrom the late 1980s, many countries in Latin America introduced universal health coverage[1]. In the context of universality, access to medicines is a fundamental human right and results from the interaction of a complex network composed of patients, pharmaceutical industries, regulatory agencies, health systems, and healthcare services[2]. When access to medicines is prevented, patients have resorted to lawsuits to ensure this fundamental right[1,4]. This phenomenon, known as “judicialization of access to medicines”, has emerged in several middle-income Latin American countries, such as Argentina, Brazil, Chile, Colombia, Costa Rica, Peru, and Uruguay[1,5,6,7,8]. Judicialization has caused positive and negative effects on the access of medicines, affecting both the population and the health and justice systems[2,5]
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