Constitutional claim and the assimilation of recent Supreme Court jurisprudence regarding Topics No. 6 and 1234

Abstract

The judicialization of public health consists of resorting to the Judiciary to obtain actions, services, medications, and health technologies from the Unified Health System (SUS), a right guaranteed by the 1988 Federal Constitution. In this scenario, the Supreme Federal Court (STF), as guardian of the Constitution, plays a central role in standardizing the interpretation of the right to health through its jurisprudence. In 2024, the STF ruled on Topics 6 and 1234, which redefined the parameters for the judicial granting of medications by the SUS. Topic 6 established rigorous cumulative criteria, requiring proof of the efficacy and safety of the medication based on Evidence-Based Medicine, the non-existence of an incorporated therapeutic alternative, and the financial incapacity of the plaintiff. Theme 1234, in turn, regulated the judicial competence and passive legitimacy of federative entities, in addition to linking judicial provision to the Maximum Price for Sale to the Government (PMVG). These understandings were consolidated in Binding Precedents 60 and 61, whose non-compliance authorizes the filing of a Constitutional Claim with the STF, an instrument intended to preserve the authority of the Court's decisions. However, recent decisions, such as Constitutional Claim No. 87,745/RJ, highlight difficulties in assimilating the new parameters. The study points out that the Constitutional Claim has consolidated itself as a relevant mechanism for the process of assimilating the recent jurisprudence of the STF, revealing interpretative tensions and the need for greater decisional harmonization to ensure legal certainty, equity, and sustainability to the SUS.

Received: December 19, 2025 | Revised: February 23, 2026 | Accepted: February 27, 2026