No. 07-00-166/2016-02  Date: 26 May, 2016

OPINION

The opinion was issued in the procedure following complaint from S.R. from S. filed in the name and with the consent of his son D.R., against the National Health Insurance Fund of the Republic of Serbia. The complaint states, inter alia, that D. is cured of severe form of osteoporosis and has been diagnosed with West Syndrome, cerebral palsy and epilepsy, and therefore, for further treatment he needs Forteo drug which is on the list of drugs of NHIF (list A1), but this drug “is given only to women, and not to men, even though they are suffering from the same disease.” The National Health Insurance Fund mentioned in their declaration that there were no differences in the conditions for prescribing and issuing Forteo with regard to age or sex, but the restrictions were based on medical parameters. During the procedure it was established that D. R. was diagnosed with osteoporosis, in 2015 he had a femur fracture and his doctor thought he should start using Forteo. However, as D. was not in the postmenopause, he could not obtain the drug at the expense of compulsory health insurance. The Commissioner for the Protection of Equality determined that the analysis of the case showed that although NHIF did not explicitly state in their rulebook that only women could obtain Forteo at the expense of compulsory health insurance, the requirement for prescribing and issuing that drug related to the postmenopause clearly indicated that none of men, although satisfying all other requirements, could obtain the drug because of his biological and physiological characteristics. Namely, although the postmenopause is certainly a medical parameter, it also indicates sex of a person going through this process, and it, as a requirement for prescribing and issuing Forteo drug, completely precludes persons of male sex from obtaining this drug at the expense of compulsory health insurance. The Commissioner for the Protection of Equality issued the opinion that by denying the right to D. R. to obtain prescribed Forteo drug at the expense of compulsory health insurance, the National Health Insurance Fund made indirect discrimination on grounds of sex prohibited by Article 7 of the Law on Prohibition of Discrimination. Therefore, the National Health Insurance Fund was recommended to take all necessary actions and measures within their competence to ensure that Forteo, while meeting the requirements based on medical parameters for prescribing and issuing this drug, is also available to men at the expense of compulsory health insurance and, in the future not to violate the rules on the prohibition of discrimination in the course of their regular operations and activities.