Abstract:
:This study analyzes expenditures backed by court rulings to ensure the public provision of medicines for treatment of mucopolysaccharidosis (MPS), a rare disease that requires high-cost drugs not covered by the Brazilian government's policy for pharmaceutical care and which have disputed clinical efficacy. The methodology included a review of files from 196 court rulings ordering the Brazilian Ministry of Health to provide the medicines, in addition to Ministry of Health administrative records. According to the analysis, the "judicialization" of the health system subjected the Brazilian government to a monopoly in the distribution of medicines and consequently the loss of its capacity to manage drug purchases. The study also indicates that the imposition of immediate, individualized purchases prevents obtaining economies of scale with planned procurement of larger amounts of the medication, besides causing logistic difficulties in controlling the amounts consumed and stored. In conclusion, litigation results from the lack of a clear policy in the health system for rare diseases in general, thereby leading to excessive expenditures for MPS treatment.
journal_name
Cad Saude Publicajournal_title
Cadernos de saude publicaauthors
Diniz D,Medeiros M,Schwartz IVdoi
10.1590/s0102-311x2012000300008subject
Has Abstractpub_date
2012-03-01 00:00:00pages
479-89issue
3eissn
0102-311Xissn
1678-4464pii
S0102-311X2012000300008journal_volume
28pub_type
杂志文章abstract::The objective of this study was to compare the avoidability of infant deaths according to different classification methods. This was a descriptive comparative study from 2006 to 2013 in Espírito Santo State, Brazil, focusing on the classification of 5,316 infant deaths according to five different methods. The methods ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00125916
更新日期:2017-06-12 00:00:00
abstract::A historical cohort of children born between January 2000 and December 2002 from low-income families attending a primary health care facility on the periphery of Pelotas, Rio Grande do Sul, Brazil, was studied in relation to prevalence of exclusive breastfeeding. Analysis was based on a life table focusing on interrup...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2005000200014
更新日期:2005-03-01 00:00:00
abstract::This study aimed to measure the occurrence of multimorbidity and to estimate the number of individuals in the Brazilian population 50 years or older at risk for severe COVID-19. This was a cross-sectional nationwide study based on data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil), conducted in 2015-201...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00129620
更新日期:2020-11-20 00:00:00
abstract::Stomach cancer, the worl&dacute;s most common malignant neoplasia in 1980, has shown a decrease in death and incidence rates in several countries. Still not totally elucidated, the decline in incidence and death rates has been attributed to environmental factors. It is unlikely that the decline has stemmed primarily f...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract::Tuberculosis (TB) is a poverty infectious disease that affects millions of people worldwide. Evidences suggest that social protection strategies (SPS) can improve TB treatment outcomes. This study aimed to synthesize such evidences through systematic literature review and meta-analysis. We searched for studies conduct...
journal_title:Cadernos de saude publica
pub_type: 杂志文章,meta分析,评审
doi:10.1590/0102-311X00153116
更新日期:2018-02-05 00:00:00
abstract::This study aimed at establishing the cross-cultural equivalence of scales used to evaluate physical activity level and measure cardiorespiratory fitness, for further application in elderly subjects. Three scales were identified after systematic review: Veterans Physical Activity Questionnaire (VSAQ), Rating of Perceiv...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2008001100005
更新日期:2008-11-01 00:00:00
abstract::This study deals with adherence to tuberculosis treatment among men and women as well as the disease's links and consequences vis-à-vis life styles and treatment outcomes. The ethnographic study was a component of the Tuberculosis Epidemiological Control Project in the city of Pelotas and aimed to identify the reasons...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x1999000400012
更新日期:1999-10-01 00:00:00
abstract::Muscular-skeletal disorders of the upper limbs resulting from work involving repetition strain (RSI) are now the most frequent work-related diseases in early or late industrialized countries. The author maintains that in addition to being work-related diseases, RSIs are symbolic illnesses revealing the contradictions ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract::Health professionals view medical ethics as a discipline that provides the basis for more adequate patient care. In recent years the concepts of quality of care and human rights - with their attending discourses - have joined the concept of medical ethics among the paradigms to consider in care for humans both at the ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章,评审
doi:10.1590/s0102-311x2008000100002
更新日期:2008-01-01 00:00:00
abstract::Women's perception of childbirth care in a birthing center, the focus of this study, should be considered to assess and improve quality of care. The study method was narrative analysis. Inductive and interpretative analysis of narratives by 17 women produced the following descriptive categories: distinct experiences w...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311x00039713
更新日期:2013-12-01 00:00:00
abstract::Despite being widely used in industry, the literature on tin and its effects in humans is scarce, especially regarding reference values in biological indicators such as blood and urine. Similarly, environmental limits are also rare. This study sought to assess the spatial distribution of hotspots in the environmental ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00079818
更新日期:2019-10-14 00:00:00
abstract::A case-control study was conducted to investigate risk factors for hysterectomy among women using the public health system in Northeast Brazil. The cases were 373 women aged 30-54 years that had undergone elective hysterectomy for benign pelvic conditions. Controls were 742 women with preserved uterus selected from pu...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2003000800022
更新日期:2003-01-01 00:00:00
abstract::This study was undertaken using a case-control, prevalence survey design, aimed at verifying the effects of socioeconomic, environmental, and biological/morbidity variables on the growth of schoolchildren from low-income families. The study focused on schoolchildren whose height/age (H/A) ratio was < or = 2SD (NCHS). ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2001000100008
更新日期:2001-01-01 00:00:00
abstract::The aim of this study was to investigate factors associated with negative self-rated oral health. Elderly subjects from the Brazilian Ministry of Health's oral health survey (2002-2003) who rated their own oral health as bad or very bad were compared to those who rated their oral health as excellent, good, or fair, us...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2009000200021
更新日期:2009-02-01 00:00:00
abstract::Occupational exposure to some pesticides, and particularly DBCP and chlordecone, may adversely affect male fertility. However, apart from the therapeutic use of diethylstilbestrol, the threat to human reproduction posed by "endocrine disrupting" environmental contaminants has not been supported by epidemiological evid...
