In its decision no. 2933/23 of 8 July 2025, the European Court of Human Rights (ECHR) rejected the appeal filed by B.R. against Switzerland regarding the refusal by the health insurance company Visana to cover the costs of the claimant’s treatment. The complainant suffered from the rare disease Spinal Muscular Atrophy (SMA) type 2.

The court considered that public health issues were subject to a wide margin of discretion on the part of the national authorities, as they were best placed to assess priorities, the use of available resources and the needs of society. Therefore, the court would generally respect the way in which the state interprets the requirements of public interest, unless its judgment proves to be “manifestly without reasonable foundation”.

Regarding the margin of appreciation in the specific case, the court held that even if the treatment with Spinraza, a medication that was on the List of Pharmaceutical Specialties (Spezialitätenliste, SL) but with certain restrictions, had a high level of benefits for the complainant, no obligation of cost coverage by the insurance was indicated. The fact that Swiss law required the proof of the effectiveness of the medication to be determined using scientific methods, could not be criticised. While the court acknowledged the extremely difficult situation of the complainant, it also considered the limited resources of the authorities and the resulting difficult decisions regarding the allocation of those resources. As a result, the court, within the limits of its review, did not consider that the Swiss authorities exceeded their discretion in refusing to grant the complainant the treatment she requested. Therefore, no violation of Article 8 of the European Convention on Human Rights (ECHR) was detected.

Regarding the claim of the complainant that a refusal of the cost coverage would constitute a breach of her human dignity in the sense of Article 3 ECHR, the court determined that the complainant’s argument was based on an interpretation of Article 3 ECHR which gives the concept of inhumane or degrading treatment a wider scope than it has. The refusal of the cost coverage did not directly contribute to the complainant’s suffering, which she had already experienced since early childhood.

Based on the aforementioned argumentation, the court also denied the claim of discrimination by the complainant under Article 14 in combination with Articles 3 and 8 ECHR.

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