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Success before the Supreme Administrative Court on the petition for special payment of the medicine OPDIVO
Article 16 of the Public Health Insurance Act enables a health insurance company to pay for treatment that is not covered by general health insurance. This article is applicable when the proposed treatment represents the only option for a patient in terms of his/her state of health.
In our case, we represented an oncological patient who went through 4 chemotherapy lines, all of which were not effective. Due to the ineffectiveness of this treatment, a request was made for payment of immunotherapy medicine OPDIVO, which contains the active substance nivolumab. The health insurance company and the Municipal Court in Prague considered the claim of “the only option for the patient” in the mentioned article. They also considered that the complainant was offered alternative treatment covered by general health insurance, i.e. chemotherapy. It was held by the Municipal Court that while chemotherapy would be less effective, it would still, in their opinion, be lege artis (according to the rules of the field).
The Supreme Administrative Court disagreed with these observations, referring to the practice of the Constitutional Court, and stated that this opinion is completely unsustainable and that such a restrictive interpretation denies the meaning of Article 16. The Supreme Administrative Court thus concluded that the conditions of Article 16 were met in this case, and the complainant is entitled to a special payment of treatment.
Our other achievements include winning disputes over the payment of KEYTRUDA medicine with the active substance pembrolizumab, and FAMPYRA with the active substance fampridine.
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Markéta Poledníková
Markéta Poledníková
"I was extremely satisfied with the services provided by Holubová advokáti. The collaboration was always professional, systematic, and attentive to detail. At the same time, I greatly appreciated their human and personal approach. Everything was explained to me clearly, I had ample opportunity to ask questions, and I felt a genuine interest in resolving my situation. In my view, the combination of expertise and personal care is exactly what one should expect from legal services. I can wholeheartedly recommend them."
Martin Herna
Martin Herna
"I would like to take this opportunity to express my sincere gratitude to the law firm Holubová advokáti s.r.o. for their professional yet genuinely compassionate approach in an exceptionally difficult period of my life.
The firm successfully represented me in a dispute with my health insurance company concerning reimbursement for a medication that enables me to actively fight an oncological illness and has already begun to show positive treatment results.
From the very outset, I felt a high level of expertise, thoroughness, and a genuine interest not only in the case itself but also in the person behind it. All legal steps were explained clearly and comprehensibly, and the communication was factual, calm, and supported by clear arguments. In a time of great uncertainty, this provided me with a much-needed sense of reassurance and trust.
My special and greatest thanks go to JUDr. Klára Dvořáková, whose commitment, precision, and empathy meant more to me than can be conveyed in just a few sentences. Her work was not only highly professional but also marked by human sensitivity and deep respect for the seriousness of the situation.
I can wholeheartedly recommend this law firm to anyone seeking top-tier legal assistance combined with a truly human approach."
Dietmar Repka
Dietmar Repka
"We express our recommendations for the law firm Holubova Advokati.
Holubova Advokati was able to resolve a project for us with confidence, composure, and perseverance that German experts had deemed hopeless.
About 80 years ago, my grandparents and my father had to leave their home. The property has now been returned to our family through the inheritance that was initiated, and thanks to the excellent work of the law firm.
During the two-and-a-half-year negotiations, there were no language problems; everyone was always well informed about the current status.
Keep up the good work, everyone."