the Government Gazette

Value-for-money drug guide raises industry doubts

THE Department of Health has finalised guidelines for assessing new medicines’ " value for money" in the local market, which is expected to help the government and medical schemes to determine which drugs to provide patients.

It will also open their decisions to greater public scrutiny, potentially giving more power to patient groups lobbying for access to expensive new medicines.

The guidelines, which were published in the Government Gazette on February 1 and come into effect on April 1, provide technical details of how pharmaceutical companies should build their arguments for the value-for-money of new treatments compared with the existing standard of care.

Health board withdraws controversial tariff guidelines

IN A politically damaging about-turn, the Health Professions Council of South Africa (HPCSA) has bowed to pressure from doctors and dentists and withdrawn its controversial tariff guidelines.

The guidelines were due to be published in the Government Gazette on Friday, and the HPCSA had hoped they would be used as a benchmark for the private healthcare sector. But the figures it published were slammed by the three most influential groups for healthcare professionals, which described them as unscientific and divorced from the costs of running a practice.

Durban moves to lead fight against cancer

Durban is planning to become the first city in the country to set up its own environmental cancer surveillance unit. The move coincides with a national process to declare cancer a reportable disease and improve data collection on the disease, which kills or disfigures several thousand South Africans every year. Ten years ago The Mercury uncovered evidence of potentially high cancer rates in children in Durban's southern industrial area. Official figures suggest that at least 50 000 new cases of cancer are diagnosed around the country every year, although these statistics are recognised as an underestimation of the true picture. The aim of the new surveillance unit (or registry) is to monitor the number and different types of cancer cases in the Durban area by gathering accurate information on where, how and why the disease occurs, and the extent to which air pollution and other environmental risks might add to the cancer burden. Siva Chetty, the deputy head of pollution control for the eThekwini Health Department, said the plan was to start collecting information on cancer cases in Durban by next year.

State clarifies medicine pricing

The health department has corrected a confusing notice it issued last month on the pricing of nonprescription medicines, making it clear that schedule 0 products are exempt from the two key provisions in the Medicines Act that control prices.

Tough anti-smoking Bill ready for Cabinet

The Department of Health has finished revising its proposed tougher anti-smoking legislation -- and has not backed down on the massive fines lawbreakers will face.

SA passes total asbestos ban

Many decades after South Africa became aware of conclusive medical evidence of the deadly risks of asbestos, the government is finally acting to protect public health by banning the fibres completely from a wide range of day-to-day building, piping and motor car products.

A sick note from your sangoma

Trying to convince your employer to accept a medical certificate from a traditional healer could be a thing of the past in terms of a new bill to come before parliament. According to Jan Stemmett, chairperson of the Labour Law Committee of the Law Society of South Africa, the minister of health has published a notice in the Government Gazette indicating that she intended to introduce the Traditional Health Practitioners Bill. The bill will allow traditional healers, or traditional health practitioners as they will be known, to issue medical certificates for purposes of sick leave. Among other things, the bill provides for the establishment of an Interim Traditional Health Practitioners Council, the registration of traditional health practitioners,the fees they may charge and restrictions on unregistered persons. Healers will, however, not be able to issue certificates for purposes of maternity leave. Employers are advised to check whether a traditional healer is registered with the new Council before accepting his or her certificate. Presumably, certified healers will be issued with registration numbers.(source SAPA, 29 October 2003) Links //\// Traditional Health Practitioners Bill Latest Developments: This Bill was submitted on 14 August 2003 in terms of Joint Rule 159 and referred to the Portfolio Committee on Health and the Select Committee on Social Services. Background: The Bill provides for the establishment of an Interim Traditional Health Practitioners Council. It also provides a regulatory framework to ensure safety, efficacy and quality of treatment. The Bill provides for control over registration and training. For more information contact Debbie Pearmain at 012 312 0611 or email: Draft Traditional Health Practitioners Bill

Franchising of retail pharmacies

The Government Gazette of 6 December 2002, No. 24116, announced that the SA Pharmacy Council has resolved to investigate the principle of franchising of retail pharmacies in South Africa and of the use of trading titles or trademarks or logos or brand names by retail pharmacies. To achieve this objective, the Council has appointed its Registration and Permits Committee to conduct an investigation. The issues that the Committee is to consider will include the following: . Whether the franchising of retail pharmacies constitutes a contravention of the provisions of the Pharmacy Act, 53 of 1974) and, if so, in what respect. Consideration will also be given to the legality or not of the use of trading titles, trademarks, brand names or logos by pharmacies where the lawful owner of the trading title, trademark, brand name or logo is not a registered pharmacist. . Whether the concept of franchising of retail pharmacies and the use of trading titles, trademarks, brand names or logos constitutes a contravention of the Rules relating to acts or omissions in respect of which the Council may take disciplinary steps or not. . The setting of guidelines and/or criteria in order to determine the conditions upon which the franchising of retail pharmacies should be allowed, should it be concluded that franchising is in fact permissible in terms of the Act. . The setting of guidelines and/or criteria in order to determine the conditions upon which the use of trading titles, trademarks, brand names or logos should be allowed, should it be concluded that the use of such trading titles, trademarks, brand names or logos is in fact permissible in terms of the Act. All stakeholders are invited to make written submissions regarding the above investigation. The written submissions should be directed to the Registrar of the SAPC and should reach him by not later than 15 January 2003.(Source: PSSA Newsletter #1/2003 - 6 January 2003)

Members will pay if prescribed benefits are extended

If parliament adopts new regulations, drafted by the Council for Medical Schemes, that would extend compulsory benefits, members of medical schemes will ultimately have to pay for such benefits. This is according to Sarah Bennett, a healthcare actuary at NMG-Levy Consultants & Actuaries. The draft regulations were published in the Government Gazette last week for public comment. Bennett says although the council's proposal to add 20 common chronic conditions to the list of prescribed minimum benefits would be to members' advantage, it would also cost them more. In many cases, chronic medication is currently only available in the more expensive options within a medical scheme. Bennett says medical schemes have used chronic medication benefits as a method of rating members according to the financial risk they pose, which is against the spirit of the Medical Schemes Act. The Act aims to encourage community rating, whereby young and healthy members cross-subsidise the elderly and sickly. Bennett says currently schemes must cover prescribed minimum benefits at public hospitals only. The draft regulations stipulate that if public facilities are not available or are full, prescribed minimum benefits must be covered in private hospitals. The council has proposed that the following conditions be added to the list of prescribed minimum benefits: voluntary HIV testing and counselling; the treatment of HIV/AIDS conditions; the prevention of mother-to-child-transmission; screening and preventative therapy for tuberculosis; the diagnosis and treatment of sexually transmitted diseases; pain management for the terminally ill; and preventative treatment following sexual assault. Some medical schemes already provide cover for these conditions. Bennett says that, for schemes that do not, extending the benefits is likely to result in a small increase in costs. Bennett says the council's proposal to allow members to use an affidavit, rather than documentation from a medical scheme, to show that they were previously covered by a scheme is likely to be contentious. Another contentious proposed clause prevents members from accumulating benefits from one year to the next, except for funds held in a medical savings account. (Source: Personal Finance, 12 May 2002)