Discount pharmacy chain Dis-Chem was hurriedly altering its pricing system on Tuesday after it was found that Discovery Health medical aid members were charged more for their medicines than other customers.
Dis-Chem is one of a number of pharmacies, along with Clicks, Pick ‘n Pay and Shoprite’s MediRite, who have pledged to abide by the government’s disputed 26% or R26 cap on dispensing fees. This is displayed prominently in their stores.
To stretch their annual benefits, many consumers now use discount pharmacies over community pharmacists who are charging higher fees.
Dis-Chem has been commended by the Department of Health for abiding by its regulations.
Taking up the Department of Health’s challenge to consumers to shop around for the best medicine prices, Sapa discovered that due to the way medical aid claims are processed, Discovery Health members are paying more for their medicine than anybody else at Dis-Chem.
The differences were minor on smaller items, but added up on more expensive medication. Fosamax, the osteoporosis medication, cost R331,92 cash on other medical aids, but cost Discovery Health members R361,68.
Asked for comment on Monday, Dis-Chem’s Niall Hegarty said that although his company wants to offer the best prices, it deals with clearing houses that facilitate the payments electronically and apply the medical aids’ own fee structures.
In such cases, the system used by Discovery was allowing the higher amount to be processed.
According to Discovery’s website, it has agreed to pay the manufacturer’s set price plus the lower mark-up of 36% or R59,40 including VAT, to close the co-payment gap at smaller pharmacies who are charging higher fees.
A community pharmacist who uses the Managed Healthcare Systems-proposed rate charges R393,62 for Fosamax, leaving the medical aid member to cover the difference.
However, when the Discovery formula is applied at discount pharmacies, the final claimable amount is higher than the discount pharmacy’s own set price.
”Who am I to turn down extra money?” Hegarty said, explaining that although the company has settled on the government-recommended maximum R26/26% dispensing fee, it is not enough and was not something it can continue indefinitely.
Spokespersons for the Clicks and Pick ‘n Pay pharmacies said they disregard the higher claimable amount and keep to their lower in-store pricing policy.
”We chose not to claim more than the ’26’, so when I submit a claim to Discovery I even get a message back thanking me for charging the lower price,” quipped Hippo Zourides, Pick ‘n Pay’s national pharmacy coordinator.
”This helps extend the benefits of medical members.”
An angry Discovery Health managing director Barry Swartzberg said he found it ”completely unacceptable”.
”They can’t discriminate against certain members to pay more. We are going to take it up with them.”
He said that his company had introduced the new fee structure to make sure its members were not compromised.
However, by Tuesday morning Dis-Chem said it would no longer charge its members the higher fees and had instructed all its stores to have their computers programmed to reflect this by Wednesday.
”We want to keep Discovery members happy and don’t want to be the bad boys on the block,” he said.
Shoprite did not reply to questions on its pricing policy at its MediRite stores. – Sapa