Judicialization of access to medicines in four Latin American countries: a comparative qualitative analysis
Abstract Background The valuation of medicines as health needs vary depending on the stakeholders involved (users, prescribers, managers, etc.) and their expectations. These factors modulate the role of medicines as a health need and influence access to medicines, and could be useful to explain the...
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BMC
2019-06-01
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Series: | International Journal for Equity in Health |
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Online Access: | http://link.springer.com/article/10.1186/s12939-019-0960-z |
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doaj-11fb5a6564604aa28176628e17a646f9 |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Claudia Marcela Vargas-Pelaez Marina Raijche Mattozo Rover Luciano Soares Carine Raquel Blatt Aukje K. Mantel-Teeuwisse Francisco Augusto Rossi Luis Guillermo Restrepo María Cristina Latorre José Julián López María Teresa Bürgin Consuelo Silva Silvana Nair Leite Mareni Rocha Farias |
spellingShingle |
Claudia Marcela Vargas-Pelaez Marina Raijche Mattozo Rover Luciano Soares Carine Raquel Blatt Aukje K. Mantel-Teeuwisse Francisco Augusto Rossi Luis Guillermo Restrepo María Cristina Latorre José Julián López María Teresa Bürgin Consuelo Silva Silvana Nair Leite Mareni Rocha Farias Judicialization of access to medicines in four Latin American countries: a comparative qualitative analysis International Journal for Equity in Health Right to health Essential medicines Access to medicines Lawsuits Argentina Brazil |
author_facet |
Claudia Marcela Vargas-Pelaez Marina Raijche Mattozo Rover Luciano Soares Carine Raquel Blatt Aukje K. Mantel-Teeuwisse Francisco Augusto Rossi Luis Guillermo Restrepo María Cristina Latorre José Julián López María Teresa Bürgin Consuelo Silva Silvana Nair Leite Mareni Rocha Farias |
author_sort |
Claudia Marcela Vargas-Pelaez |
title |
Judicialization of access to medicines in four Latin American countries: a comparative qualitative analysis |
title_short |
Judicialization of access to medicines in four Latin American countries: a comparative qualitative analysis |
title_full |
Judicialization of access to medicines in four Latin American countries: a comparative qualitative analysis |
title_fullStr |
Judicialization of access to medicines in four Latin American countries: a comparative qualitative analysis |
title_full_unstemmed |
Judicialization of access to medicines in four Latin American countries: a comparative qualitative analysis |
title_sort |
judicialization of access to medicines in four latin american countries: a comparative qualitative analysis |
publisher |
BMC |
series |
International Journal for Equity in Health |
issn |
1475-9276 |
publishDate |
2019-06-01 |
description |
Abstract Background The valuation of medicines as health needs vary depending on the stakeholders involved (users, prescribers, managers, etc.) and their expectations. These factors modulate the role of medicines as a health need and influence access to medicines, and could be useful to explain the rising of Judicialization of access to medicines. Aim To conduct a comparative analysis of the causes and consequences of judicialization of access to medicines in Argentina, Brazil, Colombia and Chile from the perspective of medicines as health needs. Methods A qualitative, cross-country study was carried out in these 4 countries. Semi-structured interviews were conducted with 50 representatives of the different stakeholders involved in the judicialization of access to medicines, including Executive branch, Judiciary, health system managers, patient organizations. The interviews were audio-recorded and transcribed verbatim. Thematic analysis used a framework approach based on the theoretical model for medicines as health needs. Findings Representatives from Argentina, Brazil and Colombia considered judicialization of access to medicines as a widespread phenomenon in their respective countries. Meanwhile in Chile, the respondents highlighted that most lawsuits related to the right to health were filed against private insurers because of unjustified increases in the insurance premiums. The comparative analysis showed that judicialization of access to medicines emerged in the four countries regardless of the constitutional protection or the health system population coverage. Among the causes were mentioned difficulties in guaranteeing access to covered medicines and the influence of pharmaceutical marketing on needs assessment and prescription behaviours. The interviewees highlighted the pressure to health system managers to fulfil their responsibilities as a positive impact of litigation. In contrast, the funding of medicines without evidence of efficacy or safety was considered a negative impact. Only in Brazil, judicialization has had impact on R&D policies. In Colombia, litigation also encouraged the recognition of the right to health as a fundamental right and the development of policies for controlling medicines prices. Conclusion The results suggest that applying the adopted theoretical model creates the possibility of identifying critical points to guide policy makers to improve the health systems performances and to control lawsuits for access to medicines. |
