After refusing to foot the bill for an expensive drug to treat a local three-year-old boy diagnosed with a rare genetic disorder, the Pretoria High Court has ordered Medihelp medical scheme to pay up.
An Alberton mother took Medihelp to court earlier this year, after twice applying for authorization for a medication called elaprase for her son – who suffers from hunter syndrome – and twice being refused.
The medication is the only registered treatment for the condition in the country.
But Medihelp’s arguments in court included that although the condition was prescribed minimum benefit, elaprase’s use wasn’t a ‘prevailing predominant public hospital practice’.
In court, the applicants put up affidavits from practitioners in the public sector in which they confirmed elaprase was prescribed to patients with Hunters Syndrome in their facilities as well as from the pharmaceutical company that supplies elaprase – which also confirmed it supplied the drug to various public facilities.
And in his ruling, Anthony Millar said from these affidavits it was clear to him that the use of elaprase was “the only available treatment” for hunters syndrome – both in the private and public sectors.
The little boy at the heart of the case’s condition has deteriorated over the last year. The judge found that if he wasn’t afforded the treatment, his “life and quality of life will be irreparably adversely affected”.
Judge Millar ordered Medihelp to authorise the treatment and care costs of all medical interventions required by the boy – including elaprase – within 30 days, pending the outcome of a complaint his mother’s lodged with the Council for Medical Schemes.
-EWN
In other news – Bianca Naidoo fights to take over late Riky Rick’s Ferrari, Mercedes-Benz & all the money
Late SA hip-hop star, Riky Rick’s baby mama and partner, Bianca Naidoo has taken the Johannesburg Master of the High Court and Home Affairs Minister Aaron Motsoaledi to court to be recognized as his wife and executor of his estate as the rapper died in February without a will.
A local publication reports that Bianca Naidoo is fighting for her baby daddy rapper Riky Rick’s estate, who reportedly committed suicide in February without a will. Learn More
