Category Healthcare
SUB CATEGORIES General  |  HIV |  Medical Schemes | 

Discovery Health enhances drug funding as Dept of Health ups prices

01 November 2006 Beachhead Media & Investor Relations

*  Schering-Plough reduces cost of biological arthritis drug with 17.5% following discussions with Discovery Health
*  Helps to extend cost-effective access to top quality care for more South Africans
The Discovery Health Medical Scheme, South Africa's largest medical aid scheme that covers close on two million lives will, from the 1st of November 2006, be able to enhance its funding of Revellex for its members suffering from acute rheumatoid arthritis, other rheumatologic conditions and Crohn's disease.

This is against the backdrop of today's announcement that the Department of Health has raised the single exit price for drugs in SA by 5%.

Revellex is a biological drug manufactured by Schering-Plough and used mainly to ease the symptoms and stop the progression of rheumatoid arthritis, a disabling and painful inflammatory condition, which can lead to substantial loss of mobility due to pain and joint destruction.

Discovery Health's Chief Executive Officer, Neville Koopowitz, says Discovery has been funding Revellex on an interim basis, based on its new specialty medicine benefit, which will be implemented in 2007. This provides funding up to a maximum of 80% of the cost of the drug and up to an annual limit of R100 000. Members were responsible for the balance.

"Following extensive discussions between Discovery and the manufacturer, Schering-Plough has reduced the cost of Revellex by 17.5% from the 1st of November 2006 and initiated a waste management programme to reduce the cost of treatment. This has enabled us to drop the requirement that members pay for 20% of the cost of the drug for all Revellex treatments.

"This is just one of the advantages of transparent benefit design and is great news for the health industry in South Africa."

Koopowitz says that the further funding Revellex is part of pilot programme that will run until August 2007 to allow the scheme to fully evaluate the benefits of the waste management programme.

"The price of Revellex will stay the same until the end of 2007.

"The cost of using the drug could prove to be another 10% cheaper in addition to the 17.5% headline saving, as Schering-Plough has introduced a system whereby patients' treatments are clustered so that less of the drug goes to waste."

Ashly Pearce, CEO of pharmaceutical company, Schering-Plough, said that the whole of the South African market will benefit from the lower cost of Revellex, not just Discovery Health members.

"We have also set up infusion centres throughout SA to ensure that the drug is used in the most cost-effective manner."

Koopowitz notes that the Revellex is not automatically available for all arthritis sufferers and that each case will undergo a process of approval.

"Each rheumatism and arthritis case will be reviewed for appropriateness by a panel of specialists who have been appointed by SARAA (South African Rheumatism and Arthritis Association) before an independent funding decision is recommended. 

Revellex treatment typically costs around R9 000 per month.

Rheumatoid arthritis is a Prescribed Minimum Benefit (PMB) condition and is therefore covered as a chronic condition on all Discovery Health Medical Scheme plans.

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