The Supreme Federal Court (Stf) unanimously approved an interfederative agreement that redefines the funding of oncology drugs in the Unified Health System (Sus). The decision sets rules for reimbursement by the Union and determines judicial competence for actions related to these treatments. The agreement follows the creation of a new oncology pharmaceutical assistance policy.
The Supreme Federal Court (Stf) endorsed, in a session on Thursday, February 19, the homologation of an agreement between the Union, states, and municipalities regarding the funding of cancer drugs in the Unified Health System (Sus). This measure aims to reorganize the acquisition and dispensation of these drugs, following the issuance of Portaria Gm/Ms 8.477/2025 by the Ministry of Health, which established the Af-Onco, a component of Oncology Pharmaceutical Assistance.
A key aspect is the maintenance of 80% reimbursement by the Union in cases where oncology drugs are provided by judicial order. This proportion applies to lawsuits filed until June 10, 2024, and provisionally to subsequent cases, until a new consensus is reached and approved by the Stf.
The case rapporteur, Minister Gilmar Mendes, included a thesis to regulate jurisdictional competence. Thus, claims involving drugs acquired centrally by the Ministry of Health will fall under Federal Justice. Decentralized acquisitions will be handled by State Justice.
To ensure legal certainty, the Stf modulated the decision's effects: the competence change will apply only to actions started after October 22, 2025, the publication date of the portaria creating Af-Onco. This approach prevents the redistribution of ongoing cases and seeks to balance the public health system with judicial demands.
