JUDICIALIZAÇÃO DA SAÚDE E FEDERALISMO COOPERATIVO: REPERCUSSÕES JURÍDICAS E ADMINISTRATIVAS DO TEMA 1234

This article analyzes the judgment of Topic 1234 by the Brazilian Supreme Court (STF), which represents a milestone in healthcare law in Brazil. The decision established objective criteria for defining drugs incorporated and not incorporated into the Unified Health System (SUS), as well as the distribution of federal responsibilities for drug provision. Through this ruling, the STF consolidated the judicialization of healthcare in the country, emphasizing the principle of judicial deference to SUS administrative decisions in formulating public health policies. The decision seeks to balance the protection of the fundamental right to health with fiscal responsibility, using Clinical Protocols and Therapeutic Guidelines, official drug lists, and evidence-based medicine as central criteria. Additionally, the article discusses the implications for patients with rare, ultra-rare diseases, and cancer, highlighting the excessive burden of proof on the plaintiff. The adoption of risk-sharing agreements is proposed as an alternative to minimize the financial impact of high-cost treatments on the public health system.