/ 9 March 2006

Manto announces new medicine dispensing fees

Savings of between 13% and 15% on medicines are on the cards if the draft regulations for pharmacies’ dispensing fees announced on Thursday are approved.

Health Minister Manto Tshabalala-Msimang announced the draft dispensing fees, which would be on a sliding scale.

Under the draft regulations, where the single exit price of medicine is less than R75, the maximum dispensing fee that may be charged is R7 plus 28% of the price.

Where the single exit price is more than R75, the dispensing fee would be R23 plus 7% of the price.

Where the price is R150 or more — but less than R250 — the fee would be R26 plus 5% of the single exit price.

Where the exit price is more than R250, the fee would be R31 plus 3%.

A final dispensing fee would be announced after comments on the draft had been considered, but Tshabalala-Msimang said it was up to consumers to determine the outcome.

”Do we want to continue paying exorbitant prices for medicine when, actually, a road map has been put in front of us as to how medicines can be made affordable?”

The minister noted that the draft dispensing fee is a reflection of the maximum price, but said a lower fee could be charged at the discretion of the pharmacist or pharmacy owner.

”We are trying to create competition here, too, so that South Africans can go to a pharmacy where they know medicine would not be as costly as at the next door pharmacy,” Tshabala-Msimang said.

Consumers would receive an invoice that reflects separately the single exit price of the medicine and the dispensing fee.

”We want to make it easy for citizens … to be able to calculate that they are not being taken for a ride and if the pharmacies are sticking to the rules and regulations.”

The new draft regulations follow a Constitutional Court decision in October last year, which upheld the government’s medicine-pricing regulation, but ordered a review of the dispensing fee of a maximum of R26 for medicines priced over R100, and 26% for those under R100.

Dr Anban Pillay of the Department of Health said the new fees were meant to cater both for pharmacies and consumers.

”We are trying to find a balance between lowest possible cost to the patient and the pharmacy remaining viable.”

He said the department has sent questionnaires to all 2 532 pharmacies in the country to try and determine the appropriate fee.

”We received only 162 analysable questionnaires back,” he said.

The survey showed that some pharmacies would not be viable no matter what prescription fee was charged.

”Where you have five or more pharmacies in a certain area, there are fewer prescriptions filled. There are only so many prescriptions in areas that could be filled,” he explained.

He said the new regulations would bring down the prices of medicine ”significantly”.

”We took the price of a combination analgesic. In 2003 its cost was R52,30. Under the proposed dispensing fee it now would cost R47,29, and if it [the regulation] was not introduced it would been priced at R57,66,” he said.

The department did a similar analysis of an antibiotic that in 2003 would have cost the consumer R203,11. Under the new regulations it would cost R161,38, and without the regulations R223,93.

Tshabalala-Msimang said it was difficult to gauge what the stakeholders’ response to the draft dispensing fees would be.

”They are not an homogeneous group. There are some who appreciate the imperative for an affordable pricing system in the country, and there are others who are just there to make their money, and that is it,” she said.

She said further comments on the draft regulations could be made for a month after they appeared in the Government Gazette. She could not say exactly when they would be published.

”It is really in our interest to make medicine in this country more affordable,” Tshabalala-Msimang said.

Meanwhile, the draft regulations for dispensing fees were welcomed by Netcare on Thursday.

”We were encouraged by the process of consultation embarked upon by the department in formulating the revised draft regulations,” said Ingrid Davis, executive of Netcare’s pharmacy division.

The group said it would study the details of the proposed regulations and give more comment in due course. — Sapa