Tributação justa e direito à saúde: análise crítica acerca da contradição entre a seletividade e a carga tributária incidente sobre os medicamentos no Brasil

Abstract

This article aims to analyze the contradiction between the principle of selectivity and the high tax burden on pharmaceuticals in Brazil, identifying the social impacts and proposing measures to mitigate this reality, in light of fair taxation and the right to health. The theoretical framework guiding this research is neoconstitutionalism, and the research methodologies employed were: explanatory dialectics, bibliographical, qualitative, and quantitative. The results demonstrated that the current Brazilian tax structure includes a high incidence of taxes on pharmaceuticals, which increases the final price and limits access for the population, especially the most vulnerable groups. Despite the changes introduced by the current Tax Reform, it was found that its implementation in the National Tax System will be gradual, postponing the practical effects of innovations on pharmaceutical taxation. Therefore, the article concludes that the essential nature of pharmaceuticals must be recognized, from the perspective of the principle of selectivity and fair taxation, as a way to guarantee broad access and fulfill the right to health. Measures were proposed to alleviate the tax burden, such as granting tax incentives for full exemption from ICMS for national pharmaceutical industries, tax refunds through cashback for low-income families, and the creation of a national reverse logistics program that grants discounts to citizens who return expired or unused medicines.