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首页> 外文期刊>BMC Public Health >Administrative cases: an effective alternative to lawsuits in assuring access to medicines?
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Administrative cases: an effective alternative to lawsuits in assuring access to medicines?

机译：行政案例：有效替代诉讼，以确保获得药品的诉讼？

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Although public policy in Brazil supports access to essential medicines, the health system cannot meet all demand. Increasingly, the population has used legal demands to seek access to medicines, an approach that can undermine equitable access by creating policy inconsistencies (e.g., granting access to medicines outside the SUS formulary). In response, the Executive Branch has signed institutional agreements to create an administrative case for submitting requests for medicines directly to the Executive Branch. The objective of this study was to assess the degree to which the administrative cases for requests are in accordance with public policies and guidelines, e.g., if administrative cases results in fewer decisions to purchase outside the SUS formulary. This descriptive study used secondary data from lawsuits filed against the Executive Branch from 2003 to 2015 and from administrative cases granted by the Executive Branch from 2010 to 2015 in the capital of a state located in the central-western region of Brazil. The variables included plaintiffs' sociodemographic characteristics and diseases as well as the characteristics of the medical products sought via the processes. Comparing the requests submitted through lawsuits and the administrative cases revealed differences in the incomes of plaintiffs and the costs of medicines. Both methods for submission recorded requests for medicines for diseases of endocrine and circulatory systems; the only difference was the prevalence of diseases of the genitourinary system in the lawsuits. A higher proportion of lawsuits sought medicines outside the SUS formulary with therapeutic alternatives, while medicines outside the SUS formulary without an alternative were more commonly requested in administrative cases. Administrative cases adhere to the public policies and guidelines of the SUS. The administrative cases results in fewer decisions to purchase outside the SUS formulary with alternative, and more decisions to purchase drugs for which there is a formulary alternative. In addition, administrative cases provide greater equity by favoring lower income applicants. However, administrative cases also reveal deficiencies in the State's implementation of existing pharmaceutical policies. The public pressure for effective implementation of existing policies may help expand access to medicines.
机译：虽然巴西的公共政策支持获得基本药物，但卫生系统无法满足所有需求。越来越多地，人口已经利用法律要求寻求获得药物，这是一种能够通过创造政策不一致而破坏公平获取的方法（例如，授予SUS形式之外的药物）。作为回应，行政部门已签署机构协议，以创建一个行政案件，以便直接向行政部门提交药品的请求。本研究的目的是评估请求的行政案件符合公共政策和准则的程度，例如，如果行政案件导致在SUS惯例外购买的决定较少。这项描述性研究使用了2003年至2015年向行政部门提交的诉讼中的辅助数据，从2010年到2015年在巴西中西部地区的一家国家的资本授予的行政部门的行政案件。变量包括原告的社会碘目特征和疾病以及通过流程寻求的医疗产品的特征。比较通过诉讼提交的请求和行政案件的请求揭示了原告收入和药物费用的差异。对内分泌和循环系统的疾病进行提交的提交请求的两种方法;唯一的差异是诉讼中泌尿生殖系统疾病的患病率。诉讼中的诉讼比例较高，在疗法替代品外，在SUS替代品之外寻求药物，而在没有替代方案的SUS惯例之外的药物则在行政案件中更常见。行政案件遵守SUS的公共政策和指导方针。行政案件导致在SUS形式之外购买的决定较少，以及更多的决定购买有形式替代方案的药物。此外，行政案件通过有利于较低的收入申请人提供更大的股权。但是，行政案件还揭示了该州的现有药物政策执行情况的缺陷。有效执行现有政策的公众压力可能有助于扩大对药物的访问。

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