{"id":380,"date":"2026-07-23T18:23:53","date_gmt":"2026-07-23T18:23:53","guid":{"rendered":"https:\/\/moizes.adv.br\/blog\/?p=380"},"modified":"2026-07-23T18:23:54","modified_gmt":"2026-07-23T18:23:54","slug":"tzield-teplizumabe","status":"publish","type":"post","link":"https:\/\/moizes.adv.br\/blog\/tzield-teplizumabe\/","title":{"rendered":"Plano negou o Tzield (teplizumabe)? Entenda Seus direitos."},"content":{"rendered":"<div class=\"taxonomy-category wp-block-post-terms\"><a href=\"https:\/\/moizes.adv.br\/blog\/category\/direito-da-saude\/planos-de-saude\/negativa-de-cobertura\/medicamentos\/\" rel=\"tag\">Medicamentos<\/a><span class=\"wp-block-post-terms__separator\">, <\/span><a href=\"https:\/\/moizes.adv.br\/blog\/category\/blog\/\" rel=\"tag\">Blog<\/a><span class=\"wp-block-post-terms__separator\">, <\/span><a href=\"https:\/\/moizes.adv.br\/blog\/category\/direito-da-saude\/\" rel=\"tag\">Direito da Sa\u00fade<\/a><span class=\"wp-block-post-terms__separator\">, <\/span><a href=\"https:\/\/moizes.adv.br\/blog\/category\/direito-da-saude\/direitos-do-paciente\/\" rel=\"tag\">Direitos do Paciente<\/a><span class=\"wp-block-post-terms__separator\">, <\/span><a href=\"https:\/\/moizes.adv.br\/blog\/category\/direito-da-saude\/planos-de-saude\/\" rel=\"tag\">Planos de Sa\u00fade<\/a><\/div>\n\n\n<p class=\"wp-block-paragraph\">Saber que um filho ou familiar tem risco elevado de desenvolver <a href=\"https:\/\/www-healthline-com.translate.goog\/health\/diabetes\/stages-of-diabetes?_x_tr_sl=en&amp;_x_tr_tl=pt&amp;_x_tr_hl=pt&amp;_x_tr_pto=tc\" target=\"_blank\" rel=\"noopener\">diabetes tipo 1<\/a> gera muita preocupa\u00e7\u00e3o. A chegada do Tzield (teplizumabe), o primeiro medicamento capaz de retardar o in\u00edcio cl\u00ednico da doen\u00e7a, traz esperan\u00e7a e d\u00favidas. Uma delas \u00e9 se o plano de sa\u00fade precisa cobrir o Tzield. Este artigo explica o que \u00e9 o medicamento e o que a legisla\u00e7\u00e3o determina sobre sua cobertura.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">O que \u00e9 o Tzield (teplizumabe)<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">O Tzield, cujo princ\u00edpio ativo \u00e9 o teplizumabe, \u00e9 um medicamento aprovado pela Anvisa em mar\u00e7o de 2026. Ele \u00e9 indicado para pacientes a partir de 8 anos que est\u00e3o no chamado <a href=\"https:\/\/www-healthline-com.translate.goog\/health\/diabetes\/stages-of-diabetes?_x_tr_sl=en&amp;_x_tr_tl=pt&amp;_x_tr_hl=pt&amp;_x_tr_pto=tc\" target=\"_blank\" rel=\"noopener\">est\u00e1gio 2 do diabetes <\/a>tipo 1. Nessa fase, j\u00e1 existem marcadores da doen\u00e7a no organismo, mas os sintomas ainda n\u00e3o apareceram.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Seu objetivo \u00e9 retardar a progress\u00e3o para o est\u00e1gio 3, quando o diabetes se manifesta clinicamente e a insulina passa a ser necess\u00e1ria. Os estudos indicam que o tratamento pode atrasar esse momento por um per\u00edodo mediano de cerca de dois anos. Isso d\u00e1 \u00e0s fam\u00edlias mais tempo de prepara\u00e7\u00e3o. O medicamento \u00e9 administrado por infus\u00e3o, em um ciclo de aplica\u00e7\u00f5es.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Quando o plano de sa\u00fade deve cobrir o teplizumabe<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">O Tzield j\u00e1 tem registro na Anvisa, o que \u00e9 determinante para a discuss\u00e3o de cobertura. No <a href=\"https:\/\/www.stj.jus.br\/sites\/portalp\/Paginas\/Comunicacao\/Noticias-antigas\/2018\/2018-11-13_08-05_Repetitivo-desobriga-planos-de-fornecer-medicamento-nao-registrado-pela-Anvisa.aspx\" target=\"_blank\" rel=\"noopener\">Tema 990<\/a>, o Superior Tribunal de Justi\u00e7a definiu que a operadora n\u00e3o \u00e9 obrigada a custear medicamento sem registro na Anvisa. Por\u00e9m, ap\u00f3s o registro, n\u00e3o pode recusar o custeio do tratamento prescrito pelo m\u00e9dico.