We were acting in the member's best interest - Discovery Health

Discovery Health has explained the circumstances surrounding a case in which it had refused to provide funds for a valve implant called a Xen stent for a glaucoma patient, saying this particular valve is brand new and that there is not sufficient evidence to prove its efficacy or safety.

RELATED: 'Discovery judgment is operating in terms of the law'

Discovery of Health CEO Dr Ryan Noach says a world leading health assessment organisation has also rated the Xen stent as Grade C - which means it is possibly helpful but this is unproven.

In this category of new technology device, we often see a syndrome of these devices being used and then being found not to be safe or not useful or not durable and needing to be replaced or removed or alternatives considered over time. They often end up being withdrawn. Now I am not proposing that is what going to happen with the Xen stent, I am talking about this category of approval.

Dr Ryan Noach, CEO - Discovery Health

Noach has made it clear that they in fact did approve funding, but for stens that are commonly used and have safety and efficacy data that is unquestionable.

The funding we approved was actually for double the price of the Xen stent, we approved funding up to R20,000 for this particular case. The Xen stent costs R9,000. This was not about the money, this decision was relating to the rules of the scheme which is where we fund evidence-based medicine only.

Dr Ryan Noach, CEO - Discovery Health

We very clearly offered in compliance with our funding obligations here, to fund for an alternate valve where we know that it is safe and the evidence supports it.

Dr Ryan Noach, CEO - Discovery Health

We were acting in the member's best interest.

Dr Ryan Noach, CEO - Discovery Health

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