ACCESS TO HIGH-COST MEDICATIONS IN THE BRAZILIAN PUBLIC HEALTH SYSTEM (SUS): DOCUMENTATION, CLINICAL CRITERIA, AND THE ROLE OF THE PHARMACIST

Abstract

Introduction: Access to high-cost medications in the Unified Health System (SUS) is one of the greatest challenges for Brazilian public health, given the clinical importance of these therapies and their economic impact. General objective: To analyze the clinical criteria, required documentation, and pharmacist intervention in the provision of high-cost medications by the SUS. Methodology: This is an integrative, qualitative, and descriptive literature review conducted in SciELO, PubMed, Google Scholar, and indexed journals, considering studies published between 2023 and 2025. Articles, dissertations, theses, and official documents related to pharmaceutical services and the judicialization of healthcare were included. Results: The research indicates that the greatest demand is for oncology, immunobiological, and rare disease medications. The request process requires detailed medical reports, clinical reports, and diagnostic tests, reinforcing the importance of document standardization. It was found that judicialization represents a frequent access route, directly impacting the public budget. Pharmacists' intervention proved essential in prescription analysis, pharmacotherapeutic monitoring, pharmacovigilance, and patient guidance, reducing clinical risks and strengthening treatment adherence. Conclusion: The study found that integration between clinical protocols, public policies, and the active role of pharmacists is essential to ensuring equity, therapeutic safety, and sustainability in the SUS.