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A <a href=\"https:\/\/www.planalto.gov.br\/ccivil_03\/_ato2019-2022\/2022\/lei\/l14454.htm\" target=\"_blank\" rel=\"noopener\">Lei 14.454\/2022<\/a> estabeleceu que o rol da ANS \u00e9 uma refer\u00eancia b\u00e1sica. Assim, a aus\u00eancia do Tzield no rol n\u00e3o \u00e9, isoladamente, justificativa v\u00e1lida para a recusa, quando h\u00e1 indica\u00e7\u00e3o m\u00e9dica e comprova\u00e7\u00e3o cient\u00edfica de efic\u00e1cia.<\/p>\n\n\n\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Cormorant+Garamond:wght@500;600;700&#038;family=Source+Sans+3:wght@400;500;600;700&#038;display=swap\" rel=\"stylesheet\">\n<style>\n#gmc-cta *{box-sizing:border-box;margin:0;padding:0;}\n#gmc-cta{font-family:\"Source Sans 3\",system-ui,Arial,sans-serif;background:#1C2B4A;color:#fff;padding:46px 24px;text-align:center;border-radius:6px;margin:34px 0;}\n#gmc-cta .in{max-width:620px;margin:0 auto;}\n#gmc-cta h2{font-family:\"Cormorant Garamond\",Georgia,serif;font-weight:600;font-size:clamp(26px,4vw,38px);color:#fff;max-width:620px;margin:0 auto;line-height:1.12;letter-spacing:-.01em;}\n#gmc-cta p{color:rgba(255,255,255,.78);margin:16px auto 28px;max-width:480px;line-height:1.6;font-size:16px;}\n#gmc-cta .btn{display:inline-flex;align-items:center;gap:9px;background:#C8A96E;color:#0D1A30;font-size:15px;font-weight:600;padding:14px 24px;border-radius:2px;text-decoration:none;transition:background .2s;}\n#gmc-cta .btn:hover{background:#F0D9A8;}\n#gmc-cta .btn svg{width:17px;height:17px;}\n<\/style>\n<section id=\"gmc-cta\">\n  <div class=\"in\">\n    <h2>Tem um caso parecido com algum desses?<\/h2>\n    <p>Conte o que aconteceu. A avalia\u00e7\u00e3o inicial \u00e9 sem compromisso \u2014 e o prazo do seu direito j\u00e1 est\u00e1 correndo.<\/p>\n    <a class=\"btn\" href=\"https:\/\/wa.me\/5511952218110?text=Ol%C3%A1%2C%20vim%20pelo%20blog%20e%20gostaria%20de%20avaliar%20o%20meu%20caso.\" target=\"_blank\" rel=\"noopener\">\n      <svg viewBox=\"0 0 24 24\" fill=\"currentColor\"><path d=\"M12.04 2C6.58 2 2.13 6.45 2.13 11.91c0 1.75.46 3.45 1.32 4.95L2 22l5.25-1.38c1.45.79 3.08 1.21 4.79 1.21h.01c5.46 0 9.91-4.45 9.91-9.91C21.96 6.45 17.5 2 12.04 2zm5.8 14.04c-.25.7-1.44 1.33-1.99 1.41-.53.08-1.18.11-1.9-.12-.44-.14-1-.32-1.72-.64-3.03-1.31-5-4.36-5.16-4.56-.15-.2-1.23-1.64-1.23-3.12 0-1.49.78-2.22 1.06-2.52.28-.3.61-.38.81-.38.2 0 .41 0 .58.01.19.01.44-.07.69.53.25.6.86 2.09.94 2.24.08.15.13.33.03.53-.1.2-.15.33-.3.5-.15.18-.32.39-.45.53-.15.15-.31.31-.13.61.18.3.79 1.3 1.69 2.11 1.17 1.04 2.15 1.36 2.46 1.51.3.15.48.13.66-.08.18-.2.76-.89.96-1.19.2-.3.41-.25.69-.15.28.1 1.76.83 2.07.98.3.15.5.22.58.35.07.12.07.72-.18 1.42z\"\/><\/svg>\n      Avaliar meu caso\n    <\/a>\n  <\/div>\n<\/section>\n\n\n\n<h2 class=\"wp-block-heading\">O que a lei determina<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">A <a href=\"https:\/\/www.planalto.gov.br\/ccivil_03\/leis\/l9656.htm\" target=\"_blank\" rel=\"noopener\">Lei 9.656\/1998<\/a> permite que a operadora defina as doen\u00e7as cobertas, mas n\u00e3o o tipo de tratamento prescrito, que \u00e9 decis\u00e3o do m\u00e9dico. O C\u00f3digo de Defesa do Consumidor se aplica aos planos de sa\u00fade, conforme a <a href=\"https:\/\/www.stj.jus.br\/internet_docs\/biblioteca\/clippinglegislacao\/Sumula_608_2018_segunda_secao.pdf\" target=\"_blank\" rel=\"noopener\">S\u00famula 608 do STJ<\/a> (exceto autogest\u00e3o). Isso permite reconhecer como abusivas cl\u00e1usulas que neguem tratamento essencial.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">O que dizem os tribunais sobre medicamentos registrados<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Ainda n\u00e3o existem decis\u00f5es espec\u00edficas sobre o Tzield, por ser um medicamento muito recente. No entanto, os tribunais t\u00eam entendimento consolidado de que, havendo registro na Anvisa e prescri\u00e7\u00e3o m\u00e9dica para doen\u00e7a coberta, a recusa de cobertura tende a ser considerada abusiva. A discuss\u00e3o deixa de girar em torno da exist\u00eancia de registro e passa a focar na imprescindibilidade do tratamento e na soberania da prescri\u00e7\u00e3o m\u00e9dica.