Great indignation about health insurance: a boy with cancer (12 years old) does not receive money for his medications – Switzerland

The diagnosis and therapy of the 12-year-old son was a shock and an incredible burden for a family in southern Ticino. For one year, the boy was treated intensively for soft malignant tissue due to malignant sarcoma. But a second shock occurred when the maintenance treatment began to reduce the risk of returning this extremely rare tumor. The health insurance company refused to give 3,000 francs for a medicine prescribed by Pierluigi Brazzola, pediatric oncologist and chief medical officer at the cantonal hospital of San Giovanni in Bellinzona, to his young patient. Because the family has not been able to increase this amount itself.

Brazzola published the case earlier this week on the newspaper "The Regione" published in Bellinzona. And did not spare with the criticism of the health insurance responsible: "It's a dangerous development, if you get a cure, if you pay yourself."

drug proved on the European scale

In detail, according to the child oncologist Brazzola is a drug, imported from Germany and taken orally in combination with two other drugs available in Swiss. The health insurance company had argued that there was no sufficient literature, according to which the drug was appropriate for this sarcoma. According to Brazzola, the drug has been tried and tested all over Europe.

The case immediately caused strong waves in southern Switzerland. Especially in social media. And the case also triggered great solidarity. In two days, more than 20,000 francs were collected Wednesday, with which medical costs are covered. The rest should go to help cancer, especially for children. Many donors have volunteered for the newspaper or directly in the oncology department of the cantonal hospital of Bellinzona

Meanwhile, the cantonal health department said in a statement that the drug in question was not on the list of necessarily reimbursed drugs should be. In addition, Swissmedic's approval is missing. Therefore, it belonged to the only health insurance company to determine if it wanted to pay the fees. Against the decision of the money can be recidivated. However, the canton has assured that in this case the costs would be borne by third parties, such as the Cancer League, if no agreement can be reached with the relevant health insurance.

Childhood Cancer Association

For Peter Lack, Director of the Swiss Childhood Cancer Association in Basel, is not it the first time that he hears about such incidents. Precisely because there are fewer empirical studies available in pediatric oncology and very few specific drugs, health insurances should pragmatically address such cases. "It may be legal, but ethically problematic, not to take such drugs," says Lack at the request of "Northwestern Switzerland". His association would work to ensure that such legal "loopholes" are closed.

Therefore, the announcement of the Ticino National Councilor Marina Carobbio, she wants to bring the case to the fall of the National Council on Social Security and Health, Meaning of the Childhood Association Cancer Switzerland. Carobbio has suggested assimilating childhood cancer cases with so-called rare diseases. This "rare group" of patients with childhood cancer, asks Carobbio, "requires official recognition".