Fonseca, Rafael Campos Soares daCarneiro, Hamilton Gomes2026-11-102026-11-102026https://repositorio.unialfa.com.br/handle/123456789/860The dissertation examines the effects of General Repercussion Theme No. 1,234 of the Supreme Federal Court, whose leading case was Extraordinary Appeal No. 1,366,243/SC and which was crystallized in Binding Precedent No. 60, regarding access to justice for indigent claimants in lawsuits seeking the supply of medicines not included on the dispensing lists of the Unified Health System. In this study, the Supreme Court’s jurisprudence is divided into expansive (1997 to 2010), rationalizing (2010 to 2020), and restrictive (2022 to present) phases, demonstrating that, in the latter, the precedent replaced the evidentiary standard established by Repetitive Theme No. 106 of the Superior Court of Justice—which required only a substantiated medical report, proof of indigence, and proof of the drug’s registration with ANVISA— with the cumulative requirement of randomized clinical trials, systematic reviews or meta-analyses, and demonstration of the illegality of the administrative act by the National Commission for the Incorporation of Technologies in the Unified Health System (CONITEC). It is argued that this model institutes a structural technicalinformational asymmetry, as it imposes on the indigent claimant the burden of contesting technical analyses produced by the State itself, with data that only the State holds, making the evidentiary burden materially unattainable and violating the substantive adversarial principle safeguarded by art. 5, LV, of the Federal Constitution. Furthermore, it is observed that the establishment of the thesis has not led to a reduction in the number of lawsuits on this topic, given the courts’ reluctance to enforce it and the 460% increase in constitutional health claims between 2023 and 2025, as documented by Minister Gilmar Mendes himself in a single-judge decision issued in August 2025. The analysis of six judgments handed down by the civil chambers of the Goiás State Court of Justice between 2025 and 2026 reveals a jurisprudential neutralization mechanism for the most burdensome requirements, adopted as a strategy to preserve the protection of the fundamental right to health in concrete cases. It is concluded, based on the prohibition of social retrogression and on the theoretical framework of Sarlet, Alexy, and Cappelletti and Garth, that Theme No. 1,234 preserves the right to health at the normative level and denies it in practice precisely to those who need it most, due to the structural barriers it establishes.ptjudicialização da saúde; tema de repercussão geral n. 1.234; acesso à justiça; retrocesso social; assimetria técnico-informacional estrutural.