Tamar Kahn
14 January 2009
Cape Town — With the threat of yet another bruising court case looming large, the health department now looks set to negotiate in earnest with doctors intent on securing an increase in the fees they may charge for dispensing medicines.
The National Convention on Dispensing (NCD), which represents the interests of doctors who provide medicines to their patients, launched legal action against the department late last year after their efforts to get officials to review their fees stalled. The fees were introduced in April 2004 as regulations to the Medicines Act, and stipulated that doctors could charge no more than 16% for prescription medicines.
The NCD has previously told Business Day that the fees are insufficient to cover costs, and have led to a significant decline in the number of doctors who dispense medicines to their patients, compromising the quality of care they can provide. Most dispensing doctors serve communities in rural areas or townships.
Last week the health department said it planned to oppose the NCD's bid to get the Pretoria High Court to scrap the dispensing fee regulations, but on Monday afternoon Health Minister Barbara Hogan, her deputy, Molefi Sefularo, and the health department's head of pharmaceutical and economic planning, Anban Pillay, met representatives from the NCD to discuss the possibility of settling out of court.
The NCD had now agreed to give the department a four-week extension on Monday's deadline for filing a response to its founding affidavit, during which time the parties would try to reach an interim agreement on a new dispensing fee for doctors, said NCD committee member Lex Visser.
Visser said two models were under discussion -- one based on a flat rate per prescription, the other based on an itemised and tiered pricing structure.
If the NCD and the health department reached an agreement, it would be considered an interim model, as the department intended to carry out its own costing study of the sector, said Visser.
The department rejected an earlier study commissioned by the NCD, which suggested doctors should be able to charge up to 40% of the cost of the medicines they dispensed.
"The m inister is confident that, given the outcome of the meeting, a satisfactory result to the dispute will be possible without adversarial litigation, or having to seek redress from the courts at this stage," said health department spokesman Fidel Hadebe .
"The m inister has therefore undertaken to ensure that all steps are taken to address the issue of the appropriateness of the dispensing fee for all those entitled to dispense medicines in SA, including the dispensing doctors, in a timeous and transparent manner," he said.
The health department has trod a conflict-ridden path in its efforts to regulate medicine sales in the private sector. Two of its battles went all the way to the Constitutional Court, which separately upheld the rights of doctors to dispense medicines to their patients.
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