Open letter to South African Medical Schemes re: covering linezolid

civil society
Dec. 15, 2014, 5:34 p.m.
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Several organizations and individuals working on TB are concerned that some medical schemes may be refusing to cover the cost of linezolid for drug-resistant tuberculosis.

On December 11, 2014 several organizations and individuals working on TB sent an open letter to South African Medical Schemes regarding the coverage of linezolid for drug-resistant tuberculosis.

The letter expresses the concern of the numerous signatories that some medical schemes may be refusing, in certain cases, to cover the cost of linezolid for drug-resistant tuberculosis despite a legal and ethical responsibility to do so, as well as the potentially
devastating public health consequences of refusing coverage.

The letter gives an overview of TB -- the leading cause of death in South Africa -- and explains the importance of linezolid for treating drug-resistant strains of the disease. The letter also presents the legal duty of schemes to cover treatment with linezolid.

Therefore, the letter requests that each medical scheme:

1) Provide in writing its policy on providing coverage for linezolid (at the full dose and length prescribed by the treating clinician or specialist);

2) Commit in writing to providing coverage for treatment with linezolid for its members as required by law and policy; and

3) Refund any amounts paid for linezolid by its members on an out-of-pocket basis because it previously denied them coverage.

You can download the open letter from here.