All eyes are on what could be a precedent-setting case at the Council for Medical Schemes as a former champion athlete takes his fight to Discovery Health Medical Scheme to get his cancer treatment paid for in full.

A landmark ruling is in the offing that could clear a path to compel medical schemes to revise how they pay for multiple myeloma cancer treatments that schemes have until now declined, or approved but with burdens of hefty co-payments for patients.

In this fight is 62-year-old Capetonian Oscar Chalupsky against Discovery Health Medical Scheme, the largest medical aid in the country, which has an estimated three million beneficiaries. The matter first came before the Council for Medical Schemes for adjudication in January 2024.

Chalupsky is a well-known sportsman having had a formidable sporting career. He is a 12-time Molokai Challenge surfski champion, multiple winner of the Umkomaas River Canoe Marathon and he represented South Africa in the 1992 Barcelona Olympics.

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The case has centred around the funding of a cancer drug called Daratumumab (Darzalex) that Chalupsky needed as his cancer progressed. Chalupsky was diagnosed in 2019 with multiple myeloma, a blood cancer that affects plasma cells. It is classified as a prescribed minimum benefit condition under the Medical Schemes Act 1998. According to the Council for Medical Schemes, prescribed minimum benefits are a set of "essential healthcare services that all registered medical schemes are legally required to cover, regardless...