Medical aid bullying tactics put pharmacies at risk

The Independent Community Pharmacy Association (ICPA) said local pharmacies are under imminent threat of closure due to increasing pressure from medical aid schemes on members to transfer their prescriptions from local dispensers to corporate and courier pharmacies.

Cape Times, 18 March 2016

Yesterday, the ICPA called on the Department of Health and the Council for Medical Schemes (CMS) to investigate how medical schemes appoint designated service providers (DSPs). ICPA chairperson Mogologolo Phasha said the squeeze is on privately owned pharmacies. Closed DSPs limit the patient's choice and imposes large penalty co-payments on the consumer even if the pharmacy charges the same rate as that of the DSP. Phasha said one of the main reasons why community pharmacies were under threat is due to "closed DSPs" where medical aid schemes designate service providers and often exclude independent community pharmacies from these arrangements.

He said that while co-payments may be necessary to ensure rational drug use, which protects schemes from paying for inappropriate medicines, the ICPA challenges the penalty co-payment that is imposed to use pharmacies outside the DSP arrangements. Phasha said it is important to recognise that it is not the independent pharmacy charging the medical scheme or patient more, but the medical scheme charging a penalty co-payment. He said local pharmacies are under threat of closure countrywide and many have been left in a position where they are unable to continue operating as viable businesses. Phasha said 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. Health department spokesperson Joe Maila said the ICPA should direct its call for an investigation to the CMS.