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Um ponto de aten\u00e7\u00e3o: forma de administra\u00e7\u00e3o<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Como o Tzield \u00e9 aplicado por infus\u00e3o, sob supervis\u00e3o de profissional de sa\u00fade, ele tende a n\u00e3o se enquadrar na exclus\u00e3o de medicamentos de uso domiciliar prevista na Lei 9.656\/1998. Os tribunais j\u00e1 decidiram, em outros contextos, que a medica\u00e7\u00e3o administrada por via intravenosa com supervis\u00e3o profissional n\u00e3o se confunde com tratamento domiciliar. Trata-se de ponto que refor\u00e7a o pedido de cobertura, mas depende de an\u00e1lise individual.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">O que fazer diante de uma negativa<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Diante de uma recusa, costumam ser \u00fateis o relat\u00f3rio m\u00e9dico comprovando o diagn\u00f3stico de diabetes tipo 1 em est\u00e1gio 2, com os autoanticorpos e as altera\u00e7\u00f5es de glicemia, e a indica\u00e7\u00e3o do Tzield. Tamb\u00e9m s\u00e3o importantes a negativa por escrito e a forma de administra\u00e7\u00e3o (infus\u00e3o assistida). Quanto mais completo o laudo m\u00e9dico, mais s\u00f3lida tende a ser a discuss\u00e3o sobre a cobertura. Cada caso exige an\u00e1lise individual por um advogado de confian\u00e7a.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Conclus\u00e3o<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">O Tzield (teplizumabe) inaugura uma nova abordagem no diabetes tipo 1, ao atuar antes do surgimento dos sintomas. Como j\u00e1 tem registro na Anvisa, a discuss\u00e3o sobre cobertura pelo plano de sa\u00fade parte de um cen\u00e1rio s\u00f3lido para o paciente, ancorada na natureza exemplificativa do rol e na preval\u00eancia da prescri\u00e7\u00e3o m\u00e9dica. A recusa n\u00e3o deve ser aceita sem an\u00e1lise.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Se este artigo foi \u00fatil, leia tamb\u00e9m nosso conte\u00fado sobre\u00a0<a href=\"https:\/\/moizes.adv.br\/blog\/plano-de-saude-negou-medicamento\/\">negativa de cobertura de medicamentos pelo plano de sa\u00fade<\/a>\u00a0e sobre\u00a0<a href=\"https:\/\/moizes.adv.br\/blog\/rol-da-ans-plano-de-saude-negativa-abusiva\/\">como funciona o Rol da ANS<\/a>.<\/p>\n\n\n<div class=\"taxonomy-post_tag wp-block-post-terms\"><a href=\"https:\/\/moizes.adv.br\/blog\/tag\/diabetes\/\" rel=\"tag\">Diabetes<\/a><span class=\"wp-block-post-terms__separator\">, <\/span><a href=\"https:\/\/moizes.adv.br\/blog\/tag\/negativa-de-medicamento\/\" rel=\"tag\">Negativa de Medicamento<\/a><span class=\"wp-block-post-terms__separator\">, <\/span><a href=\"https:\/\/moizes.adv.br\/blog\/tag\/perguntas-frequentes\/\" rel=\"tag\">Perguntas Frequentes<\/a><span class=\"wp-block-post-terms__separator\">, <\/span><a href=\"https:\/\/moizes.adv.br\/blog\/tag\/rol-da-ans\/\" rel=\"tag\">Rol da ANS<\/a><span class=\"wp-block-post-terms__separator\">, <\/span><a href=\"https:\/\/moizes.adv.br\/blog\/tag\/tema-990-stj\/\" rel=\"tag\">Tema 990 STJ<\/a><span class=\"wp-block-post-terms__separator\">, <\/span><a href=\"https:\/\/moizes.adv.br\/blog\/tag\/tutela-de-urgencia\/\" rel=\"tag\">Tutela de Urg\u00eancia<\/a><\/div>\n\n\n<h2 class=\"wp-block-heading\">FAQ: perguntas frequentes sobre Tzield (teplizumabe)<\/h2>\n\n\n\t\t<div class=\"sp-easy-accordion-block sp-eab-regular-accordion alignwide\"\n\t\t\t\t>\n\t\t\t<div class=\"sp-eab-wrapper sp-eab-vertical-accordion sp-eab-48471a957784\">\n\t\t\t\t\t\t\t\t<div class='sp-eab-accordion sp-eab-mode-vertical sp-eab-vertical-one