There is a glimmer of hope for Medscheme members concerned about the implications of the new Medicine price list (MPL).
The MPL, which kicked in on Wednesday, is a list of 2 400 medicines, mostly generics, which the scheme deems to be effective but which cost less than their brand-name counterparts.
Medscheme, which is the largest medical scheme administrator in South Africa and represents about 40 percent of the medical aid market, said several major pharmaceutical manufacturers have dropped the prices of 76 different drugs to bring them within the specified price threshold.
Medscheme director Gary Taylor on Wednesday said the average price reduction was 18 percent, but in one case it was as much as 71 percent.
Taylor believes that as drug prices are reduced to within the MPL price range, there will be "even greater flexibility for prescribing medicines that attract no co-payment".
Co-payment is the variance between the MPL price (often for generic drugs) and the branded-drug price.
Under the present scheme, those who choose to take more expensive brand-name drugs are liable for the difference between the MPL price and the brand-name price.
Some of the companies that have indicated that they will be decreasing prices are Aspen Pharmacare, Cipla Medpro and Pharmadynamics.
While the Pharmaceutical Manufacturers Association has criticised the MPL, dubbing it a "benefit-slashing" exercise, Taylor said the association's objection was because its members' profit margins were threatened.
However, Medscheme believed this list would help to reduce the scheme's R4-billion annual medicine bill by half.
Taylor said all generic medicines had been passed for use by the Medicines Control Council. In cases where patients have adverse reactions to generics, or they do not function as well, doctors could obtain authorisation from Medscheme for the more expensive drugs to be provided, Taylor pointed out.
This could occur when patients with multiple health problems were on a number of drugs, he said.
When seeking pre-authorisation, patients can talk to doctors or pharmacists from Medscheme to discuss alternatives.
Taylor said he was "absolutely delighted" that pharmaceutical companies had dropped prices.
He added that consumers benefited when "purchasing alliances" were able to negotiate reductions in prices.
According to Taylor, bringing down costs would keep health-care providers healthy themselves, and in the long run benefit the consumers.
He said it was in everyone's interests for private health care to remain affordable, otherwise more and more people would flood the public health system, which "would be a disaster".
Taylor said he believed pharmaceutical companies had made a pragmatic decision that would enable them to make sales in greater volumes.