A EVOLUÇÃO DA SOLIDARIEDADE NO FORNECIMENTO DE MEDICAMENTOS: UMA ANÁLISE DO TEMA 1234/STF

The right to health, enshrined as a fundamental social right in the 1988 Brazilian Constitution (articles 6 and 196), materializes, among other aspects, in access to medications, essential goods for the maintenance of life and well-being. Guaranteeing this right, however, has proven to be a persistent challenge in Brazil, given the complexities of the Unified Health System (SUS), the State's budgetary limitations, and the growing demands for high-cost medications and new technologies. This scenario has led to intense judicialization of health, with thousands of citizens seeking in the Judiciary the guarantee of access to medications, especially those not incorporated into the SUS. Faced with this phenomenon, the Supreme Federal Court (STF), as the guardian of the Constitution and the court of last resort, has played a crucial role in seeking solutions that balance the individual guarantee of the right to health with the need for efficient management of public resources, the preservation of Brazilian federalism, and the promotion of sustainable public policies. This work analyzes the evolution of STF jurisprudence on this issue, from initial precedents such as the Suspension of Preliminary Injunction (STA) No. 175 and General Repercussion Theme No. 793, to the recent and paradigmatic General Repercussion Theme No. 1234, seeking to understand the challenges and potentialities of judicial action in the realization of the right to health in Brazil, in light of Neoconstitutionalism, judicial activism, and the complex dynamics of the Brazilian federal system. The research employs bibliographic and jurisprudential methodology, with an in-depth analysis of the ministers' votes, the established theses, and the impacts of these decisions on the organization and financing of SUS, considering the reservation of the possible, the minimum existential, and the balancing of principles as instruments for the pursuit of fair and balanced solutions. The results demonstrate a progressive search by the STF for more objective and restrictive criteria for the judicial granting of medications, aiming at the rationalization of health judicialization, legal certainty, and the promotion of a more effective inter-institutional dialogue between the Executive, Legislative, and Judicial branches, as well as an improvement in the interpretation of the concept of solidarity, aiming for a more adequate application to the reality of Brazilian federalism and SUS. Theme No. 1234, by establishing more specific parameters for judicial action, prioritizing alternative dispute resolution, creating management mechanisms such as the national medication platform, and providing for reimbursement between federative entities, represents a milestone in the search for systemic solutions to the health crisis, with the potential to strengthen SUS and promote a more efficient allocation of public resources. Its effectiveness, however, depends on collaboration between federative entities, the system's capacity to absorb demands, and more proactive action by the Executive in implementing public health policies, reducing dependence on the Judiciary and promoting the system's sustainability.