sp-d-flex' data-accordion-settings=\"{&quot;mode&quot;:&quot;vertical&quot;,&quot;activeEvent&quot;:&quot;click&quot;,&quot;defaultAccordionOpen&quot;:&quot;first-item&quot;,&quot;selectedItemOpen&quot;:0,&quot;openMultiItemAtaTime&quot;:false,&quot;scrollToTopOnLoad&quot;:false,&quot;scrollToTopOnClick&quot;:false,&quot;accordionItemToUrl&quot;:false,&quot;animationEffect&quot;:false,&quot;applyAccessibility&quot;:true}\">\n        \t    \t\n\t\t\t<div\n\t\t\t\tid =\"sp-eab-item-e24ada5273d2\"\n\t\t\t\tclass=\"sp-eab-accordion-item eab-item-957784\"\n\t\t\t\t\t\t\t>\n\t\t\t\t<div class=\"sp-eab-accordion-item-wrapper\">\n\t\t\t\t\t\t\t\t<h3 class='sp-eab-accordion-heading sp-d-flex sp-align-center eab-heading-957784'\n\t\t\t\t\t\t>\n\t\t\t\t<span class='sp-eab-accordion-header-wrapper sp-d-flex sp-align-center eab-icon-position-end'>\n\t\t\t\t\t<span class='sp-eab-accordion-header-start sp-d-flex sp-justify-left sp-align-center'>\n\t\t\t\t\t\t<span class='sp-eab-title-subtitle-wrapper sp-d-flex'>\n\t\t\t\t\t\t\t<span class='sp-eab-accordion-title-wrapper sp-d-flex sp-align-center'>\n\t\t\t\t\t\t\t\t<span class='sp-eab-accordion-title-text'>\n\t\t\t\t\t\t\t\t\tPara que serve o Tzield e quem pode usar?\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<span class='sp-eab-accordion-header-end eab-icon-animated'>\n\t\t\t\t\t\t\t\t\t\t\t\t<span class='sp-eab-expand-collapse-icon sp-d-block'>\n\t\t\t\t\t\t\t<i class='sp-eab-expand-icon eab-icon-angle-down-solid'><\/i>\n\t\t\t\t\t\t\t<i class='sp-eab-collapse-icon eab-icon-angle-up-solid'><\/i>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t<\/span>\n\t\t\t<\/h3>\n\t\t\t\t\t\t\t<!-- accordion body -->\n\t\t\t\t\t<div class='sp-eab-accordion-content eab-content-957784'>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class='sp-eab-accordion-content-wrapper'>\n\t\t\t\t\t\t\t<div class='sp-eab-accordion-body'>\n\t\t\t    \t\t\t\t\n\n<p class=\"wp-block-paragraph\">O Tzield serve para retardar a progress\u00e3o do diabetes tipo 1 para a fase em que a insulina passa a ser necess\u00e1ria. Ele \u00e9 indicado para pacientes a partir de 8 anos que est\u00e3o no est\u00e1gio 2 da doen\u00e7a, quando j\u00e1 existem marcadores no organismo, mas os sintomas ainda n\u00e3o apareceram.<\/p>\n\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div\n\t\t\t\tid =\"sp-eab-item-566ec3f2add8\"\n\t\t\t\tclass=\"sp-eab-accordion-item eab-item-957784\"\n\t\t\t\t\t\t\t>\n\t\t\t\t<div class=\"sp-eab-accordion-item-wrapper\">\n\t\t\t\t\t\t\t\t<h3 class='sp-eab-accordion-heading sp-d-flex sp-align-center eab-heading-957784'\n\t\t\t\t\t\t>\n\t\t\t\t<span class='sp-eab-accordion-header-wrapper sp-d-flex sp-align-center eab-icon-position-end'>\n\t\t\t\t\t<span class='sp-eab-accordion-header-start sp-d-flex sp-justify-left sp-align-center'>\n\t\t\t\t\t\t<span class='sp-eab-title-subtitle-wrapper sp-d-flex'>\n\t\t\t\t\t\t\t<span class='sp-eab-accordion-title-wrapper sp-d-flex sp-align-center'>\n\t\t\t\t\t\t\t\t<span class='sp-eab-accordion-title-text'>\n\t\t\t\t\t\t\t\t\tO Tzield j\u00e1 foi aprovado pela Anvisa?\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<span class='sp-eab-accordion-header-end eab-icon-animated'>\n\t\t\t\t\t\t\t\t\t\t\t\t<span class='sp-eab-expand-collapse-icon sp-d-block'>\n\t\t\t\t\t\t\t<i class='sp-eab-expand-icon eab-icon-angle-down-solid'><\/i>\n\t\t\t\t\t\t\t<i class='sp-eab-collapse-icon eab-icon-angle-up-solid'><\/i>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t<\/span>\n\t\t\t<\/h3>\n\t\t\t\t\t\t\t<!-- accordion body -->\n\t\t\t\t\t<div class='sp-eab-accordion-content eab-content-957784'>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class='sp-eab-accordion-content-wrapper'>\n\t\t\t\t\t\t\t<div class='sp-eab-accordion-body'>\n\t\t\t    \t\t\t\t\n\n<p class=\"wp-block-paragraph\">Sim, o Tzield foi aprovado pela Anvisa em mar\u00e7o de 2026. Esse registro \u00e9 fundamental, pois garante que o medicamento passou por avalia\u00e7\u00e3o de seguran\u00e7a e efic\u00e1cia no Brasil.