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Some medications are classified as high cost, with monthly expenses exceeding R$ 200,000.000. For the distribution of such drugs, the Ministry of Health publishes lists called exceptional dispensing drugs, federally funded with cash transfers to states and municipalities. However the access to medicines, under the Health System, presents various administrative obstacles. To understand the reasons for the failures of exceptional drugs distribution as well as the consequences for management in public health it was the objective of this survey. A documental analysis of official lists of five Brazilian states and other ordinances related to the dispensing of high-cost drugs was performed, in addition to content analysis of secondary sources as the lawsuits brought by patients with rare diseases, with the Public Prosecutor. The paper also discusses new proposals and guidelines for the management of the list of high-cost medicines state.

Medicamentos de Alto Custo: Compreendendo o Gerenciamento e Falhas de Dispensação em Cinco Estados Brasileiros