Former South African surfski champion Oscar Chalupsky is fighting Discovery Health Medical Scheme for full reimbursement of his multiple myeloma treatment. The case, before the Council for Medical Schemes, could set a precedent for how medical aids cover expensive cancer drugs like Daratumumab. Delays in the ruling have forced Chalupsky to seek advanced care abroad at his own expense.
Oscar Chalupsky, a 62-year-old from Cape Town and celebrated athlete with 12 Molokai Challenge surfski titles, multiple Umkomaas River Canoe Marathon wins, and a spot representing South Africa at the 1992 Barcelona Olympics, was diagnosed with multiple myeloma in 2019. This blood cancer affecting plasma cells is a prescribed minimum benefit (PMB) condition under the Medical Schemes Act of 1998, meaning schemes must cover essential care fully.
Chalupsky began treatment in June 2020, but after three years, his maintenance therapy failed, leading to relapses. His doctor prescribed Daratumumab (Darzalex) due to prior treatments and complications, including melanomas. Discovery Health, South Africa's largest medical scheme with about three million members, approved the drug but covered only 50% of costs from October 2023 to May 2024, resulting in a near R300,000 shortfall that Chalupsky covered with help from friends and family. The scheme funded R3 million total for his cancer care, including R1 million for Daratumumab, with some co-payments offset by third-party programs.
Supported by the NGO Campaigning for Cancer, Chalupsky filed a complaint with the Council for Medical Schemes in January 2024. His legal team argued the treatment was medically justified and should be fully funded as a PMB. The council ruled in his favor, stating that following Discovery's protocol would have been ineffective or harmful, and Daratumumab was appropriate. However, Discovery appealed twice, and a December hearing was postponed to early 2026, extending Chalupsky's wait for reimbursement to nearly two years.
Currently hospitalized in Shanghai, China, for advanced treatment he is funding himself, Chalupsky shared: “I need Discovery to pay up the very money they should have paid to fund this next treatment that they will also not cover.” Using #noretreatnosurrender on social media, he highlighted others' struggles, noting scathing public comments like “Discovery’s priority is profit!” Discovery maintains independent advisers deem Daratumumab non-PMB and an alternative exists.
Lauren Pretorius of Campaigning for Cancer called for transparency and revised funding models amid rising cancers—projected at 121,000 cases by 2030—stressing individual case merits and global benchmarks to avoid shifting costs to patients.