Open Letter to South African Medical Schemes re: Covering Linezolid
11 December 2014
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:
- Provide in writing its policy on providing coverage for linezolid (at the full dose and length prescribed by the treating clinician or specialist);
- Commit in writing to providing coverage for treatment with linezolid for its members as required by law and policy; and
- Refund any amounts paid for linezolid by its members on an out-of-pocket basis because it previously denied them coverage.