Court decision on a cancer drug not covered by SSI

SAFAKNA TURKEY – Pensioner H.G. was diagnosed with lung cancer at the University Hospital of Bashkent, from where he was removed.

After the tests, it was stated that the disease was started, chemotherapy and radiation therapy would not give results, and Lenvima with the active ingredient lenvatinib would be used for treatment.

HG approached SCC on the grounds that she could not afford medicines brought from abroad and the treatment cost 1,300 euros.

SGK, on ​​the other hand, responded that the drug could not be covered on the basis that it did not comply with the Health Implementation Communiqué and its additional conditions and was not on the reimbursement list.

APPLICABLE TO THE JUDICIARY

HG, through her lawyer, Elise Atlı, applied to the 14th Administrative Court of Ankara with a request for SGK drug coverage in order to delay the execution and start treatment as soon as possible.

The petition states: “Failure to pay SSI for a drug will keep a client from receiving treatment and will bring them one step closer to death every day. Therefore, the unsecured suspension we requested from a respected court is of vital importance to the client. If the decision is not made, the drug, which is very important for the client’s continued treatment, will not be paid for and his health will be irreparably harmed.

THE COURT MAKES THE FINAL DECISION

The court, by its interlocutory decision, immediately after the application, decided to suspend the execution of the SCC decision and decided to reimburse the cost of the medicine.

After issuing an interlocutory ruling, the court asked the SGC to send to the court, along with the defense, the original or a certified copy of the transaction file, which contains all the information and documents related to the transaction.

In his defense submitted to the SCC court, he demanded that the case be dismissed, stating that Lenvima was not included in the list of medicines payable in the Communiqué on the implementation of health care, therefore the cost of the medicines in question could not be paid to the plaintiff, and the procedure was in in accordance with the law.

After evaluating the information, documents and objections submitted by the parties to the court, the court ruled to dismiss the pending claim and ruled that the drug would be insured by SGC.

“THE GOVERNMENT SHOULD PROVIDE HER LIFE”

In its judgment, the Court referred to the relevant articles of the Universal Declaration of Human Rights, adopted by the General Assembly of the United Nations and to which Turkey is a party, and the International Covenant on Economic, Social and Cultural Rights, which entered into force on November 8, 2003.

It was indicated that in the case under consideration, the doctor considered it appropriate to use the drug “Lenvima”,
it was said:

*The Respondent Administration, on the grounds that the drug is not included in the list of medicines payable in the Communication on the Implementation of Health Measures, will restrict the right to life, which is a basic human right, in a state of complete physical incapacity. , mental and social well-being, while the right to life, which is ensured by medical services at every stage of the service, In addition to individuals, institutions and organizations, must also be taken into account by all stakeholders at all levels and positions participating in the service, since everyone has the right to life, to the protection and development of their material and spiritual existence, and that no body or person has the right to cancel this right, and that the state has the right to protect the life of everyone. that the subject of the claim is responsible for ensuring the physical and mental health of the child, it is concluded that there is no legality in the action in question, since it is understood that the action in question will also violate the principle of a social legal state enshrined in the Constitution of the Republic of Turkey and the right to social security.

“HE OPENED ACCESS TO THE MEDICINE, THE ONLY MEDICINE FOR THE PATIENT”

Lawyer Elise Utley said that standard treatments for cancer patients are not enough and that patients are now being referred to smart drugs or immunotherapy treatments: “The drugs in question are used at short intervals, such as once every 14 days or once every 21 days. . . Unfortunately, due to the import of medicines, patients cannot start treatment or are forced to leave the treatment they have started incomplete. As a result of our legal fight, which we started, in particular for our client, regarding the right to life and the right to health, which find a common area of ​​​​protection with the Constitution and international conventions, the court opened the way for the client to access drug addiction treatment, which is recommended as the only and last resort, by reversing the action taken by the respondent institution. “This decision is extremely important for cancer patients,” he said.