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19 May 2004 Angelo Coppola

What do new drug pricing regulations mean for medical scheme members?

The Government's regulations on drug pricing has caused much confusion and no little concern among medical scheme members.

"But medical scheme members should not panic about the new regulations," reassures Heidi Kruger, spokesperson at the Board of Healthcare Funders (BHF)

"We have issued guidelines to member schemes to ensure that until such time as the Single Exit Price has been finalised, medical scheme members should not be paying more for pharmaceuticals."

The Single Exit Price is the actual price of drugs leaving the manufacturer, without discounts, rebates or mark-ups. This price has not yet been finalised.

These prices will be worked out on a company-by-company and product-by-product basis.

According to Kruger, the BHF has urged its member schemes not to pass the potential temporary increases in pharmaceutical prices on to their members since once the Single Exit Price is implemented, it is envisaged that the temporary expenditure will be offset against savings which will occur.

"We recognise that this is an interim arrangement which will last only for a few weeks until the Single Exit Price comes into force," she continued. "Then the mark-up approach will become redundant and the dispensing fee system will become effective."

The BHF is urging its member schemes to negotiate new contracts with service providers so that members of medical schemes are not liable for co-payments.

Quick Polls

QUESTION

There are countless articles written about South Africa’s poor retirement outcomes. Which of the following would you single out as the biggest contributor to local savers not accumulating enough to buy an adequate and sustainable pension?

ANSWER

Lack of personal accountability
Poor participation in formal retirement funds
Reluctance to seek financial advice early on
SA’s high unemployment rate
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