Ruling in lawsuit against SGK for cancer medication
A final ruling has been issued by the appellate court in the legal battle regarding the reimbursement of the cost of a cancer medication used by Nurettin Boyar, which his family had procured with their own resources: The Social Security Institution (SGK) is required to reimburse the family for the cost of the medication.
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The family of Nurettin Boyar, who passed away during his treatment for lung cancer, has achieved a significant legal victory in the lawsuit they initiated to demand reimbursement for the smart cancer medication used in his treatment. The 10th Civil Chamber of the Ankara Regional Court of Justice rejected the appeal filed by the Social Security Institution (SGK) on its merits, definitively ruling that the cost of the medication must be reimbursed to the family.
As his illness progressed, Boyar began using a smart medication recommended by his doctors instead of standard chemotherapy and radiotherapy. However, because the medication was not on the SGK's list of reimbursed drugs, the family procured the expensive medication through their own means. Boyar, who experienced a regression in his illness during the treatment process, passed away on April 12, 2023, due to an infection while at the hospital for a check-up.
Boyar's daughter, Sevcan Özmen, filed an application on her father's behalf, requesting that the cost of the cancer medication used be covered by the SGK. However, the institution rejected the request on the grounds that the medication was not on the reimbursement list.
Following this, the family applied to the Ankara 8th Labor Court and submitted a report obtained from the hospital stating that the medication was essential for life. In its ruling dated July 9, 2024, the court ordered that the medication cost of 147 thousand 908 Turkish Lira and 52 kuruş be paid to Boyar's wife and children. The ruling stated that expert reports clearly demonstrated that there was no equivalent to the medication for the treatment and that its medical necessity was evident.
The SGK appealed this decision and took the case to the appellate court. The SGK's counsel argued that the short-term use of the medication on the deceased was not sufficient evidence and that the fee could not be paid due to the limited nature of state resources. However, the 10th Civil Chamber of the Ankara Regional Court of Justice, upon evaluation, examined both the expert reports and similar cost research, ruling that there was no irregularity in the decision rendered by the court of first instance. Thus, the SGK's appeal was rejected, paving the way for the family to claim the cost of the medication along with legal interest.
The family's lawyer, Eliz Atlı, made the following statement regarding the decision: “Unfortunately, because these medications are expensive and treatments are not covered by the SGK, patients either fall into heavy debt to access these drugs or are forced to refuse treatment when it is recommended to them. The appeal process initiated by the institution regarding the case we started on behalf of the deceased, which had a positive outcome in the court of first instance, has been concluded, and as a result of the examination by the relevant chamber, the institution's application was found to be unjustified, and a decision was made to reject the appeal. Thus, by once again emphasizing the principle of the social state, it has become possible for the costs of medication covered by the patient or their relatives to be reimbursed with legal interest, even if the patient has passed away, provided that they benefited from the medication they used.”
With this ruling, an important step has been taken that could set a precedent for families experiencing similar grievances regarding the payment for medication.