Tamar Kahn
16 November 2009
Cape Town — The pharmacy industry has rejected the government's latest proposals for dispensing fees, saying officials have ignored input from the sector and floated a system that will put many of its members out of business.
The Pharmacy Stakeholders Forum (PSF), an umbrella body for SA's retail pharmacy associations, is due to meet the acting director-general for health, Kamy Chetty, today in a bid to resolve the impasse.
On Friday, the PSF flatly rejected the Department of Health's latest proposals released recently. This increases pressure on the department's pricing committee to resolve the long dispute as the health minister has made it clear he does not want another bruising court battle.
Meanwhile, pharmacists continue to set their own rates, leaving consumers to pay different prices for medicines depending on where they shop and how much medical schemes reimburse them -- a far cry from the system the department envisaged for consumers to get detailed information on prices and an assurance that pharmacy mark-ups would not exceed state-determined levels.
Pharmacists challenged the department's first attempt at capping their fees in 2004, precipitating a dispute that has still not been settled three years after the Constitutional Court in 2006 ordered officials to come up with a better deal for pharmacists.
In the latest twist, the department angered pharmacists by publishing a new set of draft Medicines Act regulations that leave fees it proposed in June largely unchanged, and introduces scope for marginal businesses to apply for ministerial exemption if they can prove the levies would make them unviable.
PSF joint co-ordinator Ivan Kotze said the move surprised pharmacists as there was no hint of it at their meeting in August with Health Minister Aaron Motsoaledi and officials. The exemption clause was tantamount to admitting the dispensing fees were unreasonable, he said. "Surely the fee is not appropriate if pharmacists can apply for exemption."
The PSF challenged the June regulations, arguing the pricing committee underestimated pharmacy running costs and set unreasonably low caps on dispensing fees.
The meeting left the PSF convinced its submissions would be taken on board, said Kotze. "We were very optimistic at that stage. We were told there would be significant increases in the fee. Anban (Pillay) said that in the presence of the minister," he told Business Day.
Pillay, who heads the department's pharmaceutical economic planning unit, disagreed. In a text message sent from Australia, he said: "I never stated that the fee will increase significantly in the meeting. I said the proposal had changed significantly -- ie (the) exemption framework and definition of dispensing.
"The new draft is 14% higher than the previous draft fee so it is untrue that the fee is unchanged." (The fees are 14% higher because they now exclude VAT.)
The definition of dispensing has been tightened so pharmacists may charge extra fees for mixing complex medicines, such as those used for cancer.
On Friday, the PSF said it would not rule out court action if the department did not back down.
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