This article assesses the hypothesis that the judicialization of medicine for mucopolysaccharidosis in Brazil is an action promoted by the economic elites. Previous studies upholding the thesis of judicialization by elites are discussed. This discussion concerns the methodology of these studies and their conclusions, as well as the empirical basis for the thesis in the case of other types of medication that are more costly for the Unified Health Service (SUS). The study includes an analysis of all 196 processes containing information about judicial processes brought to court from February 2006 to December 2010 that ended with the determination that the State should provide such medication free of charge to patients. There is evidence that attorneys’ fees were covered by entities interested in the results of judicialization, such as distributors or pharmaceutical industries. Patients may also be migrating from diagnosis and treatment to university centers that are a benchmark for medical innovation in the country, as the option for public health services is related to their higher technical and scientific capacity. Thus, the resort to private lawyers, indicators of social exclusion based on the address of patients and the use of public health services, are not adequate class information to corroborate or refute the thesis of judicialization by the elites.