This paper aims to demonstrate how the responses of public health officials to judicial decisions have shaped drug distribution policies in the state of São Paulo. Data was collected and structured interviews were conducted at the state of São Paulo Department for Health in order to show how different strategies of response to judicial decisions affected the policy of medication distribution by the public sector. We also analysed recent Supreme Federal Court jurisprudence to show how the Court reformed its earlier views on the subject as a result of the demands made by public health officials. It is our understanding that the current literature has failed to produce a more comprehensive view of this phenomenon because of its focus solely on judicial decisions, without taking a step further to analyse how public health officials reacted to them, which would have addressed the compliance problem inherent to positive rights enforcement. Finally, we see this process not as merely positive or negative, but as one that goes beyond the different normative biases present in the literature on the subject, and focus on the mechanisms behind the impact of the judicialization of the right to healthcare on policies of medication distribution.
