Juniarti, a breast cancer patient who tested positive for human epidermal growth factor receptor 2 ( HER2 ), and her husband Edy Haryadi filed a civil lawsuit against the government, BPJS Kesehatan president director Fachmi Idris and the Clinical Advisory Council (DPK) in July, demanding that the drug be put back on the BPJS coverage list.

Presiding judge Mery Taat Anggarasih issued a court order to put in force the settlement at the South Jakarta District Court on Wednesday, officially putting an end to the lawsuit.

In the settlement signed by all parties in the civil case on Sept. 27, BPJS Kesehatan agreed to cover trastuzumab for HER2 stage three and above patients, in accordance with the technical guidelines stipulated in a 2018 health ministerial regulation (Permenkes) issued in July.

“I hope all parties will follow the terms of this settlement,” Mery said before ending the hearing.

Juniarti, Edy and their lawyers expressed satisfaction over the outcome of the lawsuit, which was described by the plaintiffs as a victory for all HER2-positive breast cancer patients.

“I think that today shows that justice was served even though it was a close outcome. This is what we were looking for as seekers of justice,” Edy told The Jakarta Post after the hearing. “I hope that this can be a lesson for BPJS [Kesehatan], because this is about human lives.”

Juniarti was diagnosed with stage three HER2-positive breast cancer in May and was prescribed with trastuzumab and three other chemotherapy drugs after her mastectomy one month later.

Upon trying to obtain the drug at a pharmacy, she discovered that BPJS Kesehatan had stopped covering trastuzumab for patients treated under its state-funded National Health Insurance-Healthy Indonesia Card (JKN-KIS) scheme since April 1. The removal of the drug was based on an instruction letter from BPJS director of healthcare service assurance R. Maya Armiani Rusady, which stated that the drug was ineffective in treating HER2 breast cancer, a claim rejected by Juniarti and her legal team.

“I think the Permenkes regulation has set out in clear detail why trastuzumab is necessary for HER2 patients, so I think this settlement is fair and serves as strong legal backing for myself and other HER2 patients,” Juniarti said.

Juniarti has already gone through four chemotherapy treatments without trastuzumab since her mastectomy and said that she hoped the drug would be available for her next treatment, scheduled for three weeks from Friday.

“I hope that this settlement will soon be implemented by BPJS [Kesehatan] and will not just be something on paper,” she said.

BPJS Kesehatan previously insisted that the drug was costly and ineffective in treating breast cancer in its argument before the civil court and during two out-of-court mediation sessions before Juniarti brought the case to court.

BPJS Kesehatan spokesperson Iqbal Anas Ma’ruf said the agency was in the process of updating its regulations to reflect the guidelines set out in the Permenkes regulation.

“We are very thankful for the peaceful settlement,” he said. “Of course, BPJS Kesehatan will follow [the ministerial regulation] and the suggestions of experts in creating regulations. The process is ongoing and will be applied to all JKN-KIS users.”

He did not, however, specify a timeline for making the trastuzumab available to qualifying BPJS Kesehatan users, saying only that “the administrative process is ongoing”.