Legal summary
May 2023
B.R. v. Switzerland (communicated case) - 2933/23
Article 14
Discrimination
Non-reimbursement of costly medication for rare illness, absent sufficient proof of heightened benefit, without examining patient’s claim to contrary: communicated
Article 3
Degrading treatment
Inhuman treatment
Non-reimbursement of costly medication for rare illness, absent sufficient proof of heightened benefit, without examining patient’s claim to contrary: communicated
Article 8
Article 8-1
Respect for private life
Non-reimbursement of costly medication for rare illness, absent sufficient proof of heightened benefit, without examining patient’s claim to contrary: communicated
The applicant, who suffers from a rare condition (spinal amyotrophy type 3), started taking a very costly medication (sold under the name Spinraza) which was the only effective solution for her. It appeared on a list of medication reimbursed by mandatory insurance except in the case of patients requiring continuous ventilation. That was the applicant’s situation.
However, on an exceptional basis the health insurance funds are obliged to cover medication subject to such limits where its use brings a “heightened benefit” in respect of an illness that is likely to be fatal for the person insured or to cause him or her serious or chronic health problems, and where, in the absence of any alternative treatment, there is no other authorised effective solution. According to domestic case-law, such “heightened benefit” must be proven, not only in the actual case of the patient concerned but also more generally on the basis of certain scientific standards.
The applicant’s appeals against the refusal to reimburse the medication in question were rejected without any examination of her claims as to the positive effects on her state of health (after she had starting taking the medication, financed by private funds). The domestic authorities had concluded that the medical studies on the medication in question, as presented to them, did not provide the requisite proof under the second above-mentioned aspect.
Case communicated under Articles 3 and 8 of the Convention (substantive and procedural limbs) taken separately and in conjunction with Article 14.
© Council of Europe/European Court of Human Rights
This summary by the Registry does not bind the Court.
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