<\/p>\n\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div\n\t\t\t\tid =\"sp-eab-item-5e0dbc6a4791\"\n\t\t\t\tclass=\"sp-eab-accordion-item eab-item-957784\"\n\t\t\t\t\t\t\t>\n\t\t\t\t<div class=\"sp-eab-accordion-item-wrapper\">\n\t\t\t\t\t\t\t\t<h3 class='sp-eab-accordion-heading sp-d-flex sp-align-center eab-heading-957784'\n\t\t\t\t\t\t>\n\t\t\t\t<span class='sp-eab-accordion-header-wrapper sp-d-flex sp-align-center eab-icon-position-end'>\n\t\t\t\t\t<span class='sp-eab-accordion-header-start sp-d-flex sp-justify-left sp-align-center'>\n\t\t\t\t\t\t<span class='sp-eab-title-subtitle-wrapper sp-d-flex'>\n\t\t\t\t\t\t\t<span class='sp-eab-accordion-title-wrapper sp-d-flex sp-align-center'>\n\t\t\t\t\t\t\t\t<span class='sp-eab-accordion-title-text'>\n\t\t\t\t\t\t\t\t\tO plano de sa\u00fade \u00e9 obrigado a cobrir o Tzield?\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<span class='sp-eab-accordion-header-end eab-icon-animated'>\n\t\t\t\t\t\t\t\t\t\t\t\t<span class='sp-eab-expand-collapse-icon sp-d-block'>\n\t\t\t\t\t\t\t<i class='sp-eab-expand-icon eab-icon-angle-down-solid'><\/i>\n\t\t\t\t\t\t\t<i class='sp-eab-collapse-icon eab-icon-angle-up-solid'><\/i>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t<\/span>\n\t\t\t<\/h3>\n\t\t\t\t\t\t\t<!-- accordion body -->\n\t\t\t\t\t<div class='sp-eab-accordion-content eab-content-957784'>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class='sp-eab-accordion-content-wrapper'>\n\t\t\t\t\t\t\t<div class='sp-eab-accordion-body'>\n\t\t\t    \t\t\t\t\n\n<p class=\"wp-block-paragraph\">A jurisprud\u00eancia tende a considerar abusiva a recusa de cobertura para medicamentos com registro na Anvisa e prescri\u00e7\u00e3o m\u00e9dica. Com base na Lei 14.454\/2022 e no Tema 990 do STJ, a operadora n\u00e3o pode negar o tratamento apenas por ele n\u00e3o estar no rol da ANS.<\/p>\n\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div\n\t\t\t\tid =\"sp-eab-item-8c40b91173c8\"\n\t\t\t\tclass=\"sp-eab-accordion-item eab-item-957784\"\n\t\t\t\t\t\t\t>\n\t\t\t\t<div class=\"sp-eab-accordion-item-wrapper\">\n\t\t\t\t\t\t\t\t<h3 class='sp-eab-accordion-heading sp-d-flex sp-align-center eab-heading-957784'\n\t\t\t\t\t\t>\n\t\t\t\t<span class='sp-eab-accordion-header-wrapper sp-d-flex sp-align-center eab-icon-position-end'>\n\t\t\t\t\t<span class='sp-eab-accordion-header-start sp-d-flex sp-justify-left sp-align-center'>\n\t\t\t\t\t\t<span class='sp-eab-title-subtitle-wrapper sp-d-flex'>\n\t\t\t\t\t\t\t<span class='sp-eab-accordion-title-wrapper sp-d-flex sp-align-center'>\n\t\t\t\t\t\t\t\t<span class='sp-eab-accordion-title-text'>\n\t\t\t\t\t\t\t\t\tO Tzield est\u00e1 no rol da ANS?\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<span class='sp-eab-accordion-header-end eab-icon-animated'>\n\t\t\t\t\t\t\t\t\t\t\t\t<span class='sp-eab-expand-collapse-icon sp-d-block'>\n\t\t\t\t\t\t\t<i class='sp-eab-expand-icon eab-icon-angle-down-solid'><\/i>\n\t\t\t\t\t\t\t<i class='sp-eab-collapse-icon eab-icon-angle-up-solid'><\/i>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t<\/span>\n\t\t\t<\/h3>\n\t\t\t\t\t\t\t<!-- accordion body -->\n\t\t\t\t\t<div class='sp-eab-accordion-content eab-content-957784'>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class='sp-eab-accordion-content-wrapper'>\n\t\t\t\t\t\t\t<div class='sp-eab-accordion-body'>\n\t\t\t    \t\t\t\t\n\n<p class=\"wp-block-paragraph\">Como \u00e9 um medicamento muito recente, ele pode n\u00e3o constar no rol da ANS. No entanto, a lei estabelece que o rol \u00e9 apenas uma refer\u00eancia b\u00e1sica, e a aus\u00eancia do medicamento n\u00e3o justifica a negativa de cobertura se houver indica\u00e7\u00e3o m\u00e9dica.