No Cover for Certain Drugs

My Medical Aid No. is ***, Classic Saver.

Discovery Health does not have the best interests of their members when it comes to health. I was diagnosed last year with cirrhosis of the liver (not alcohol related) and pancreatic insuffiency. I have been consulting a specialist gastro-entomologist who has tried many medications to make the condition more bearable.

My symptoms do not allow me to live a normal life. I have uncontrollable diaharia even if I follow a preventative diet, and the specialist has tried many medications to provide relief. I am unable to leave the house, do shopping, socialize etc, which has a huge impact on my wellbeing.

However, one drug does provide me relief. it is a drug called Creon, and I have been taking it for a few months. But Discovery does not pay for it as a chronic medication. As a 75 year old pensioner I am struggling to afford to keep going as the drug is rather expensive. My specialist have written a motivation and Abbott Laboratories (the manufacturers) have approached Discovery, but to no avail. One would expect that the payment would fall under PMBs as the organs are liver and pancreas.

This letter is an appeal to management to reconsider their policy of refusing payment when the member has a condition as debilitating as this. I would like a response from the MD of Discovery, and not somebody without any authority to change the policy in dispute.