Rare disease funding is under scrutiny after the Council for Medical Schemes (CMS) Appeals Committee ordered KeyHealth to cover a teenager’s treatment in full. The Board of Healthcare Funders (BHF) says the case shows why schemes need a way to share the cost of exceptionally expensive treatments. The 15-year-old has paroxysmal nocturnal haemoglobinuria, a rare blood disorder. Treatment with AstraZeneca’s…
Tag: KeyHealth
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KeyHealth Ordered to Fully Fund Teenager’s Rare-Disease Treatment
A KeyHealth PMB ruling requires the medical scheme to fund a teenager’s rare blood disorder treatment in full, without membership conditions. The Council for Medical Schemes (CMS) appeals committee issued its decision on 29 October. However, KeyHealth has notified the registrar that it intends to appeal to the CMS appeals board. The case involves a 15-year-old with paroxysmal nocturnal haemoglobinuria,…