South African healthcare providers expressed their concern with the recent decision by the Government Employees Medical Scheme (GEMS) to only allow their HIV/Aids members to obtain their antiretroviral (ARV) medication from a postal courier service.
This follows the already worrying number of private medical aid schemes that are forcing patients to obtain medication for the treatment of chronic illnesses (including HIV and Aids) via postal courier or from a designated service provider. Patients that choose to obtain their medication from a pharmacy other than Medipost (GEMS's Designated Service Provider for chronic medication) are penalised with a co-payment of 30%.
This new GEMS regulation affects more than 62,000 HIV positive patients - placing them in a very vulnerable position with regards to their overall health.
The Independent Community Pharmacy Association (ICPA), a national industry body and voice for over 1,500 independently owned pharmacies, has taken a firm stand on this, as it impacts on South Africans' freedom of choice in the selection of a healthcare provider. Part of the association's action steps include rallying the support of 6,500 South Africans via a petition conducted in pharmacies across the entire country. The GEMS issue has also been officially raised with the Minister of Health, Dr Aaron Motsoaledi.
No substitute for face-to-face interaction
"The decision to withdraw the provision of ARVs from independent pharmacies specifically and to force patients into using a designated courier service is not in line with Good Pharmacy Practice Regulations," says the ICPA Chairperson, Sham Moodley. "Face-to-face interaction, counselling and follow-up care are vital to the overall well-being of chronic patients, particularly those with HIV and Aids.
"Timing of delivery and the correct storage of the medication cannot be guaranteed. Is this really to the benefit of the patient?"
The ICPA believes that there is no substitute for the direct interaction between the patient and the healthcare provider which allows for opportunities for optimum medicine management, detection of non-compliance and management of side effects to name but a few.
Moodley warns that the postal courier system will result in a breakdown in the care of vulnerable patients with the potential for treatment-failure and poor health and financial outcomes. "Medical aid members that receive their ARVs from pharmacies, have the comfort and the reassurance of direct and personal care, which not only benefit their physical wellbeing, but also most importantly, adds to their psychological and social wellbeing. In many cases the pharmacist is familiar with, and interacts with "buddy carers" who are responsible for ensuring treatment compliance. This is particularly true in the more rural settings of KZN and Limpopo."
Protect freedom of choice
Moodley says forcing patients to use designated pharmacies and then punishing those who do not use that pharmacy with a co-payment, undermines the constitutional right to freedom of choice. "It may even be anti-competitive and a breach of the Competition Act," he adds.
Work with us not against us
For the ICPA these developments also relate to a bigger issue with the independent pharmacy sector that's currently under-valued as a resource by Government. "If properly utilised this could alleviate the healthcare burden facing the state by up to 40%," Moodley says.
"A significant pool of skills and resources are located outside of Government institutions. By recognising this fact and by finding ways to partner with the independent pharmacy sector, Government could overcome two of its biggest challenges namely the shortage of human resources and healthcare facilities. By partnering with the ICPA's members right now to dispense to its chronic patients, Government could immediately reduce the load on the public sector. The already over-burdened state resources could then be focused on improving the quality of care to the balance of the patients." - (Sapa/Health24, August 2011)
Source: Press release issued by Nadia Rossouw Communications & PR