HDefinitions of high-cost medicines present in Brazilian scientific and academic literature on health judicialization

Abstract

The study aimed to single out definitions and interpretations regarding high-cost medicines in the scientific and academic literature on health litigation. A scoping review followed the methodology proposed by the Joanna Briggs Institute. MEDLINE, EMBASE, LILACS, Web of Science and Scopus, and the Digital Library of Dissertations and Theses were searched for empirical studies on litigation for access to medicines that included high-cost drugs, published or presented between 2005 and 2022. A total of 62 scientific papers and 66 dissertations and theses were selected. Explicit definitions of high-cost medicines were scarce, presented in just 19.1% of papers and 15.2% of the academic output. Among the most available core themes were those related to high unit or overall treatment cost of medicines, resulting from chronic conditions, and generating financial impact on household budgets. Other patterns of meaning that emerged were: ‘new’ medicines without marketing approval in the country, medicines absent from funding lists, drugs for genetic or rare diseases, or those with specificities regarding procurement or dispensing. Conceptual imprecision in the field of high-cost drugs hinders a clear viewpoint of the importance of this group of medicines in the scenario of health litigation in Brazil.