A favourable judgment in a case of reimbursement of medicinal products

Ellex in Latvia has accomplished a favourable judgment of the Administrative District Court in a pro bono case where the government refused to grant an individual reimbursement of medicinal products. The actions of the National Health Service (NSS) and the Ministry of Health were found to be unlawful, and the patient had a compensation adjudicated for non-pecuniary damage. This is a judgment of crucial significance, not only for the particular patient, but also for the society in general.

One of the most essential findings of the court was that a legal provision must be interpreted reasonably. In particular, the rules on granting of individual reimbursement do not apply only where the reimbursement list does not contain any medicinal product for the diagnosis in question, but also in those situations where the medicinal product is listed but cannot be used for effective treatment of the particular patient according  to an opinion of the medical council.

The patient represented by Ellex in Latvia is one of numerous cancer patients who have faced discriminatory treatment on the part of the government and have been rejected in reimbursement of at least part of vitally important medicines. Despite the opinion of the medical council about the need for a particular medicine, the responsible authorities issued their rejection under pretext of formal reasons without delving into the substance of the case.

Liga Merwin, Managing Partner of Ellex in Latvia, and Associate Pauls Ančs provided the legal assistance to the patient.