OPINION

This opinion was issued in the proceedings upon the complaint filed by N. М. Đ, on behalf and with the consent of her mother V. М. M, against RFZO, for discrimination on grounds of health condition. The complaint stated that V. М. М. has hepatitis C and has not been approved by the RFZO Commission for treatment with DAA therapy because she does not meet a single criterion, namely, previous failure of PEG-INF therapy, which was not available in her case, as it is was contraindicated. In its statement, RFZO specified, inter alia, that hepatitis C medicines are introduced into therapy based on the opinion of an expert commission that the prescribed drugs are provided for the indication prescribed in the Medicines List in accordance with the commission’s decision, and after a review of the insured person’s complete documentation. It further stated that the commission had reviewed the documentation submitted by V. М. М. at the sessions of November 28, 2018 and February 20, 2019, and determined that the patient “did not meet the criteria for DAA therapy and was not eligible for pegylated interferon therapy.” The statement added that at a session on April 24, 2019, the commission reviewed the patient’s documentation and noted that she meets the criteria from the Medicines List, and that it would decide in the next sessions to introduce DAA therapy into V. M. M. treatment. During the procedure, it was determined that for two hepatitis C medicines from the Medicines List, inter alia, the criterion “exclude patients with contraindications to pegylated interferon and ribavirin therapy” is prescribed, while for other hepatitis C medicines one of the prescribed criteria is “previously unsuccessfully treated compensated liver cirrhosis”, that is, “previously unsuccessfully treated compensated and decompensated liver cirrhosis”. Further analysis showed that hepatitis C patients with contraindications to interferon pegylated therapy were placed in an unequal position compared to patients with hepatitis C who did not have contraindications to this therapy. Patients who have contraindications to pegylated interferon cannot use medicines form the PEG-INF therapy, nor the two medicines from DAA therapy on the Medicines List, and the criterion of previously unsuccessfully treated liver cirrhosis puts these patients in a situation that they do not not qualify for other medicines from DAA therapy on the Medicines List. Therefore, the Commissioner for the Protection of Equality gave the opinion that the RFZO, by its treatment of V. М. М., violated the provisions of section 7 in relation to section 27 of the Law on the Prohibition of Discrimination. It is recommended to the RFZO to introduce DAA therapy into treatment of V. М. М. as soon as possible, as well as to harmonize the criteria for authorizing the use of medicines from DAA therapy with the anti-discrimination regulations, either by amending the Rulebook on the List of Medicines prescribed and issued at the expense of compulsory health insurance funds, or by giving the commission instructions for the application and interpretation of the criteria prescribed in this Rulebook so that patients who cannot use another therapy in the treatment of hepatitis C are not excluded.

COMMISSIONER FOR THE PROTECTION OF EQUALITY
Brankica Janković