“Zohreh’s health and life are at stake, and urgent intervention is critical.”<\/p><\/blockquote>\n
<\/p>\n
Hossein Majlesi says he may have to sell the family home to afford CAR T-cell treatment for Ms Sajjad. (Supplied: Hossein Majlesi)<\/p>\n
CAR T-cell treatment works by encouraging the immune system to attack cancerous cells.<\/p>\n
T-cells \u2014 a type of white blood cell \u2014 are taken from a patient’s blood then genetically engineered in a lab to produce molecules called chimeric antigen receptors (CAR).<\/p>\n
These receptors allow the cells to target cancer cells but ignore others.<\/p>\n
Mr Majlesi said his family felt duped by Medibank, with the health insurer hiding behind technicalities to avoid paying for the CAR T-cell treatment.<\/p>\n
“We’re being forced to liquidate assets to save my wife’s life,” he said.<\/p>\n
‘Living drug’ keeping cancer patients in remission<\/a><\/p>\n When Doug Olsen’s blood cancer returned after five years in\u00a0remission, he signed up for an experimental therapy that would use his own immune system against the disease.<\/p>\n In correspondence from Medibank, Ms Sajjad and Mr Majlesi were told CAR T-cell therapy was “a highly specialised treatment currently available to Medicare eligible recipients”.<\/p>\n Ms Sajjad is not able to access Medicare as she is not yet an Australian permanent resident.<\/p>\n “When we enrolled with Medibank, they were fully aware that we were not permanent residents and explicitly included this in our policy,” Mr Majlesi told the ABC.<\/p>\n “The policy clearly states that all cancer treatments, including immunotherapy, radiotherapy, and chemotherapy, are covered.<\/p>\n “Meanwhile, we face selling our home to afford CAR-T therapy.”<\/p><\/blockquote>\n A Medibank spokeswoman told the ABC they had been “been in regular contact about the treatment options available”.<\/p>\n “We’ll continue to support the customer with eligible treatments available through their health cover,” she said.<\/p>\n “We wish her the very best with her ongoing treatment.”<\/p>\n Technicalities preventing access to treatment<\/p>\n Because Ms Sajjad and Mr Majlesi are not able to access Medicare benefits due to their residency status, they have had to take out a private health insurance policy that essentially covers them in the same way Medicare would for Australian residents and citizens.<\/p>\n Ms Sajjad’s insurance policy says it covers “Chemotherapy, radiotherapy and immunotherapy for cancer” but only medical services “where a Medicare benefit is payable” and drugs when they’re listed on the federal pharmaceutical benefits scheme (PBS).\u00a0<\/p>\n However, CAR T-cell treatment is funded jointly by the state and federal governments through the National Health Reform Agreement, after approval from the Medical Services Advisory Committee<\/a>, rather than Medicare.<\/p>\n If it was funded through Medicare and the PBS, it would have an “item number”.<\/p>\n