Cancer Patient Dies After 9-Month Wait for R$1.1 Million Medication
Eduardo da Silva, a 62-year-old resident of Santos, São Paulo, passed away from follicular non-Hodgkin lymphoma (NHL) after waiting nearly nine months for a judicial decision on a life-saving medication. His defense team had requested urgency in December 2025 for the drug Epcoritamabe, which was estimated to cost approximately R$1.1 million annually. Silva had been battling the disease since 2023 and sought the medication after exhausting therapies available through the public health system (SUS). He received treatment at the State Cancer Institute of São Paulo (Icesp) and died on Wednesday, June 22nd, due to complications from the illness.
The initial request for the medication was denied in the first instance in November 2025, despite two favorable technical opinions from the Judiciary's Technical Support Unit (Natjus) that highlighted the risk of death. The court cited the treatment's high cost as a factor that could compromise the distributive logic and collective interest of the SUS. Judge Anita Villani stated that while exceptional provision might be possible, the case did not meet the criteria for economic and high-level scientific evidence evaluation, emphasizing the need to preserve the public health system for collective well-being.
The defense appealed to the Regional Federal Court (TRF) in December 2025, seeking an expedited review, but the case was only scheduled for judgment at the end of July, with the session set for Thursday, June 30th. The TRF cited internal procedures and scheduling as reasons for the delay, noting that the case proceeded directly to merit judgment without prior preliminary review. The court indicated that if the lawyer's notification of Silva's death was not received before the hearing, the case would proceed to judgment as scheduled.
This case highlights a critical tension between individual patient needs and the sustainability of public healthcare systems when faced with extremely high-cost, novel treatments. The judicial system's delay, attributed to internal processes, resulted in a tragic outcome for the patient, raising questions about the efficiency and responsiveness of legal mechanisms designed to ensure access to essential medicines. The court's decision to prioritize collective budgetary concerns over an individual's life, despite expert recommendations, underscores the complex ethical and economic trade-offs inherent in healthcare resource allocation. Moving forward, robust frameworks are needed to balance the imperative of providing life-saving treatments with the fiscal realities of public health, potentially through more streamlined evaluation processes for high-cost drugs or innovative funding models that do not necessitate protracted legal battles.
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