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Chief Justice of the Brazilian Federal Supreme Court suspends municipal participation in the obligation to provide high-cost medication

The Chief Justice of the Brazilian Federal Supreme Court (STF), Justice Dias Toffoli, granted a preliminary injunction to suspend, only in relation to the Municipality of Jundiaí (SP), a judicial order of the Federal Regional Court of the 3rd Region (TRF-3), which had determined that the Union, the State of São Paulo and the mentioned municipality must supply the drug Spinraza (nusinersen) to a patient suffering from Spinal Muscular Atrophy (AME). The decision, which was issued in the Suspension of Temporary Guardianship (STP) 127, takes into account the definition of the responsibilities of each entity of the federation within the Unified Health System (SUS) and the very high cost of the drug.

Disrespect of the system

In the request for suspension of guardianship, the municipality argued that actions and public health services should constitute a hierarchical network, so determining to the municipality the supply of medicines outside its responsibility "is to disrespect the entire system." Another aspect was the serious injury to the public economy, due to the high cost of medication: according to the information provided, the four doses granted cost more than R$ 1.1 million, and its supply "will suppress the right of access to health to the other patients, given the scarce available resources for health system".

Still according to the argumentation, the municipal budget of 2019 destines R$ 33 million to the promotion of the actions of pharmaceutical assistance, of which about half is exclusively destined to attend purchase of judicial orders. However, it will receive from the State of São Paulo and the Union less than 10% of the forecast total.


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