Illness boxes in Switzerland –
Insurance refuses to reimburse him a vital treatment
Achievement of a rare disease, a Swiss is fighting to access an essential medication for its survival. A case revealing the limits of the health system.
Switzerness has spinal amyotrophy, a rare and degenerative disease (pretext photo).
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Achievement of an incurable genetic disease, a Swiss has fought for years to obtain the reimbursement of a treatment capable of slowing down its progress, relates the site Watson.
After having been dismissed by all Swiss bodies, she has just wiped a new failure before the European Court of Human Rights (ECHR), which agreed to her sick leave. His lawyer denounces the priority given in Suisse economic interests on human dignity.
The patient has spinal amyotrophy, a rare and degenerative disease. In a wheelchair, powered by gastric probe and in respiratory assistance, she uses her index to control her wheelchair and her phone, which helps her a lot on a daily basis. However, since 2018, this finger has also started to weaken.
No refund
However, treatment can change things: Spinraza, a medication capable of slowing down, or even stopping the progression of the disease. Each injection costs 90,000 francs, however and it is necessary to make six the first year, then two per year.
However, seven years ago, Swiss insurance refuses to reimburse this treatment, the drug not then registered on the list of special treatments defined by the Confederation. The patient is committed to a long legal fight, which will go to the Federal Court.
She manages to finance a first injection, observes improvements, documents them through expert reports, and provides new scientific studies. But justice considers these insufficient evidence, due to the lack of solid statistical data, and rejects its request.
Use of the ECHR
In 2020, the Spinraza was finally added to the list of reimbursed treatments – but only for patients over 20 years old not ventilated artificially. The Swiss therefore remains excluded from the system.
She then decides to grasp the ECHR. But the judges reject his request to a short majority (four votes against three), believing that Switzerland has not violated the European Convention on Human Rights.
A vital refund
Her lawyer, Philip Stolkin, says he is amazed by the decision: “If she does not receive this medication, she dies,” he argues with our colleagues. According to him, Switzerland has other levers to supervise the costs of treatments – such as the implementation of a single box -, but chooses to protect the interests of insurers.
The OFSP defends itself from any opposition in principle to reimbursement, affirming to our colleagues that “the price is absolutely not” the problem. According to the OFSP, it is the reimbursement criteria that are at stake, and these require solid evidence of efficiency-deemed insufficient here. The lawyer now plans to bring the case to the Grande Chamber of the ECHR, due to the tight vote.
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