BONITAS REFUSES SIMVASTATIN FOR INSULIN DEPENDENT DIABETIC OF 22 YEARS????

<p>I am COMPLAINING about BONITAS on behalf of my daughter who is a MEDICAL PRACTITIONER and who has been suffering from INSULIN DEPENDANT DIABETES MELLITUS for the last 23 years. At her last 2 visits to her DIABETOLOGIST/ENDOCRINOLOGIST her cholesterol level has been elevated. Her doctor therefore motivated to Bonitas that she be put on Simvastatin as a CHRONIC medication. Bonitas declined this application as indicated below:</p> <p>CHRONIC MEDICINE MANAGEMENT</p> <p>Feedback on your application</p> <p>Patient Name: Johara Khan</p> <p>Medicine Application Number: BON ********** 371</p> <p>Member: ********** 6409 (00)</p> <p>Below is more specific feedback on your application for chronic medicine. We have sent your prescribing doctor a</p> <p>copy of this letter as this information can be quite clinical and is mostly intended to inform the doctor about the</p> <p>decision. Your doctor is welcome to call the Healthcare Professional Managed Care Call Centre on ***</p> <p>to discuss this further.</p> <p>NOTE: If your request has been declined, please discuss the reason with your doctor and ensure that he/she</p> <p>provided any extra clinical information that was requested.</p> <p>* Authorisation for payment of ASPEN SIMVASTATIN has been declined. Your request will be reassessed if the</p> <p>following is submitted to Chronic Medicine Management:</p> <p>(a) initial and most recent fasting lipogram results</p> <p>(b) recent TSH levels</p> <p>(c) information required to assess risk (BP, smoker, etc.).</p> <p>(d) confirm if patient has diabetes mellitus type 1 with microalbuminuria/proteinuria ,with 2 readings</p> <p>Treatment should be initiated at the lowest possible starting dose. Higher doses will only be considered if target</p> <p>levels are not reached on the low starting dose.</p> <p>After acceding to the above requirements she was AGAIN declined as per below:</p> <p>CHRONIC MEDICINE MANAGEMENT<br />Feedback on your application<br />Patient Name: Johara Khan<br />Medicine Application Number: BON ********** 371<br />Member: ********** 6409 (00)<br />Below is more specific feedback on your application for chronic medicine. We have sent your prescribing doctor a<br />copy of this letter as this information can be quite clinical and is mostly intended to inform the doctor about the<br />decision. Your doctor is welcome to call the Healthcare Professional Managed Care Call Centre on ***<br />to discuss this further.<br />NOTE: If your request has been declined, please discuss the reason with your doctor and ensure that he/she<br />provided any extra clinical information that was requested.<br />* Authorisation for payment of the condition - Hyperlipidaemia, unspecified - has been declined. Funding of this<br />diagnosis is only considered for patients who meet risk score criteria, as set out by the Medical Schemes<br />Regulations that define funding obligations. Contact Chronic Medicine Management if you need more<br />information.</p> <p>THE IRONY IS THAT I HAVE HEARD FROM AN OLD GP THAT BONITAS INSTRUCTS THEM TO START STATIN TREATMENT FOR DIABETICS SOONER RATHER THAN LATER. IN FACT I WAS TOLD THAT GP's ARE PENALISED FOR NOT DOING THIS BY BEING PAID A LOWER RATE. HOW THEN DOES BONITAS JUSTIFY DENYING AN IDDM PATIENT OF 23 YEARS WITH ELEVATED CHOLESTEROL LEVELS AT HER LAST 2 VISITS (OVER A PERIOD OF BETWEEN 1-2 YEARS). </p> <p>I EXPECT THIS MATTER TO BE RESOLVED ASAP OTHERWISE I WILL USE MORE DIRECT METHODS THAN HELLO PETER TO DEAL WITH BONITAS. OUR CONTACT DETAILS ARE AS PER BELOW:</p> <p>I AM DR AA KHAN - CELL - ********** 416</p> <p>MY DAUGHTER IS DR JOHARA KHAN CELL - ********** 206.</p>