Region: Europe
Year: 2010
Court: Supreme Court
Health Topics: Chronic and noncommunicable diseases, Health systems and financing, Medicines
Tags: Access to drugs, Access to medicines, Essential medicines, Health expenditures, Health insurance, Health spending, Out-of-pocket expenditures, Reimbursement
G.Z., the applicant, was diagnosed with type 1 Gaucher’s disease. The only treatment is a medication, Imiglucerase, which was not in the list of the State Reimbursed Medicines but is on the European Medicines Agency list of registered medicines.
G.Z. brought a claim to fully compensate the purchase costs (LVL 81,900) of the medication against the Health Compulsory Insurance State Agency (HCISA). The HCISA agreed to compensate LVL 10,000 of the cost, but the Ministry of Health rejected the claimed amount.
G.Z. appealed the decision to the district court, which found in his favor but was rejected by the regional court. The regional court found that Regulation No. 899 on compensation of medication for out-patient treatment did not provide the appellant with reimbursement. The applicant appealed the decision, but shortly afterwards the Senate passed a resolution to terminate legal proceedings in the case. G.Z. then submitted an application to the Constitutional Court. The Constitutional Court found in Case No. 2009-12-03 that LVL 10,000 was sufficient considering the State budgetary options.
The Court held that the regional court’s dismissal of the case was valid. The Administrative Procedure Law allows a court to rule that a judgment of a lower instance court is based on correct and reasonable grounds, without elaborating further reasoning. The Senate did just that by agreeing with the arguments of the regional that there should be no deviation from Regulation No. 899 as it would be disproportional and unjust.
“[9] According to Paragraph 4 of Section 349 of the Administrative Procedure Law a court, while reviewing a matter, may rule that a judgment of a lower instance court is based on correct and reasonable grounds, and the court may refer to that in the motivation part by mentioning that it agrees with those grounds. In this case there is no need for more detailed argumentation. According to the aforementioned Regulations and by verifying legitimacy of that judgment, the Senate acknowledged that grounds of the ruling of the Regional Court of Administrative Cases are correct and reasonable. The Senate, therefore, agrees with the arguments of the Regional Court of Administrative Cases.”