“The elimination is based on the organization’s Dewan Pertimbangan Klinis,” said BPJS Kesehatan spokesman Nopie Hidayat, as quoted by kompas.com on Wednesday, referring to the BPJS Kesehatan's Clinical Advisory Board.

“The board said the drug has no medical basis to be used for patients with metastatic breast cancer […],” Nopie said.

The BPJS Kesehatan, however, declined to comment on the case of Yuniarti Tanjung, a HER2 breast cancer patient in East Jakarta. Yuniarti and her family plan to sue the agency for removing trastuzumab from its list of approved drugs.

Yuniarti was diagnosed with HER2 breast cancer on May 10. On on June 24, a doctor at East Jakarta's Persahabatan Hospital prescribed trastuzumab, along with three other drugs, for her chemotherapy treatment.

However, she did not receive the trastuzumab because the hospital said a policy issued on Apr. 1 prohibited the national health insurance program from covering the drug. 

Yuniarti would have to pay Rp 25 million (US$1,700) to obtain the medication.

The national healthcare agency would only cover trastuzumab under the National Health Insurance-Healthy Indonesia (JKN-KIS) program for breast cancer patients who were prescribed the drug before Apr. 1, so that they could complete their treatment, Nopie said.

Nopie said the agency believed the policy would not prevent breast cancer patients from receiving proper medical treatment, saying that there were many other drugs that could replace trastuzumab.

“The doctors can choose other drugs to treat breast cancer patients based on each patient’s needs,” he said. (vla)

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