journal_title:Cadernos de saude publica
pub_type: 杂志文章,评审
doi:10.1590/s0102-311x2002000200003
更新日期:2002-03-01 00:00:00
abstract::The aim of this cross-sectional study nested in a cohort was to describe the targeting and coverage of the Family Income program in children 13 to 35 months of age. Data were obtained from the BRISA Birth Cohorts in Ribeirão Preto, São Paulo State, and São Luís, Maranhão State, Brazil. The cohorts started in 2010 with...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00159718
更新日期:2019-07-04 00:00:00
abstract::Recent studies have emphasized that there is no justification for using the odds ratio (OR) as an approximation of the relative risk (RR) or prevalence ratio (PR). Erroneous interpretations of the OR as RR or PR must be avoided, as several studies have shown that the OR is not a good approximation for these measures w...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311x00077313
更新日期:2014-01-01 00:00:00
abstract::In Brazil, nonprofit or charitable organizations are the oldest and most traditional and institutionalized form of relationship between the third sector and the state. Despite the historical importance of charitable hospital care, little research has been done on the participation of the nonprofit sector in basic heal...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2007000100013
更新日期:2007-01-01 00:00:00
abstract::This paper discusses dental fluorosis as a relevant public health problem, using a review of epidemiological studies published in the last 10 years on the disease's prevalence, severity, and risk factors. The results suggest that there are already more cases than expected, although few studies refer to major severity....
journal_title:Cadernos de saude publica
pub_type: 杂志文章,评审
doi:10.1590/s0102-311x2002000100002
更新日期:2002-01-01 00:00:00
abstract::Different factors have been identified as influencing drug prescribers. Some studies emphasize the role played by sources of information available to physicians. Reports have been published on the influence of marketing strategies on these health professionals. Such strategies include advertisements in medical journal...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2000000200012
更新日期:2000-04-01 00:00:00
abstract::The object of this study is the organization of activities in the vaccination program in Ribeirão Preto, São Paulo, during the process of municipalization of health services, analyzing changes and estimating results. The methodology included a survey performed during supervisory visits and questionnaires with 20 nurse...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x1996000100019
更新日期:1996-01-01 00:00:00
abstract::The aim of this study was to identify different profiles in the AIDS epidemic in Brazil by relating them to the health sector's organization, situations involving increased risk of infection, and the degree of implementation of the response by health services. The Brazilian municipalities (counties) were grouped accor...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2010001200014
更新日期:2010-12-01 00:00:00
abstract::Brazil is one of the countries with the lowest intergenerational income mobility. This article aimed to analyze intergenerational income mobility in the 1982 Birth Cohort in Pelotas, Rio Grande do Sul State. Two methods were used, intergenerational income elasticity and quantile regressions, in order to measure hetero...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00067714
更新日期:2015-06-01 00:00:00
abstract::This study was a comparison of neonatal mortality rates in four maternity hospitals in the city of Rio de Janeiro, Brazil. The study population consisted of newborns with birth weight below 1,500 g. The research instrument was a questionnaire with data reported by the mother and collected from the patient record. For ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章,多中心研究
doi:10.1590/s0102-311x2005000500017
更新日期:2005-09-01 00:00:00
abstract::Hexachlorocyclohexanes (HCHs) are currently considered potentially carcinogenic to humans. In Brasil, severe soil contamination by HCHs has been identified at Cidade dos Meninos, Duque de Caxias, Rio de Janeiro, where an old HCH factory was abandoned 40 years ago, leaving 1,700 local residents at risk. Calcium oxide t...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2003000200011
更新日期:2003-03-01 00:00:00
abstract::Emergency rescue after an earthquake is complex work which requires the participation of relief and social organizations. Studying earthquake emergency coordination efficiency can not only help rescue organizations to define their own rescue missions, but also strengthens inter-organizational communication and collabo...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00039514
更新日期:2015-05-01 00:00:00
abstract::The objective of the present study was to investigate the significance of linear childhood growth retardation in relation to classroom performance. It began with a Height Census carried out in the 1989 school year, involving children attending the first grade of all public and private schools in Osasco (Greater S o Pa...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x1995000200007
更新日期:1995-04-01 00:00:00
abstract::During 1999 and 2000, a population-based cross-sectional study was conducted in Pelotas, southern Brazil, to describe the population distribution of abdominal adiposity according to "action level points" and to identify risk factors. The study included a sample of 1,935 adults (20-69 years) residing in urban areas. Ab...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2006000600010
更新日期:2006-06-01 00:00:00
abstract::Stillbirth rate is high in Brazil, and it is important to identify its determinants. A nested case-control was conducted to explore the determinants of fetal death in a population treated at public services in Rio de Janeiro from 2002 to 2004. Data were collected from mothers' interviews and medical records. A structu...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2010000200004
更新日期:2010-02-01 00:00:00
abstract::An external quality assessment in coproparasitology was carried out in 77 laboratories from Havana City. A questionnaire and ten plastic vials with different intestinal parasites in a small nylon bag, duly sealed, were sent to each laboratory. Answers were collected during the 72 hours after delivery. Results were ana...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00