Concerned about what they view as a potential threat to the continued existence of independently owned, community-based pharmacies, the Independent Community Pharmacy Association (ICPA) has this week distributed a petition to call on the National Department of Health to look into “the bullying tactics of medical aid schemes”.
The hard copies of the petition are being distributed in conjunction with an online petition the organisation launched at a media briefing last month.
Through the petition, the organisation is calling on the minister of health, the Council for Medical Schemes and the Registrar of Medical Schemes to “stop medical scheme network practices that threaten independent community pharmacies and patient care countrywide”.
Expanding on these practices at the media briefing, Mogologolo Phasha, chairman of the organisation, said: “Independent community pharmacies are under imminent threat of closure countrywide due to changes in the dispensing fees structures and increasing pressure from medical aid schemes on members to transfer their prescriptions from independent community pharmacies to corporate and courier pharmacies, which has left many of these community pharmacies in a position where they are unable to continue operating as viable businesses.”
Mr Phasha added: “One of the main reasons community pharmacies are under threat, is closed DSPs (Designated Service Provider’s). Through this, medical aid schemes decide who your service provider is and often exclude independent community pharmacies from these arrangements. Closed DSPs limit the patients’ choice and imposes large penalty co-payments on the consumer – even if the pharmacy charges the same rate as that of the DSP. We are calling on the minister of health and the registrar of Council for Medical Schemes to investigate how medical schemes appoint their DSPs.”
Mr Phasha added that, in addition to a lack of access to medicines, the closure of independent community pharmacies would result in widespread job losses as the sector is responsible for the creation of more than 20 000 jobs, most of which are within the communities they are located in.
“Medical schemes’ bully tactics force patients to go to specific corporate pharmacies or use courier services. This practice negatively impacts the independent pharmacy which contributes to a downfall of an essential community pharmacy service. It ultimately denies the patient choice,” said Mr Phasha, adding: “I believe this practice is unfair to both the consumer and the independent community pharmacies.”
Neville van der Heijden, co-owner of Strand Street’s LiteKem pharmacy, said the use of closed DSPs by medical aid schemes has had a negative impact on the 60-year-old pharmacy.
“It has definitely affected our bottom line, he says, adding: “It’s hard to quantify, but we do also see the level of care dropping, with patients using courier services to have chronic medication delivered. Some come in here saying they haven’t received their medication and, as a result, have to buy little bits to cover that lag time.”
Graeme Sarembock, owner of Olsens Pharmacy in Long Street, which employs eight people, added: “I can’t fight against the big corporates, so it is difficult.”
Pointing out the curios he also has on sale in the pharmacy, Mr Sarembock said: “Have to sell this. Otherwise I would end up with all the other pharmacies that have closed.”
Mr Sarembock added: “I have lost quite a lot of PolMed clients, because PolMed members have to go to one of the larger retail chains for their chronic medication. If they come to me for their medication, they will have to pay a 30% co-payment. But when they go there, they pay none. It’s unfair.”
Mr Phasha added: “If 200 independent community pharmacies shut shop South Africans will have to reach the superstores to get their medicines. In a country where many people do not have access to transport or the funds to pay for such transport to get them to major centres, this is an unrealistic expectation and will mean many people in outlying and rural areas will be left without options and without medicines.”
Mr Phasha added: “Given the current problems associated with the already overburdened state health facilities, independent community pharmacies will continue to play an important role in the South African healthcare system going forward. However, in the face of these external pressures community pharmacies face their ultimate demise, unless things change soon. Medical aid schemes are quick to justify the savings for members and medical schemes, but at what long term cost to the South African healthcare system?”
Said Mr Van Der Heijden: “We need a level playing field. The problem is where does this stop? In the race for profit, how do you balance actual quality healthcare.”
* Requests for comments from both Medscheme and the National Department of Health proved unsuccessful.