topic |
Right to health Essential medicines Access to medicines Lawsuits Argentina Brazil |
url |
http://link.springer.com/article/10.1186/s12939-019-0960-z |
work_keys_str_mv |
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doaj-11fb5a6564604aa28176628e17a646f92020-11-25T03:54:30ZengBMCInternational Journal for Equity in Health1475-92762019-06-0118111410.1186/s12939-019-0960-zJudicialization of access to medicines in four Latin American countries: a comparative qualitative analysisClaudia Marcela Vargas-Pelaez0Marina Raijche Mattozo Rover1Luciano Soares2Carine Raquel Blatt3Aukje K. Mantel-Teeuwisse4Francisco Augusto Rossi5Luis Guillermo Restrepo6María Cristina Latorre7José Julián López8María Teresa Bürgin9Consuelo Silva10Silvana Nair Leite11Mareni Rocha Farias12Programa de Pós-Graduação em Farmácia, Universidade Federal de Santa Catarina, Campus Universitário TrindadeDepartamento de Ciências Farmacêuticas. Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Campus Universitário TrindadePrograma de Pós-Graduação em Saúde e Meio Ambiente, Universidade da Região de JoinvilleDepartamento de Farmacociências, Universidade Federal de Ciências da Saúde de Porto AlegreWorld Health Organization Collaborating Centre for Pharmaceutical Policy & Regulation, Utrecht Institute for Pharmaceutical Sciences (UIPS)Fundación IFARMAFundación IFARMAFundación IFARMADepartamento de Farmacia, Universidad Nacional de ColombiaIndependent researcherCorporación de Investigación MEGA 2Programa de Pós-Graduação em Farmácia, Universidade Federal de Santa Catarina, Campus Universitário TrindadePrograma de Pós-Graduação em Farmácia, Universidade Federal de Santa Catarina, Campus Universitário TrindadeAbstract Background The valuation of medicines as health needs vary depending on the stakeholders involved (users, prescribers, managers, etc.) and their expectations. These factors modulate the role of medicines as a health need and influence access to medicines, and could be useful to explain the rising of Judicialization of access to medicines. Aim To conduct a comparative analysis of the causes and consequences of judicialization of access to medicines in Argentina, Brazil, Colombia and Chile from the perspective of medicines as health needs. Methods A qualitative, cross-country study was carried out in these 4 countries. Semi-structured interviews were conducted with 50 representatives of the different stakeholders involved in the judicialization of access to medicines, including Executive branch, Judiciary, health system managers, patient organizations. The interviews were audio-recorded and transcribed verbatim. Thematic analysis used a framework approach based on the theoretical model for medicines as health needs. Findings Representatives from Argentina, Brazil and Colombia considered judicialization of access to medicines as a widespread phenomenon in their respective countries. Meanwhile in Chile, the respondents highlighted that most lawsuits related to the right to health were filed against private insurers because of unjustified increases in the insurance premiums. The comparative analysis showed that judicialization of access to medicines emerged in the four countries regardless of the constitutional protection or the health system population coverage. Among the causes were mentioned difficulties in guaranteeing access to covered medicines and the influence of pharmaceutical marketing on needs assessment and prescription behaviours. The interviewees highlighted the pressure to health system managers to fulfil their responsibilities as a positive impact of litigation. In contrast, the funding of medicines without evidence of efficacy or safety was considered a negative impact. Only in Brazil, judicialization has had impact on R&D policies. In Colombia, litigation also encouraged the recognition of the right to health as a fundamental right and the development of policies for controlling medicines prices. Conclusion The results suggest that applying the adopted theoretical model creates the possibility of identifying critical points to guide policy makers to improve the health systems performances and to control lawsuits for access to medicines.http://link.springer.com/article/10.1186/s12939-019-0960-zRight to healthEssential medicinesAccess to medicinesLawsuitsArgentinaBrazil |