The juridical hospital: Claiming the right to pharmaceuticals in Brazilian courts

The judicialisation of health A retired bus driver, Edgar Lemos lives in a lower-middle-class neighbourhood of Porto Alegre, the capital of the southern Brazilian state of Rio Grande do Sul. Dealing with significant motor difficulties, Edgar had to wait for more than a year for a specialised neurological appointment at a nearby public hospital. He was finally diagnosed with hereditary cerebral ataxia in November of 2008. The neurologist prescribed the drug Somazina, which is not included on any governmental drug formulary. Raised in a destitute family, Edgar had worked since the age of eight. He was proud of the gated brick and mortar house he had built himself on the top of a hill. Edgar's ataxia affected not only his mobility but also his sense of dignity and worth, as it made him more dependent on the care of his wife and two adult daughters. Religion had become an important source of emotional sustenance and a complement to his pharmaceutical treatment. While Edgar felt that Somazina was helping to halt the degeneration of his motor abilities, he was also taking a variety of other drugs, from statins to anti-hypertensives and anti-anxiolytics, to soothe additional symptoms. During a conversation over his dining room table in August 2011, Edgar opened a box containing the five medicines that make up his regimen. As he held each one in turn, he said, ‘This one I don't judicialise, this one I don't judicialise …I only judicialise this medicine because I went into debt paying for it.’ A monthly supply of Somazina costs about 200 dollars. After paying for the drug out of pocket for several months, Edgar had to take out a bank loan. Unable to keep up the house expenses and bank interests, he had ‘no other alternative but to judicialise’. He learned about the Public Defender's Office (Defensoria Pública) from other patients also waiting for specialists’ referrals at the public health post and filed a lawsuit to compel the state to pay for his medication.