See how to get high-cost medicines paid for by SUS – News

Those who cannot pay for the medicines needed for health treatment have the right to obtain them via the SUS (Unified Health System). This benefit is part of the Pharmaceutical Assistance policy of the public health system, which provides access to products through specialized pharmacies, linked to the municipal and state health departments and to the federal government.

For this, you must have the National Health Card and a medical indication for the use of the medicine. Those who do not yet have the card must go to the UBS (Basic Health Unit) closest to their home and present copies of personal documents, such as CPF and RG, and proof of residence. In addition to medication, this card gives access to appointments and exams.

For those who are already undergoing treatment through the SUS, only the medical request is sufficient for the withdrawal of the medication at the UBS pharmacy. At each withdrawal, you must present the SUS Card, the RG and the medical prescription. People who have been consulted in the private network or in popular clinics not linked to the public system can also request medicines, but first they need to register at the pharmacy of the post where they want to pick up the products. Priority is given to those who cannot pay.

The drugs available through the SUS are listed in the rename (National List of Essential Medicines).

high cost drugs

In the case of a high-cost drug, it is necessary to ask the doctor for a report, in two copies, with information about the disease, the type and period of treatment and the dosage. Through this report, the request and authorization for the withdrawal of drugs from the Specialized Component of Pharmaceutical Assistance are evaluated.

If you still do not have the report in hand, the patient must remove the LME form (Report of Request, Evaluation and Authorization of Medication of the Specialized Component of Pharmaceutical Assistance) at the health unit and take it to the doctor to fill it out. O form is also available online.

It is essential to prove the need to use the prescribed medication. The professional will have to inform the code of the disease that appears in the ICD (International Classification of Diseases) and the number of its registration in the CRM (Regional Council of Medicine). To be valid, the form must be stamped and signed by the doctor.

There are cases in which the patient must undergo further consultations and tests to confirm the disease.

When ordering the drug, it is important to ask for a copy of the protocol. There is no set deadline for delivery, which can be made on the spot, in a few days or in three months. Therefore, some patients will receive the instructions later, by email, mail or phone call.

The patient must withdraw the high-cost medicine monthly, for three months, and always with a new prescription. After this period, it is necessary to re-apply for another three months, repeating the entire process.

If the pharmacy at the health center does not have the medication available, or if it refuses to supply it, the user can still, with the help of a lawyer specialized in health, file a lawsuit in court requesting coverage.

One option, if the patient has the resources, is to buy the drug and ask for reimbursement in court. But, if he doesn’t have a way to buy it, the solution is to file a request for the SUS to pay for the medication”, says Leandro Reimberg, a lawyer specializing in medicine and health. an action and request an injunction.

In a note, the São Paulo State Health Department informs that “the distribution of specialized medicines follows protocols and guidelines agreed between the Union, states and municipalities. Each case is evaluated individually by pharmaceutical assistance after the presentation of the medical prescription and all the documents needed at a high cost pharmacy. The necessary guidelines, forms and requirements are available in this link. Within the scope of the Specialized Component of Pharmaceutical Assistance, medicines are only dispensed to patients who meet the criteria established in the respective Clinical Protocol and Therapeutic Guideline”.

About Jenni Smith

She's our PC girl, so anything is up to her. She is also responsible for the videos of Play Crazy Game, as well as giving a leg in the news.

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