<\/p>\n\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div\n\t\t\t\tid =\"sp-eab-item-7a66f9749601\"\n\t\t\t\tclass=\"sp-eab-accordion-item eab-item-957784\"\n\t\t\t\t\t\t\t>\n\t\t\t\t<div class=\"sp-eab-accordion-item-wrapper\">\n\t\t\t\t\t\t\t\t<h3 class='sp-eab-accordion-heading sp-d-flex sp-align-center eab-heading-957784'\n\t\t\t\t\t\t>\n\t\t\t\t<span class='sp-eab-accordion-header-wrapper sp-d-flex sp-align-center eab-icon-position-end'>\n\t\t\t\t\t<span class='sp-eab-accordion-header-start sp-d-flex sp-justify-left sp-align-center'>\n\t\t\t\t\t\t<span class='sp-eab-title-subtitle-wrapper sp-d-flex'>\n\t\t\t\t\t\t\t<span class='sp-eab-accordion-title-wrapper sp-d-flex sp-align-center'>\n\t\t\t\t\t\t\t\t<span class='sp-eab-accordion-title-text'>\n\t\t\t\t\t\t\t\t\tQual \u00e9 o pre\u00e7o do Tzield?\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<span class='sp-eab-accordion-header-end eab-icon-animated'>\n\t\t\t\t\t\t\t\t\t\t\t\t<span class='sp-eab-expand-collapse-icon sp-d-block'>\n\t\t\t\t\t\t\t<i class='sp-eab-expand-icon eab-icon-angle-down-solid'><\/i>\n\t\t\t\t\t\t\t<i class='sp-eab-collapse-icon eab-icon-angle-up-solid'><\/i>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t<\/span>\n\t\t\t<\/h3>\n\t\t\t\t\t\t\t<!-- accordion body -->\n\t\t\t\t\t<div class='sp-eab-accordion-content eab-content-957784'>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class='sp-eab-accordion-content-wrapper'>\n\t\t\t\t\t\t\t<div class='sp-eab-accordion-body'>\n\t\t\t    \t\t\t\t\n\n<p class=\"wp-block-paragraph\">O Tzield \u00e9 considerado um medicamento de alto custo. O valor exato pode variar, mas trata-se de um tratamento que exige um investimento financeiro expressivo, o que refor\u00e7a a import\u00e2ncia da cobertura pelo plano de sa\u00fade.<\/p>\n\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div\n\t\t\t\tid =\"sp-eab-item-f9fbc49ac95a\"\n\t\t\t\tclass=\"sp-eab-accordion-item eab-item-957784\"\n\t\t\t\t\t\t\t>\n\t\t\t\t<div class=\"sp-eab-accordion-item-wrapper\">\n\t\t\t\t\t\t\t\t<h3 class='sp-eab-accordion-heading sp-d-flex sp-align-center eab-heading-957784'\n\t\t\t\t\t\t>\n\t\t\t\t<span class='sp-eab-accordion-header-wrapper sp-d-flex sp-align-center eab-icon-position-end'>\n\t\t\t\t\t<span class='sp-eab-accordion-header-start sp-d-flex sp-justify-left sp-align-center'>\n\t\t\t\t\t\t<span class='sp-eab-title-subtitle-wrapper sp-d-flex'>\n\t\t\t\t\t\t\t<span class='sp-eab-accordion-title-wrapper sp-d-flex sp-align-center'>\n\t\t\t\t\t\t\t\t<span class='sp-eab-accordion-title-text'>\n\t\t\t\t\t\t\t\t\tO que fazer se o plano de sa\u00fade negar a cobertura do Tzield?\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<span class='sp-eab-accordion-header-end eab-icon-animated'>\n\t\t\t\t\t\t\t\t\t\t\t\t<span class='sp-eab-expand-collapse-icon sp-d-block'>\n\t\t\t\t\t\t\t<i class='sp-eab-expand-icon eab-icon-angle-down-solid'><\/i>\n\t\t\t\t\t\t\t<i class='sp-eab-collapse-icon eab-icon-angle-up-solid'><\/i>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t<\/span>\n\t\t\t<\/h3>\n\t\t\t\t\t\t\t<!-- accordion body -->\n\t\t\t\t\t<div class='sp-eab-accordion-content eab-content-957784'>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class='sp-eab-accordion-content-wrapper'>\n\t\t\t\t\t\t\t<div class='sp-eab-accordion-body'>\n\t\t\t    \t\t\t\t\n\n<p class=\"wp-block-paragraph\">Se o plano negar a cobertura, voc\u00ea deve solicitar a negativa por escrito. Re\u00fana um relat\u00f3rio m\u00e9dico detalhado comprovando o diagn\u00f3stico no est\u00e1gio 2 e a necessidade do tratamento por infus\u00e3o assistida. Com esses documentos, \u00e9 poss\u00edvel registrar uma reclama\u00e7\u00e3o na ANS ou buscar orienta\u00e7\u00e3o jur\u00eddica para avaliar o caso.<\/p>\n\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div\n\t\t\t\tid =\"sp-eab-item-018bbefa5efb\"\n\t\t\t\tclass=\"sp-eab-accordion-item eab-item-957784\"\n\t\t\t\t\t\t\t>\n\t\t\t\t<div class=\"sp-eab-accordion-item-wrapper\">\n\t\t\t\t\t\t\t\t<h3 class='sp-eab-accordion-heading sp-d-flex sp-align-center eab-heading-957784'\n\t\t\t\t\t\t>\n\t\t\t\t<span class='sp-eab-accordion-header-wrapper sp-d-flex sp-align-center eab-icon-position-end'>\n\t\t\t\t\t<span class='sp-eab-accordion-header-start sp-d-flex sp-justify-left sp-align-center'>\n\t\t\t\t\t\t<span class='sp-eab-title-subtitle-wrapper sp-d-flex'>\n\t\t\t\t\t\t\t<span class='sp-eab-accordion-title-wrapper sp-d-flex sp-align-center'>\n\t\t\t\t\t\t\t\t<span class='sp-eab-accordion-title-text'>\n\t\t\t\t\t\t\t\t\tJ\u00e1 existe decis\u00e3o judicial obrigando o plano a cobrir o Tzield?