[e-med] Les pharmaciens sud africains perdent la bataille/prix MEG

[Philippe Longhe <Philippe.Longhe@tigerbrands.com>]

E-MED: Les pharmaciens sud africains perdent la bataille/prix MEG
---------------------------------------------------------------------

PRIX DU MEDICAMENT EN AFRIQUE DU SUD - LES PHARMACIENS SUD AFRICAINS PERDENT
LA BATAILLE DEVANT LA DAME FORTE DU DEPARTEMENT DE SANTE

Chers E-mediens,

Me référent à l'information que j'avais donnée l'autre fois sur: "La vente
du médicament en Afrique du Sud ne sera plus désormais une activité
commerciale mais plutot un service que le Pharmacien doit rendre aux malades
! ! !...", conséquence de la nouvelle loi sur le prix du médicament"SEP:
Single Exit Price" on medicine en Afrique du Sud.

Les Pharmaciens viennent de perdre la bataille au tribunal et on estime que
plus de la moitié de Phamecie d'officine peuvent fermer d'ici la fin de
l'année.

Lire ci-bas, le resumé (en Anglais) sur le deroulement des évenements...

Best regards

Philippe S Longhe
Regulatory Affairs Pharmacist
Adcock Ingram Limited
Tel: +27 11 709 9375
Fax: +27 11 709 9339
Portable: +27 72 532 5541
e-mail: philippe.longhe@tigerbrands.com



-----Original Message-----
From: Andy Gray [mailto:Graya1@ukzn.ac.za]
Sent: Tuesday, September 21, 2004 11:46
To: Drug Information & Policy
Subject: [druginfo] Pricing - a summary


Hi all

Here's a thought-provoking summary of the pricing saga, from BusRep (as
"fair use").

