Court orders insurer to provide Burosumab to child

A Colombian court has ruled that Nueva EPS must immediately provide a 10-year-old boy with the medication Burosumab and required medical tests after the health insurer repeatedly delayed access to treatment for his rare genetic disorder.

The ruling stems from a constitutional protection petition filed by the boy’s mother, who argued that Nueva EPS had failed to deliver the prescribed drug or authorize necessary diagnostic procedures for his condition, X-linked hypophosphatemia. The disorder causes low phosphate levels in the blood, which weaken bones and impair muscle development. The court found that the insurer violated the child’s rights to health, dignity, and physical integrity by imposing administrative obstacles rather than ensuring timely care.

The decision reinforces Colombia’s legal obligation to prioritize pediatric and rare-disease patients. Courts have repeatedly stressed that health providers cannot use bureaucratic delays to block access to approved treatments, particularly for conditions not fully covered by the national health plan. In this case, the prescribed drug was authorized through the MIPRES system, which handles requests for excluded or underfunded therapies.

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The platform is managed by the Ministry of Health and allows physicians to request medicines that are not listed in the standard benefits catalogue. The court also confirmed that Burosumab was available in Colombia and that the insurer had not demonstrated any effort to supply it or arrange follow-up tests, including the required venous blood gas measurement that helps monitor phosphate levels and assess the drug’s effectiveness. The ruling explicitly prohibits the insurer from creating administrative hurdles that disrupt continuous care, especially for children with rare diseases who rely on specialized interventions.

The case highlights ongoing challenges in Colombia’s healthcare system, where rare-disease patients often face gaps in coverage despite court orders. While the judgment applies specifically to this child, it sets a precedent for how insurers must handle similar cases in the future. Earlier rulings have similarly compelled insurers to honor court orders for rare-disease therapies, signaling to other health entities that administrative delays will be scrutinized by the judiciary. Families of children with rare disorders often rely on judicial intervention to obtain life-saving medicines, and this decision may shape future legal strategies aimed at securing timely access.