\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<span class='sp-eab-accordion-header-end eab-icon-animated'>\n\t\t\t\t\t\t\t\t\t\t\t\t<span class='sp-eab-expand-collapse-icon sp-d-block'>\n\t\t\t\t\t\t\t<i class='sp-eab-expand-icon eab-icon-angle-down-solid'><\/i>\n\t\t\t\t\t\t\t<i class='sp-eab-collapse-icon eab-icon-angle-up-solid'><\/i>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t<\/span>\n\t\t\t<\/h3>\n\t\t\t\t\t\t\t<!-- accordion body -->\n\t\t\t\t\t<div class='sp-eab-accordion-content eab-content-957784'>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class='sp-eab-accordion-content-wrapper'>\n\t\t\t\t\t\t\t<div class='sp-eab-accordion-body'>\n\t\t\t    \t\t\t\t\n\n<p class=\"wp-block-paragraph\">Ainda n\u00e3o existem decis\u00f5es judiciais espec\u00edficas sobre o Tzield, pois ele \u00e9 um medicamento muito recente. Contudo, os tribunais j\u00e1 t\u00eam entendimento consolidado a favor da cobertura de medicamentos registrados na Anvisa e prescritos pelo m\u00e9dico.<\/p>\n\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div\n\t\t\t\tid =\"sp-eab-item-ed447354a15e\"\n\t\t\t\tclass=\"sp-eab-accordion-item eab-item-957784\"\n\t\t\t\t\t\t\t>\n\t\t\t\t<div class=\"sp-eab-accordion-item-wrapper\">\n\t\t\t\t\t\t\t\t<h3 class='sp-eab-accordion-heading sp-d-flex sp-align-center eab-heading-957784'\n\t\t\t\t\t\t>\n\t\t\t\t<span class='sp-eab-accordion-header-wrapper sp-d-flex sp-align-center eab-icon-position-end'>\n\t\t\t\t\t<span class='sp-eab-accordion-header-start sp-d-flex sp-justify-left sp-align-center'>\n\t\t\t\t\t\t<span class='sp-eab-title-subtitle-wrapper sp-d-flex'>\n\t\t\t\t\t\t\t<span class='sp-eab-accordion-title-wrapper sp-d-flex sp-align-center'>\n\t\t\t\t\t\t\t\t<span class='sp-eab-accordion-title-text'>\n\t\t\t\t\t\t\t\t\tO plano pode alegar que o Tzield \u00e9 de uso domiciliar para negar a cobertura?\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<span class='sp-eab-accordion-header-end eab-icon-animated'>\n\t\t\t\t\t\t\t\t\t\t\t\t<span class='sp-eab-expand-collapse-icon sp-d-block'>\n\t\t\t\t\t\t\t<i class='sp-eab-expand-icon eab-icon-angle-down-solid'><\/i>\n\t\t\t\t\t\t\t<i class='sp-eab-collapse-icon eab-icon-angle-up-solid'><\/i>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t<\/span>\n\t\t\t<\/h3>\n\t\t\t\t\t\t\t<!-- accordion body -->\n\t\t\t\t\t<div class='sp-eab-accordion-content eab-content-957784'>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class='sp-eab-accordion-content-wrapper'>\n\t\t\t\t\t\t\t<div class='sp-eab-accordion-body'>\n\t\t\t    \t\t\t\t\n\n<p class=\"wp-block-paragraph\">O Tzield \u00e9 administrado por infus\u00e3o sob supervis\u00e3o de um profissional de sa\u00fade. Por isso, ele tende a n\u00e3o se enquadrar na exclus\u00e3o de medicamentos de uso domiciliar prevista na lei, o que fortalece o pedido de cobertura.<\/p>\n\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\n\n\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Cormorant+Garamond:wght@500;600;700&#038;family=Source+Sans+3:wght@400;500;600;700&#038;display=swap\" rel=\"stylesheet\">\n<style>\n#gmc-cta *{box-sizing:border-box;margin:0;padding:0;}\n#gmc-cta{font-family:\"Source Sans 3\",system-ui,Arial,sans-serif;background:#1C2B4A;color:#fff;padding:46px 24px;text-align:center;border-radius:6px;margin:34px 0;}\n#gmc-cta .in{max-width:620px;margin:0 auto;}\n#gmc-cta h2{font-family:\"Cormorant Garamond\",Georgia,serif;font-weight:600;font-size:clamp(26px,4vw,38px);color:#fff;max-width:620px;margin:0 auto;line-height:1.12;letter-spacing:-.01em;}\n#gmc-cta p{color:rgba(255,255,255,.78);margin:16px auto 28px;max-width:480px;line-height:1.6;font-size:16px;}\n#gmc-cta .btn{display:inline-flex;align-items:center;gap:9px;background:#C8A96E;color:#0D1A30;font-size:15px;font-weight:600;padding:14px 24px;border-radius:2px;text-decoration:none;transition:background .2s;}\n#gmc-cta .btn:hover{background:#F0D9A8;}\n#gmc-cta .btn svg{width:17px;height:17px;}\n<\/style>\n<section id=\"gmc-cta\">\n  <div class=\"in\">\n    <h2>Tem um caso parecido com algum desses?