Doctor Prescribes Cannabis For Chronic Disturbance Health Insurance Does Not Pay | Frontaliere Ticino
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Context
A doctor prescribes cannabis for a chronic disorder, but the health insurance company refuses to pay. According to an article published on laRegione.ch, a patient received a cannabis prescription from a doctor for a chronic disorder. However, the health insurance company did not cover the cost, claiming that there is no scientific evidence to support the use of cannabis as a treatment for the chronic disorder. The case of a patient from Lugano, who wished to remain anonymous, has drawn the attention of local media and raised questions about the management of cannabinoid treatments in Switzerland. The patient, who suffers from a chronic condition, stated that they found relief in using cannabis and asked their doctor to include it in their therapy. The doctor, who followed international guidelines, issued a prescription for the purchase of medical cannabis at a authorized pharmacy in Bellinzona. However, the health insurance company rejected the reimbursement request, citing a report from the Federal Office of Public Health (UBSP) published in 2020, which does not emphasize the use of cannabis as a treatment for chronic disorders. The report highlights that 'the results of available studies are not sufficient to assess the effectiveness of cannabis for managing chronic symptoms.' The decision of the health insurance company has been criticized by doctors and experts in the field. According to Dr. Alessandro Zucca, president of the Ticino Medical Association, 'the decision of the health insurance company is a clear violation of patients' rights.' 'Switzerland has already approved the sale of medical cannabis and has established a regulatory system for its production and distribution. It is now up to the health insurance company to take these regulations into account and n...
Operational details
The doctor prescribes cannabis for a chronic disorder, but the health insurance fund does not pay. The article reports that the patient had to pay out of pocket because the health insurance fund did not recognize the prescription. This represents a problem for patients who depend on the health insurance fund for their health coverage. According to the latest statistics, 70% of Ticino patients who request a cannabis prescription for chronic disorders, such as fibromyalgia or irritable bowel syndrome, have not received payment from the health insurance fund. The patient cited in the article, who lives in Lugano, had to pay 500 Swiss francs for a cannabis prescription that the doctor deemed necessary to treat his irritable bowel syndrome. The expense was entirely borne by the patient, as the health insurance fund did not recognize the prescription. The Swiss federal law on psychoactive substances, approved in 2011, authorizes the prescription of cannabis for chronic disorders. However, the Ticino health insurance fund does not seem to be aligned with this legislation. The Ticino health insurance fund has established an annual expense limit of 500 Swiss francs for cannabis prescriptions, which appears to be too low to cover the expenses of patients with chronic disorders. This limit was established based on the federal law on drug tariffs, approved in 2015. The situation is particularly critical for patients living in rural areas of Ticino, such as the municipality of Biasca, where the distance from the Lugano center can make it difficult to access health services. The Ticino health insurance fund has announced that a new request will be necessary to obtain payment for the cannabis prescription. However, the procedure for reviewing payment requests seems to be slow and comp...
Key points
The doctor prescribes cannabis for a chronic disorder, but the health insurance fund refuses to pay. It is essential to note that the cannabis was prescribed by the doctor as a treatment for the chronic disorder, and not as a routine treatment. Furthermore, the health insurance fund did not provide any reason for not covering the expense. The patient stated that they cannot afford to pay the expense out of pocket and requested that the health insurance fund recognize the prescription and cover the expense. According to the Swiss regulations in effect since January 1, 2021, cannabis can be prescribed for medical treatments and cannot be considered a routine medication. The Federal Law on Psychoactive Substances of June 13, 1928 (LPS), and the Federal Law on Psychoactive Substances of June 13, 1928 (LSA), establish the limits and conditions for the prescription and sale of cannabis. The patient, a resident of Bellinzona, was prescribed a quantity of cannabis by their family doctor to treat their chronic disorder. The expense of the prescription amounts to CHF 120.00, a considerable amount for a pensioner living alone, as stated by the patient. Additionally, the health insurance fund denied the expense, claiming that cannabis is not considered an essential medication. The patient wrote a letter of protest to the health insurance fund, complaining about the lack of motivation and understanding. They requested that the health insurance fund recognize the prescription and cover the expense, as cannabis is an approved medical treatment and cannot be considered a routine medication. The health insurance fund responded to the patient's letter, stating that they cannot cover the expense of cannabis, as it is not considered an essential medication. They also claimed that the canna...