Direct cost of the judicialization of continuous insulin infusion systems (Sici) in the city of Rio de Janeiro

Abstract

Objective: To estimate the annual direct cost of the Judicialization of Continuous Insulin Infusion Systems (Sici), in the city of Rio de Janeiro, between 2015 and 2017. Methods: It is a cross sectional study that analyzed the technical opinions on the Sici issued by the Core of Technical Advice on Health Actions and the respective judicial processes. The information related to the costs was obtained from the Report of Request for Compromise provided by the Center of Attendance to the Lawsuits of the state of Rio de Janeiro and budgets of the manufacturer /distributors. Results: There were 189 processes and the average age of the authors was 25.1 years and that the majority was female (57.1%). In 98 cases (51.9%) the document used in the process came from doctors of the public health network. The judge granted the suit in 153 cases (80.9%). Nine physicians were responsible for 43.9% of the prescriptions, out of a total of 75 prescribing physicians, demonstrating a concentration of prescribing physicians. The estimated value of accumulated direct cost (2015-2017), due to the Sici’s judicialization in the city of Rio de Janeiro, corresponds to R$ 6.9 million, which represents 6.7% of health care expenditures in the same period. Conclusion: Considering that the technology under review is repeatedly judicialized, the data collected can generate useful information to public healthcare decision makers, the evaluation of efficiency in the allocation of public resources, and professionals working in legal aid or for the judges themselves.