<\/h2>\n    <p>Conte o que aconteceu. A avalia\u00e7\u00e3o inicial \u00e9 sem compromisso \u2014 e o prazo do seu direito j\u00e1 est\u00e1 correndo.<\/p>\n    <a class=\"btn\" href=\"https:\/\/wa.me\/5511952218110?text=Ol%C3%A1%2C%20vim%20pelo%20blog%20e%20gostaria%20de%20avaliar%20o%20meu%20caso.\" target=\"_blank\" rel=\"noopener\">\n      <svg viewBox=\"0 0 24 24\" fill=\"currentColor\"><path d=\"M12.04 2C6.58 2 2.13 6.45 2.13 11.91c0 1.75.46 3.45 1.32 4.95L2 22l5.25-1.38c1.45.79 3.08 1.21 4.79 1.21h.01c5.46 0 9.91-4.45 9.91-9.91C21.96 6.45 17.5 2 12.04 2zm5.8 14.04c-.25.7-1.44 1.33-1.99 1.41-.53.08-1.18.11-1.9-.12-.44-.14-1-.32-1.72-.64-3.03-1.31-5-4.36-5.16-4.56-.15-.2-1.23-1.64-1.23-3.12 0-1.49.78-2.22 1.06-2.52.28-.3.61-.38.81-.38.2 0 .41 0 .58.01.19.01.44-.07.69.53.25.6.86 2.09.94 2.24.08.15.13.33.03.53-.1.2-.15.33-.3.5-.15.18-.32.39-.45.53-.15.15-.31.31-.13.61.18.3.79 1.3 1.69 2.11 1.17 1.04 2.15 1.36 2.46 1.51.3.15.48.13.66-.08.18-.2.76-.89.96-1.19.2-.3.41-.25.69-.15.28.1 1.76.83 2.07.98.3.15.5.22.58.35.07.12.07.72-.18 1.42z\"\/><\/svg>\n      Avaliar meu caso\n    <\/a>\n  <\/div>\n<\/section>\n","protected":false},"excerpt":{"rendered":"<p>Tzield (teplizumabe). Entenda o que \u00e9 o Tzield (teplizumabe), quando o plano de sa\u00fade deve cobrir o tratamento que retarda o diabetes tipo 1 e o que diz a lei.<\/p>\n","protected":false},"author":1,"featured_media":381,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_thinkrank_schema_form_data":"","_thinkrank_selected_schema_type":"","_thinkrank_additional_schemas":"","_thinkrank_canonical_url":"","_thinkrank_og_title":"","_thinkrank_og_description":"","_thinkrank_og_image":"","_thinkrank_twitter_title":"","_thinkrank_twitter_description":"","_thinkrank_twitter_image":"","_thinkrank_imported_from":"","_thinkrank_focus_keywords":[],"_thinkrank_focus_keyword":"","_thinkrank_robots_meta_enabled":0,"_thinkrank_robots_meta":"","_thinkrank_advanced_robots_meta":"","_thinkrank_primary_category":0,"footnotes":""},"categories":[69,1,66,82,67],"tags":[88,33,63,46,47,49],"class_list":["post-380","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicamentos","category-blog","category-direito-da-saude","category-direitos-do-paciente","category-planos-de-saude","tag-diabetes","tag-negativa-de-medicamento","tag-perguntas-frequentes","tag-rol-da-ans","tag-tema-990-stj","tag-tutela-de-urgencia"],"_links":{"self":[{"href":"https:\/\/moizes.adv.br\/blog\/wp-json\/wp\/v2\/posts\/380","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/moizes.adv.br\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/moizes.adv.br\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/moizes.adv.br\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/moizes.adv.br\/blog\/wp-json\/wp\/v2\/comments?post=380"}],"version-history":[{"count":1,"href":"https:\/\/moizes.adv.br\/blog\/wp-json\/wp\/v2\/posts\/380\/revisions"}],"predecessor-version":[{"id":382,"href":"https:\/\/moizes.adv.br\/blog\/wp-json\/wp\/v2\/posts\/380\/revisions\/382"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/moizes.adv.br\/blog\/wp-json\/wp\/v2\/media\/381"}],"wp:attachment":[{"href":"https:\/\/moizes.adv.br\/blog\/wp-json\/wp\/v2\/media?parent=380"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/moizes.adv.br\/blog\/wp-json\/wp\/v2\/categories?post=380"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/moizes.adv.br\/blog\/wp-json\/wp\/v2\/tags?post=380"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}