presentation to portfolio committee on health pricing regulations presented by: amos masango, acting...

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PRESENTATION TO PORTFOLIO COMMITTEE ON HEALTH PRICING REGULATIONS Presented by: Amos Masango, Acting Registrar South African Pharmacy Council 16 November 2004

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Page 1: PRESENTATION TO PORTFOLIO COMMITTEE ON HEALTH PRICING REGULATIONS Presented by: Amos Masango, Acting Registrar South African Pharmacy Council 16 November

PRESENTATION TO PORTFOLIO COMMITTEE ON HEALTH

PRICING REGULATIONS

Presented by:

Amos Masango,Acting Registrar

South African Pharmacy Council

16 November 2004

PRESENTATION TO PORTFOLIO COMMITTEE ON HEALTH

PRICING REGULATIONS

Presented by:

Amos Masango,Acting Registrar

South African Pharmacy Council

16 November 2004

Page 2: PRESENTATION TO PORTFOLIO COMMITTEE ON HEALTH PRICING REGULATIONS Presented by: Amos Masango, Acting Registrar South African Pharmacy Council 16 November

OVERVIEW OF POLICIES AND OVERVIEW OF POLICIES AND LEGISLATIONLEGISLATION

OVERVIEW OF POLICIES AND OVERVIEW OF POLICIES AND LEGISLATIONLEGISLATION

White Paper on the Transformation of the Health Care System (1997)

National Drug Policy (1996) Legislative changes

Pharmacy Act 53 of 1974 amended in 1997 and 2000 Health Professions Act 56 of 1974 amended in 1997 Nursing Bill 2003

White Paper on the Transformation of the Health Care System (1997)

National Drug Policy (1996) Legislative changes

Pharmacy Act 53 of 1974 amended in 1997 and 2000 Health Professions Act 56 of 1974 amended in 1997 Nursing Bill 2003

Page 3: PRESENTATION TO PORTFOLIO COMMITTEE ON HEALTH PRICING REGULATIONS Presented by: Amos Masango, Acting Registrar South African Pharmacy Council 16 November

OVERVIEW OF POLICIES AND OVERVIEW OF POLICIES AND LEGISLATIONLEGISLATION

OVERVIEW OF POLICIES AND OVERVIEW OF POLICIES AND LEGISLATIONLEGISLATION

Medicines and Related Substances Act 101 of 1965 amended by Act 90 of 1997 and Act 59 of 2002

National Health Act 61 of 2003 Medical Schemes Act, 1998 – preferred provider arrangements

Other important national and provincial policies

Norms and standards for pharmaceutical services District hospital service package Comprehensive PHC service package Plan for comprehensive treatment of HIV and AIDS Proposals for Social Health Insurance Hospital Revitalisation Programme

Medicines and Related Substances Act 101 of 1965 amended by Act 90 of 1997 and Act 59 of 2002

National Health Act 61 of 2003 Medical Schemes Act, 1998 – preferred provider arrangements

Other important national and provincial policies

Norms and standards for pharmaceutical services District hospital service package Comprehensive PHC service package Plan for comprehensive treatment of HIV and AIDS Proposals for Social Health Insurance Hospital Revitalisation Programme

Page 4: PRESENTATION TO PORTFOLIO COMMITTEE ON HEALTH PRICING REGULATIONS Presented by: Amos Masango, Acting Registrar South African Pharmacy Council 16 November

NATIONAL DRUG POLICYNATIONAL DRUG POLICY

Specific Objectives

Health objectives

to ensure the availability & accessibility of essential drugs to all citizens

to ensure good dispensing & prescribing practices

Specific Objectives

Health objectives

to ensure the availability & accessibility of essential drugs to all citizens

to ensure good dispensing & prescribing practices

Page 5: PRESENTATION TO PORTFOLIO COMMITTEE ON HEALTH PRICING REGULATIONS Presented by: Amos Masango, Acting Registrar South African Pharmacy Council 16 November

NATIONAL DRUG POLICYNATIONAL DRUG POLICY

Specific Objectives

Economic objectives

to lower the cost of drugs in both the private and public sectors

to promote cost-effective & rational drug use

Specific Objectives

Economic objectives

to lower the cost of drugs in both the private and public sectors

to promote cost-effective & rational drug use

Page 6: PRESENTATION TO PORTFOLIO COMMITTEE ON HEALTH PRICING REGULATIONS Presented by: Amos Masango, Acting Registrar South African Pharmacy Council 16 November

PRICING REGULATIONSPRICING REGULATIONS

PatientPatient

DepartmentOf Health

DepartmentOf Health

South African Pharmacy

Council

South African Pharmacy

Council

PharmacistPharmacist

MedicineMedicine

Rules - Section 35APharmacy Act,

1974

Pricing RegulationsMedicine Act,

1965

Page 7: PRESENTATION TO PORTFOLIO COMMITTEE ON HEALTH PRICING REGULATIONS Presented by: Amos Masango, Acting Registrar South African Pharmacy Council 16 November

PRICING REGULATIONSPRICING REGULATIONS

Transparency

Affordability

Accessibility

Transparency

Affordability

Accessibility

Page 8: PRESENTATION TO PORTFOLIO COMMITTEE ON HEALTH PRICING REGULATIONS Presented by: Amos Masango, Acting Registrar South African Pharmacy Council 16 November

To give guidance to the profession To give guidance to the public To give guidance to medical schemes

as to which services a pharmacist may levy for

Uniformity

To give guidance to the profession To give guidance to the public To give guidance to medical schemes

as to which services a pharmacist may levy for

Uniformity

INTENTION OF SAPC WITH REGARD TO PROFESSIONAL TARIFFS

INTENTION OF SAPC WITH REGARD TO PROFESSIONAL TARIFFS

Page 9: PRESENTATION TO PORTFOLIO COMMITTEE ON HEALTH PRICING REGULATIONS Presented by: Amos Masango, Acting Registrar South African Pharmacy Council 16 November

