SA medical aid numbers increases
by SAVIOUS KWINIKA
JOHANNESBURG – SOUTH Africa medical scheme members have for the first time since 2011 broken its downward spiral to reflect an increase of 1,9 percent per beneficiary when compared to 2012 figures.
This is according to Christo Rademan, Managing Director of independent specialist pharmaceutical benefit management firm, Mediscor PBM.
“Against a background of increasing medical inflation the increase in medicine expenditure is placing added strain on our healthcare funding clients.
“In light of this, it has become more important than ever to maintain control over costs by employing managed care initiatives, such as adopting medicine formularies and encouraging the use of generic medicines.
“Such initiatives should, however, never be implemented at the expense of medical scheme members,” he cautioned.
According to Madelein Bester, Manager: Benefit Management of Mediscor, the
escalation in medicine expenditure comes as a result of a 2 percent increase in cost per item and is largely attributable to the 5,8 percent approved increase in the maximum single exit price (SEP) as approved by the Department of Health (DoH) in 2013.
In the previous two years SEP increases were not a factor as no increase was permitted in 2011 and a maximum increase of only 2,14 percent was gazetted by the DoH in 2012.
From January to May 2013, 42,2 percent of manufacturers, representing 85,3 percent of products, took an increase in SEP of 4 percent or more.
In 2012, the actual increase in the same representative basket of medicines was a mere 1,2 percent when compared to the increase of 3,9 percent in 2013.
“On a positive note the use of generics again increased from 53,4 percent in 2012 to 54,5 percent in 2013.
“During the past year the vast majority (74,8 percent) of all products claimed were genericised items, and, in 72,8 percent of these instances where a generic equivalent was available, it was used.
“The on-going increase in the use of generics has resulted in significant savings for the healthcare consumer, as well as medical schemes,” observed Bester.
– CAJ News
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