The pharmacy in question makes its own ADHD medication. This is prescribed by doctors if a patient has too many side effects from the more common ADHD medication. However, the health insurer refuses to reimburse the medicine made by the pharmacy to patients who are insured with it. According to the health insurer, there is already enough equivalent ADHD medication that is reimbursed. The pharmacy has asked the court to rule that the health insurer must reimburse the drug made by the pharmacy to all insured parties who are prescribed it after they experienced too many side effects from the usual medication. The pharmacy also believes that the health insurer is acting unlawfully vis-à-vis the pharmacy if it does not reimburse the drug to patients to whom it is prescribed.
The court previously ruled in favor of the health insurer: according to the court there were not enough indications that the pharmacy wrongly rejected the claims of the insured and acted unlawfully. The pharmacy then appealed.
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