It took a three-year fight, but at last Gems will pay for mom’s vital drug
Even so, government medical aid insists giving in to pressure is a donation, not a policy change
A Knysna mother has won a three-year battle with the Government Employee Medical Scheme (Gems), which has finally agreed to pay for her R3.6m-a-year enzyme replacement therapy.
Irene Sabbat, 36, suffers from Gaucher disease. She is missing an enzyme that breaks down waste in her body, and the disease can cause organ damage, bone pain, fatigue and problems with platelets in the blood.
Since her diagnosis in 2016, Sabbat has been fighting Gems for Cerezyme, an enzyme replacement therapy. On Friday last week, just days before she was due to appear at a second appeal hearing at the medical aid regulator office in Centurion on Wednesday, Gems conceded and approved the treatment...