regards
Andy
~~~
http://www.busrep.co.za/index.php?fSectionId=&fArticleId=2230866
Health minister's bitter pills provoke grimaces of distaste from all
quarters
September 20, 2004
By Neesa Moodley

Durban - The pharmaceutical industry brings to mind a playground of spoilt
children, all shouting "What about me?" with scant or no attention to the
interest of others.

Every link in the pharmaceutical supply chain has found a bone of contention
in the pricing regulations adopted by health minister Manto
Tshabalala-Msimang.

The health department says players should change their business models to
fall in line with the new modus operandi.

But with an industry as complex and crucial as healthcare perhaps a little
more care should be taken to consider each player and its concerns -
provided each player is prepared to be accommodating.

The draft regulations were released in January and included a 50 percent
reduction in prices from manufacturers.

According to Andy Gray, a senior lecturer of pharmacology at the University
of KwaZulu-Natal's Nelson Mandela School of Medicine, the 50 percent blanket
reduction for manufacturers would have resulted in a reduction of between 40
percent and 70 percent for the consumer.

"This has now been reduced to a 15 percent to 30 percent reduction," he
said.

According to the Pharmaceutical Manufacturers' Association of South Africa
(PMA), which represents research-based drug manufacturers or their local
subsidiaries, multinationals are the primary source of new medicines and
contribute about R12 billion to the economy, with about 9 000 employees.

Vicki Ehrich, the chief operating officer of the PMA, said legislation had
previously been passed in the form of section 18A of the Medicines and
Related Substances Amendment Act, which discontinued discounts, bonuses and
rebates for manufacturers.

"The accrued savings from a lack of discounts was to be passed to the
consumer, and was initially set at 50 percent," Ehrich said.

However, manufacturers were able to provide the department of health with
research showing that the average discount was 15 percent, with some as low
as 1 percent and the majority between 10 percent and 20 percent.

Manufacturers recommended a net pricing system using an audited
company-by-company, product-by-product system, which has been included in
the new regulations.

Section 22G, which stipulates the single exit price and professional
dispensing fee, and section 18A have proved to be of great concern to the
various industry players.

The removal of all discounts, bonuses and rebates under section 18A was
effective almost immediately on May 2. The other changes were to be phased
in.

A representation was then made to the health department by the
Pharmaceutical Society of SA (PSSA) protesting against the stipulated
dispensing fees of 16 percent capped at R16 for over-the counter medicines
and 26 percent capped at R26 for schedule 1 to 6, or prescription,
medicines.

More than 400 staff and students from Wits University's medical school
marched to the Gauteng health ministry offices in Johannesburg on May 21 to
protest against the new dispensing fees, and presented a memorandum with
their concerns to the provincial health ministry.

After Managed Healthcare Systems completed a study on behalf of the PSSA,
the society announced on May 27 that more than 1 000 retail pharmacies would
close down if the regulations went ahead, and that more 21 000 jobs would be
lost.

On May 31 and June 1 the National Convention for Dispensing took the health
department to court to oppose the implementation of a law requiring all
doctors to apply for licences if they wanted to dispense drugs.

The doctors lost the case and at the end of August the health department
reported that it had received 7 744 applications from doctors for dispensing
licences and 3 202 applications had been approved.

The rest could not be processed as the applicants had not completed the
necessary dispensing course.

Pharmaceutical manufacturers were obliged to start implementing the single
exit price on June 2. Manufacturers had to supply a pricing schedule to the
health department using a weighted average of their 2003 prices, including a
logistics fee for wholesalers and distributors.

In the same week the PSSA, Netcare, United SA Pharmacies and several other
groups brought an action against the health department to overturn the
medicine pricing regulations. New Clicks instituted a separate legal action
and a decision was taken by the courts to treat the two cases as
one.

The National Association of Pharmaceutical Wholesalers was also considering
legal action at the time, but opted to negotiate a distribution or logistics
fee with manufacturers instead.

On June 15 the PSSA presented a petition to parliament in Cape Town with
more than 35 000 customer signatures supporting their position against the
pricing regulations.

The Cape high court passed a deferred judgment on June 18 to the effect that
all drug wholesalers, retailers and distributors would be exempt from the
pricing regulations until the court had pronounced on the Netcare-PSSA-New
Clicks action against the government.

At the end of June Dis-Chem Pharmacies became the first chain in the country
to implement the pricing regulations. However, Dis-Chem has a wholesalers
licence, which allows the group access to negotiate a logistics fee with
manufacturers.

Dissension between manufacturers and wholesalers over the negotiated
logistics fees, which range from 4 percent to an alleged 50 percent, has led
the health department to reveal that the minister will cap the logistics fee
before the end of the year.

Towards the end of June the National Convention on Dispensing challenged the
health ministry to reveal the formula used to arrive at the single exit
price. The formula has remained a closely guarded secret.

On June 25 the health department issued a letter to all manufacturers
thanking those who had submitted pricing schedules. It reiterated the need
for manufacturers to submit an audited pricing schedule by August 2.

The department later confirmed to Business Report that several manufacturers
had inflated the single exit price and legal action would be considered if
this continued.

On August 6 a fax was leaked to Business Report showing that Netcare
proposed a two-tier charge to medical aid schemes instead of increasing
ward, theatre and equipment fees.

Three days later media reports claimed that Afrox Healthcare and Medi-Clinic
intended increasing their ward, theatre and equipment fees by between 12
percent and 28 percent.

Both groups denied this, saying their tariff increases would be negotiated
individually with medical aid schemes.

The Board of Healthcare Funders has since elected a sub-committee to
investigate the hospitals' methods of arriving at tariff increases in order
to advise medical aid schemes.

The Netcare-New Clicks-PSSA case went in favour of the health department on
August 26. They are seeking leave to appeal.

In the interim, pharmacists have resorted to charging admin fees for
services such as photocopying and telephone calls.

As the diplomatic half of Jack Nicholson's presidential character asks in
Mars Attacks: "Why can't we all just get along?"

~~~~~~~~~~~~~~~~~~~
Andy Gray MSc(Pharm) FPS
* Senior Lecturer
Dept of Experimental and Clinical Pharmacology
* Study Pharmacist
Centre for the AIDS Programme of Research
in South Africa (CAPRISA)
Nelson R Mandela School of Medicine
University of KwaZulu-Natal
PBag 7 Congella 4013
South Africa
Tel: +27-31-2604334/4298 Fax: +27-31-2604338
email: graya1@ukzn.ac.za or andy@gray.za.net
--------------------------------------------------------------------
Please find our disclaimer at http://www.ukzn.ac.za/disclaimer
--------------------------------------------------------------------
<<<<gwavasig>>>>

---
To send a message to Druginfo, write to: druginfo@healthlink.org.za
To subscribe, write to: lyris@healthlink.org.za leave the subject line free
and in the body of the message type: subscribe followed by your name
and surname Or join online at:
http://lists.healthlink.org.za/cgi-bin/lyris.pl?join=druginfo
To unsubscribe, forward this message to
leave-druginfo-149438X@lists.healthlink.org.za
To visit the list archives go to:
http://lists.healthlink.org.za/cgi-bin/lyris.pl?visit=druginfo
Enquiries and e-mail address changes: listadmin@healthlink.org.za

--
Adresse pour les messages destinés au forum E-MED:
e-med@healthnet.org
Pour répondre à un message envoyer la réponse au forum
ou directement à l'auteur.
Pour vous inscrire, vous désinscrire et consulter les archives de e-med:
http://www.essentialdrugs.org/emed/
Pour toutes autres questions addresser vos messages à:
e-med-help@healthnet.org