Marbella pensioner with leukaemia given ten-days to prove public healthcare eligibility

In response, in September, the patient requested admission to the public healthcare system on medical and hospital grounds. In response, Muface has requested a series of medical reports, giving him ten days to provide them, and suspended the deadline for resolving the case until he submits them.

García Conde is currently receiving treatment and paying for it at a private hospital in Malaga. His concern is that the change in treatment should happen quickly, given the seriousness of his condition.

He has confirmed receipt of Muface's letter. "This is an insult, discrimination, an injustice. The letter attempts to use legal loopholes to muddy the waters. They already have a report from my doctors recommending the treatment that is already being provided by the Sas (Andalusian health service)," he said.

In the letter, Muface says it is "necessary" for García Conde to submit a medical report setting out the diagnosis, justifying the need for treatment by a multidisciplinary unit or a specific highly specialised unit at a hospital within the public healthcare system.

It has also requested a medical report by the doctor in charge of the patient's treatment at a public hospital, stating that the patient has been included or is proposed for inclusion in a clinical trial or an experimental technique or procedure.

Finally, Muface has asked for documentation proving dual membership, as well as proof of withdrawal from a scheme under which the member had been receiving healthcare through the public healthcare network for reasons not attributable to the member.

As García Conde told Sur in late September, he has been a member of Muface for 40 years, having worked as a teacher. In September 2025, he was diagnosed with leukaemia. "I've been in hospital ever since, for one thing or another," he said.

In practice, the funding dispute centres on the use of venetoclax within the requested treatment. The health insurance provider points out that gilteritinib is indeed funded as a monotherapy for this condition, so its use for García Conde could be approved subject to a favourable report.

Sources at Muface told Sur that the case was being processed. "The technical departments deal with this type of case as quickly as possible, given the nature of the claimant's health problems," they said.

"As for his specific details, given that this is highly sensitive information which is subject to special protection and which only the patient should be aware of, we are unable to disclose this information," they stated.

On 6 April 2026, a bone marrow test confirmed complete remission, but a relapse was detected on 18 August. Between the 13th and 20th of that month, García Conde suffered from sepsis, which caused liver dysfunction and septic pulmonary embolism. That's when doctors decided to perform a bone marrow transplant, but then ruled this out in view of his age, his comorbidities and his frailty.

On 14 September, García Conde was admitted to hospital as his condition had worsened. The documentation he has provided includes a request for authorisation for an initial course of treatment with the three medicines mentioned above.

"I was very surprised when Muface refused to authorise two of them, because Carlos Hara (Hospital Regional) authorises them," the patient said.

Muface has refused to fund the prescribed combination of drugs and expressly stated that gilteritinib as monotherapy is funded. "The criteria for funding under the national health service have not been met," states the decision, dated 14 September 2026.

Muface's first resolution states that venetoclax, "in combination with a hypomethylating agent, is indicated for the treatment of adult patients with newly diagnosed acute myeloid leukaemia who are not candidates for intensive chemotherapy".

In the case of gilteritinib, the health insurance organisation states that it is indicated "as monotherapy for the treatment of adult patients with relapsed or refractory acute myeloid leukaemia with an FLT3 mutation". "The use of this treatment as monotherapy is currently funded, so a favourable report could be issued for it," the resolution states.

Muface has said that it does not overrule medical prescriptions or prevent the dispensing of medicines. "A prescription does not necessarily imply that it will be funded from public funds," the resolution says.

According to García Conde, the cost he has to pay out of his own pocket amounts to around 1,700 euros every three months.

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