/ 28 May 2004

More challenges to new drug laws

Seven pharmacy and health-care groups launched a joint court challenge against controversial new medicine regulations in the Cape High Court on Friday, their legal firm confirmed.

This brings to at least nine the number of legal challenges against the Medicines and Related Substance Act, which came into force on May 2.

The Pharmaceutical Society of South Africa (PSSA), the United South African Pharmacies (USAP), the Chronic Medicines Dispensary (CMD), Pharmacross, MediCross, Netcare and IM Davis (the Netcare in-hospital pharmacies) filed a joint action in the Cape High Court to have the regulations suspended, Webber Wentzel Bowens partner Martin Versveld said.

Versveld said the application challenges the lawfulness of the recommendations of the pricing committee to Minister of Health Manto Tshabalala-Msimang.

The applicants have said on previous occasions that while they support the government’s attempts to reduce the price of medicines, they were not properly consulted and their recommendations on dispensing fees not heeded.

They said current dispensing fees will not cover their running costs and will lead to closures and job losses.

”It [court action] really is a last resort,” Netcare chief executive Jack Shevel said.

Shevel said the group, which owns 62 hospitals containing pharmacies that it has to keep by law, joined the action mainly because its pharmacy group Medicross, which has more than 90 centres countrywide, will be adversely affected.

The Chronic Medicines Dispensary, a group that couriers chronic medication to the very ill and to pensioners, said it has joined the action because it does not have a ”front shop” to sell other products to make up for the lower dispensing fee.

New Clicks Holdings, which owns the Clicks stores and which bought 80 franchise pharmacies and hopes to have 40 opened by the end of the year, filed a similar challenge on Monday and is awaiting a court date.

All say their concerns about what they consider to be too low a dispensing fee were not adequately addressed by Tshabalala-Msimang and they want the regulations suspended until they have resolved the matter.

The National Convention on Dispensing (NCD) will also go to court — next Monday and Tuesday — where it hopes the Pretoria High Court will give it permission to go to the Constitutional Court for a ruling on whether dispensing doctors have to reapply for their licences.

However, Wednesday is the end of the deadline extension for the doctors to apply for their licences. After that it will be illegal for them to dispense medicine, unless in an emergency.

Although doctors have had more than a year to obtain the licence, the Department of Health has issued a number of pleas to get doctors to complete the required course and apply for the new licences. It has warned doctors it will not be able to cope with the deluge of late applications.

Departmental spokesperson Joanne Collinge said between 400 to 500 licences have been issued.

Many do not believe it is necessary to reapply for something they were given when they qualified as doctors and health-care workers.

NCD spokesperson Norman Mabasa said that due to the low number of applications there is a concern that medical aids will not cover the cost of patients’ medication unless their doctor has a dispensing licence.

Medscheme director Gary Taylor said the company will be in breach of the law after June 2 if it pays doctors who do not have a dispensing licence, but because it does not have the software to differentiate and because applications are trickling in and it could not get a list of who has registered thus far, it will honour claims in the meantime.

It will also wait for direction for the Board of Health-Care Funders and the Health Professions Council of South Africa on a new practice number and registration system for health-care workers, which will indicate a dispensing licence.

The National Association of Pharmaceutical Wholesalers said it is monitoring the current developments. The association said it feels vulnerable because the law only calls for a ”logistics” fee for wholesalers but does not say what it should be.

In terms of the regulations, from August manufacturers and pharmacists may only charge a single exit price for medication, approved by the government.

The Democratic Alliance threw its weight behind the pharmacists and doctors, urging the Department of Health to put the regulations on hold pending further consultations.

DA health spokesperson Ryan Coetzee said that while the party supports the objective of bringing down the cost of medicines it believs further discussions are needed and that not enough time was spent on consultation.

He said that the ad hoc committee on health in Parliament has agreed to invite the Department of Health to a full discussion on the issue of drug pricing.

Meanwhile, in a statement from the PSSA, Soweto pharmacy owner Thembi Khoza said: ”I cannot afford to employ staff, I cannot pay rent or services, I cannot stock my shelves, I simply cannot continue to keep my doors open for much longer.

”If the implementation of the pricing regulations goes ahead, it is the end of Crossroads Pharmacy, and we will all suffer badly.”

The seven associations’ joint challenge returns to court on Tuesday.

Collinge said the department will defend the action. — Sapa