Kasse does not have to pay cannabis treatment for cluster headache for the time being

Federal Constitutional Court rejects express legal protection

Patients with cluster headaches may still not require the statutory health insurance to treat pain with medicinal cannabis. The Bundesverfassungsgericht (Federal Constitutional Court) in Karlsruhe rejected this decision in a resolution published on Friday, 20 July 2018 (Ref .: 1 BvR 733/18). It confirms a decision of the Hessian State Social Court (LSG).

According to the German Migraine and Headache Society, the cluster headache usually over many months, up to eight times a day, until a pain-free phase can come again. The attack-like one-sided pain can be so strong that those affected even faint. How many people are affected is unclear. Estimates vary between one in a thousand and one in a hundred.

In the case now decided, the applicant wanted to get his pain under control with medicinal cannabis. In an urgent procedure, he wanted to force his statutory health insurance company to pay the costs.

The LSG obtained an opinion from the Medical Service of the health insurances (MDK). This came to the conclusion that, according to current knowledge, the use of cannabinoids in cluster headaches bring nothing. It referred to two studies on the use of marijuana and migraine and a survey on cannabis and cluster headaches. Thereafter, there is no sufficient evidence for a therapeutic success. Ultimately, due to the poor data, the result of controlled studies has yet to be awaited.

In its summary examination, the LSG rejected the express request for reimbursement.

The headache patient saw in the LSG examination violated his right to effective legal protection and asked the Federal Constitutional Court for help. In the case of unreasonable and otherwise unavoidable adverse effects, the LSG would have to regularly review the factual and legal situation, not just in summary, but finally. This did not happen here.

In its decision of 26 June 2018, the Federal Constitutional Court rejected the urgent request. The specialized court must "examine the factual and legal situation only the more thoroughly, the more weight the threatening violation of fundamental rights and the higher their likelihood of occurrence", so the constitutional judge. However, the legal and factual situation was adequately penetrated by the LSG, even though the court assessed the outcome of the main proceedings as open, but nevertheless largely predictable.

Here, the LSG also rightly relied on the MDK report and the lack of efficacy of a cannabis treatment listed therein. The complainant had not sufficiently demonstrated why the LSG should have come to a different conclusion. fle