#DiscoveryMustFall Twitter fallout unpacked

A 38-week old pregnant women who needed emergency antiretrovirals in a bid to prevent the HI-virus being passed onto her baby had them delivered to her by a courier, after her doctor lambasted Discovery Health Medical Scheme on Twitter.

Johannesburg HIV doctor Sindi van Zyl‚ who is prolific on Twitter‚ used the hashtag "Discovery Must Fall" to ask how a pregnant woman at full term could be asked to return her medication to a pharmacy because the medical aid could not process her claim.

However‚ there is not agreement on the exact version of events.

The story told by Van Zyl is that an HIV positive pregnant patient who presented at a doctor at 38 weeks‚ needed very expensive emergency antiretrovirals treatment to prevent the virus being passed onto her soon to be born baby.

Doctors told TimesLIVE that it is advised that HIV patients must start ARVs as they realise they are pregnant‚ preferably before three months.

But in this case the patient was not on treatment.

Van Zyl explained to Discovery in the required forms that the expensive R1‚000-drug was needed to try to drop the person's viral load in one day.

"We give this and then pray [and hope]‚" she explained on the phone to TimesLIVE.

Van Zyl motivated that the patient receive this high-cost drug‚ which would not normally be available on Key Care‚ Discovery's lowest and cheapest option.

But here is where the story becomes unclear.

The patient told Van Zyl on WhatsApp that after getting the medicine‚ she was asked in a phone call by Discovery Health to return it to Dischem in Kempton Park or face paying for it.

She messaged Van Zyl: "They asked me to bring back the medication because they can't do the claim and they say you didn’t call the chronic and maybe you not in Discovery. They don’t know [ sic].”

Van Zyl was furious that she was not called by Discovery about the confusion.

She tweeted: "I am stunned. I have never. Never! They have my number. They know where to find me. If there was a problem why didn't they call ME?! #DiscoveryMustFall.

Van Zyl said: "I am shaking with rage. The patient took the medication back. She is so scared for baby. She knows that she needs the antiretroviral syrup prophylaxis. Somebody has to get fired. This is unbelievable. #DiscoveryMustFall"

Discovery Health investigated the incident‚ listened to recordings of calls and found the medicine was never dispensed and thus not returned. CEO Jonathan Broomberg said: "It is not correct that the medicine was dispensed and then the member requested to return the medicine. The medicine has not in fact been dispensed at all. We have arranged for delivery of the medicine this afternoon [on Tuesday] and informed our member about this."

According to Discovery‚ the medication was approved on December 7 by Discovery Medical Scheme.

The patient went to fetch the emergency treatment‚ four days later on December 11. But it did not show up on Dischem's system that the medicine was approved so she couldn’t get it. This was Discovery's error.

Broomberg said: "We originally approved the medication on 7/12‚ When the member went to Dischem on 11/12‚ the claim was not processed due to an error in our system that has impacted only on this member. Unfortunately‚ we were not aware of this problem at all until this was escalated to us today. Prior to this‚ all interaction has been between the member and Dischem.” Discovery have apologised.

"We approve and fund chronic medication for approximately 500‚000 members monthly‚ including almost 50‚000 for members with the same condition as this member‚ and errors of this kind are extremely rare and unfortunate."

It is agreed by both parties‚ the medicine was delivered on Tuesday.

The patient is expected to give birth very soon‚ but cannot be identified or contacted without her consent.

Dischem did not reply to repeated media queries about the Twitter incident.

Van Zyl is cancelling her personal medical aid with Discovery Medical Scheme.

More than 850 people retweeted Van Zyl's Twitter thread about the woman who needed emergency ARVs.

Many have expressed fury at medical aids and being forced by their employers to use Discovery.