Mom-to-be in ARVs bust-up

Her doctor claims medaid forced her to take drugs back

15 December 2017 - 06:47 By Katharine Child
Image: Gallo Images/Thinkstock

A 38-weeks pregnant woman who needed emergency antiretrovirals in a bid to prevent the virus from 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 disagreement on the exact version of events.

Van Zyl said an HIV-positive pregnant patient needed the expensive emergency antiretroviral treatment.

Doctors told The Times it was advised HIV patients started ARVs when they realised they were pregnant, preferably before three months. But in this case the patient was not on treatment and was 38 weeks pregnant.

Van Zyl explained to Discovery in the required forms that the expensive R1000-a- month drug was needed to try to drop the person's viral load in one day.

"We give this and then pray [and hope]," she said by phone to The Times.

She motivated that the patient receive the drug, which would not normally be available on Key Care, Discovery's cheapest option.

But this is where the story becomes unclear. The patient told Van Zyl on Whats-App that she had received the medication and was asked in a phone call by Discovery Health to return it to Dischem in Kempton Park or face paying for it.

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

She tweeted: "I am stunned. They have my number. 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 the baby. She knows she needs the antiretroviral syrup prophylaxis. Somebody has to get fired. #DiscoveryMustFall."

Discovery Health investigated the incident, listened to recordings of calls and found that the medicine had never been dispensed and was thus never returned.

CEO Jonathan Broomberg said: "It is not correct that the medicine was dispensed and the member requested to return it. 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.

Broomberg said: "We originally approved the medication on 7/12. When the member went to Dischem on 11/12, the claim had not been processed due to an error in our system. Unfortunately, we were not aware of this until it was escalated to us today."

Dischem did not reply to media queries.

Discovery has apologised, saying errors of this kind were "extremely rare and unfortunate".

The medicine was delivered on Tuesday.