The Department of Health hit out on Wednesday at pharmacies charging medical schemes an across-the-board administration fee rather than billing them for services actually rendered.
Some pharmacies charge a fee of 10% upwards of the cost of medicines prescribed, departmental spokesperson Sibani Mngadi said.
While the practice is not outlawed, it amounts to ”unethical business conduct”, he added.
The exact scale of the problem is not known, but an average of about R10 per drug prescribed is being charged, Mngadi said.
In a statement, the department said it is reasonable for pharmacists to charge for administrative services such as telephone calls, photocopies and deliveries.
But these charges have to be properly substantiated in claims lodged with medical schemes and cannot be recovered by means of a general fee.
Mngadi said medical schemes and administrators are not obliged to honour claims for general administration fees charged by pharmacists.
”If schemes are to consider paying for these services, then these services should be itemised and the cost of each item should be clearly stated,” the department said.
”The administration fee cannot be a percentage of the price of a medicine since the price of a medicine is unrelated to the cost of a photocopy or a telephone call.”
According to Mngadi, the practice appears to be a form of retaliation by pharmacists unhappy with the government’s new medicine-pricing regulations.
”It is an effort to undermine government efforts to boost access to affordable and safe medicines,” he said.
Pharmacies began the changes when an application by New Clicks Holdings, the Pharmaceutical Society of South Africa and six other parties to overturn the regulations failed in the Cape High Court on August 27.
In terms of the regulations, pharmacists are now allowed to charge a maximum 16% mark-up on over-the-counter drugs and 26% (to a maximum of R26) on prescription drugs.
Pharmacies claim this is not enough for them to survive. — Sapa