PRICING OF MEDICINE PRIOR TO MAY 2004

PRICING OF MEDICINE PRIOR TO MAY 2004

Cost of product plus 50% markup 50% included profit plus services Pharmacists were buying at discount or bonus

prices 50% plus bonuses included the so-called free

service

Cost of product plus 50% markup 50% included profit plus services Pharmacists were buying at discount or bonus

prices 50% plus bonuses included the so-called free

service

Page 10: PRESENTATION TO PORTFOLIO COMMITTEE ON HEALTH PRICING REGULATIONS Presented by: Amos Masango, Acting Registrar South African Pharmacy Council 16 November

POST MAY 2004POST MAY 2004

Pricing regulations come into effect Pharmacists were given three months to

implement the dispensing fee, i.e. 26/26 or 16/16 Medicines prices went down No discount or bonus on the product for

pharmacist or patient Pharmacists were charging SEP plus 36% on 2 August 2004 after the Court ruling the

Pricing regulations come into effect for community sector

Pricing regulations come into effect Pharmacists were given three months to

implement the dispensing fee, i.e. 26/26 or 16/16 Medicines prices went down No discount or bonus on the product for

pharmacist or patient Pharmacists were charging SEP plus 36% on 2 August 2004 after the Court ruling the

Pricing regulations come into effect for community sector

Page 11: PRESENTATION TO PORTFOLIO COMMITTEE ON HEALTH PRICING REGULATIONS Presented by: Amos Masango, Acting Registrar South African Pharmacy Council 16 November

POST AUGUST 2004POST AUGUST 2004 SEP plus 26/26 or 16/16 dispensing fees Admin fees come into effect as a result of implementation of the

dispensing fees The admin fees seem to be arbitrary and excessive in some

instances Outcry from both the profession and the public Patients feel they pay more than they used to pay before pricing

regulations Pharmacists feel there is no viability for the community sector PSSA and other groups apply for leave to appeal to the High

Court Judgement on the matter reserved

SEP plus 26/26 or 16/16 dispensing fees Admin fees come into effect as a result of implementation of the

dispensing fees The admin fees seem to be arbitrary and excessive in some

instances Outcry from both the profession and the public Patients feel they pay more than they used to pay before pricing

regulations Pharmacists feel there is no viability for the community sector PSSA and other groups apply for leave to appeal to the High

Court Judgement on the matter reserved

Page 12: PRESENTATION TO PORTFOLIO COMMITTEE ON HEALTH PRICING REGULATIONS Presented by: Amos Masango, Acting Registrar South African Pharmacy Council 16 November

15 OCTOBER 200415 OCTOBER 2004

On 13 October 2004 Council resolves that the Rules be published as matter extreme urgency

Council was responding to its mandate to protect the public and giving guidance to the profession

Council’s intention was to apply uniformity so that the public may know exactly what they are paying for when entering a community pharmacy

Council embarked on a process of consulting with all stakeholders involved in the Court case with an aim to mediate on the dispensing fees

On 13 October 2004 Council resolves that the Rules be published as matter extreme urgency

Council was responding to its mandate to protect the public and giving guidance to the profession

Council’s intention was to apply uniformity so that the public may know exactly what they are paying for when entering a community pharmacy

Council embarked on a process of consulting with all stakeholders involved in the Court case with an aim to mediate on the dispensing fees

Page 13: PRESENTATION TO PORTFOLIO COMMITTEE ON HEALTH PRICING REGULATIONS Presented by: Amos Masango, Acting Registrar South African Pharmacy Council 16 November

25 OCTOBER 200425 OCTOBER 2004

Council resolves that the rules be withdrawn with immediate effect as a result of an implementation problem

Task Team is elected to review Rules and tie up loose ends The office of the Registrar is receiving complaints on the charging

of admin fees The profession is advised to itemise all fees that are levied to

patients and fully explain to patients what the fees are for On 8 November 2004 the first meeting between the PSSA and

New Clicks group takes place The dates for the meeting with other stakeholders are set

Council resolves that the rules be withdrawn with immediate effect as a result of an implementation problem

Task Team is elected to review Rules and tie up loose ends The office of the Registrar is receiving complaints on the charging

of admin fees The profession is advised to itemise all fees that are levied to

patients and fully explain to patients what the fees are for On 8 November 2004 the first meeting between the PSSA and

New Clicks group takes place The dates for the meeting with other stakeholders are set

Page 14: PRESENTATION TO PORTFOLIO COMMITTEE ON HEALTH PRICING REGULATIONS Presented by: Amos Masango, Acting Registrar South African Pharmacy Council 16 November

WHO IS BENEFITING FROM THE IMPLEMENTATION

OF THE PRICING REGULATIONS? WHO IS BENEFITING FROM THE IMPLEMENTATION

OF THE PRICING REGULATIONS?

Medical Schemes? Manufacturers? Patients? Distributors/Wholesalers? Pharmacists? Doctors?

Medical Schemes? Manufacturers? Patients? Distributors/Wholesalers? Pharmacists? Doctors?

Page 15: PRESENTATION TO PORTFOLIO COMMITTEE ON HEALTH PRICING REGULATIONS Presented by: Amos Masango, Acting Registrar South African Pharmacy Council 16 November

WAY FORWARDWAY FORWARD

SAPC to re-publish the Rules

SAPC to mediate on the dispute regarding the dispensing fee

SAPC to re-publish the Rules

SAPC to mediate on the dispute regarding the dispensing fee