The Independent Community Pharmacy Association (ICPA) has been challenging the practice of closed DSPs for several years as they believe it does not have the interests of the consumer, or pharmacies, at heart.
Now the Council for Medical Schemes (CMS) has published, for comment, their intention to do away with closed DSPs and to re-look at the way co-payments are calculated.
What are closed DSPs?
A DSP (Designated Service Provider) is a healthcare provider network (doctor, pharmacist, hospital etc.) appointed by your medical scheme to diagnose, treat or care for their members.
“However, many medical schemes in South Africa have imposed very restrictive closed DSPs that effectively deprive medical scheme members of choice when it comes to where they can get their medicines from,” explains Jackie Maimin, CEO of the ICPA.
How does it affect us?
“Coupled with the issue of closed DSPs is the fact that if people choose to get their PMB chronic medicines from a non-DSP pharmacy they will be charged a hefty penalty co-payment,” says Maimin.
“While we accept that some co-payments may be necessary, we are challenging how these co-payments are calculated, as we believe the penalties are too high and often patients end up paying as much as 40% – 100% of the total cost of their medicines out of their own pocket. It is also critical that a patient’s history of medicine taking, acute or chronic, is managed in a single environment to avoid the possibility of dangerous drug interactions.”
How to make your voice heard
The CMS, via Board Notice 435 of 2017, invites interested persons to make written representations concerning their intention to declare certain practices by medical schemes in selecting DSP providers and imposing excessive co-payments on members as irregular or undesirable practices.
“The ICPA believes that this practice violates the constitutional right of medical scheme members to choose where they wish to have their medicines dispensed, to choose which doctors they wish to consult and to choose where they would like to be hospitalised,” says Maimin.
“This is the opportunity to stop this undesirable practice and everyone has until the end of June to make comment to the Council for Medical Schemes and the Minister of Health. If a closed DSP has negatively affected you, a loved one or someone you know, please visit your local pharmacy to fill in a commentary form. You may leave it with the pharmacist who will forward your comments to the CMS for you.”
Alternatively, interested parties may provide comment directly to the CMS by writing to the Registrar of Medical Schemes (attention: Alicia Schoeman), Block A, Eco Glades, 2 Office Park, 420 Witch-Hazel Ave, Eco Park, Centurion or email: legal @medicalschemes.com.
“Coupled with the issue of closed DSPs is the fact that if people choose to get their PMB chronic medicines from a non-DSP pharmacy they will be charged a hefty penalty co-payment,” says Maimin.
“While we accept that some co-payments may be necessary, we are challenging how these co-payments are calculated, as we believe the penalties are too high and often patients end up paying as much as 40% – 100% of the total cost of their medicines out of their own pocket. It is also critical that a patient’s history of medicine taking, acute or chronic, is managed in a single environment to avoid the possibility of dangerous drug interactions.”
How to make your voice heard
The CMS, via Board Notice 435 of 2017, invites interested persons to make written representations concerning their intention to declare certain practices by medical schemes in selecting DSP providers and imposing excessive co-payments on members as irregular or undesirable practices.
“The ICPA believes that this practice violates the constitutional right of medical scheme members to choose where they wish to have their medicines dispensed, to choose which doctors they wish to consult and to choose where they would like to be hospitalised,” says Maimin.
“This is the opportunity to stop this undesirable practice and everyone has until the end of June to make comment to the Council for Medical Schemes and the Minister of Health. If a closed DSP has negatively affected you, a loved one or someone you know, please visit your local pharmacy to fill in a commentary form. You may leave it with the pharmacist who will forward your comments to the CMS for you.”
Alternatively, interested parties may provide comment directly to the CMS by writing to the Registrar of Medical Schemes (attention: Alicia Schoeman), Block A, Eco Glades, 2 Office Park, 420 Witch-Hazel Ave, Eco Park, Centurion or email: legal @medicalschemes.com.
'We bring you the latest Garden Route, Klein Karoo, Hessequa news'
