South Africans shun medical aid
By Bronwyn Gerretsen
Fewer people are opting for medical aid cover owing to the increasing costs of health insurance overtaking salary inflation, resulting in more of people's salaries being spent on health care.
This was one of the main problems highlighted at the Board of Health-Care Funders' Southern African Conference, which closed at the International Convention Centre in Durban on Wednesday.
Dr Jacqui Miot, head of Discovery Health's health economics unit, said the cost of health insurance was being driven by several factors - including the soaring cost of new treatments, the lack of legislative bodies to control the price and quality of new health treatments, and inadequate mechanisms to manage costs associated with new expensive technologies.
She said that while it was the role of medical aids to fund high-quality care and to promote medical advances, it was important to balance this with care that was affordable and sustainable. Miot suggested that some industry solutions to the problem could be found in health economics, which ensured the right funding decisions were made to ensure equitable access, and the decline or approval of treatment cover based on the clinical- and cost-effectiveness of the product.
Other industry solutions she suggested included limiting access - for example to complicated procedures by implementing high entry barriers, reference pricing based on health economics evaluations, and allocating budgets for clinical conditions and treatments based on historical and future costs.
Anban Pillay, Director of the Department of Health's pharmaceutical economic evaluation unit, said the department's national drug policy, which was developed in 1996, assisted in ensuring that health-care costs did not imbalance the need for affordable health care.
Elements of the national drug policy which were established to address the high cost of treatment included the generic substitution policy, the establishment of a pricing committee, fixed fees for wholesalers and pharmacists, a transparent pricing system and a single exit price for medicines.
The conference also heard that there was a need to assess the cost-effectiveness of biotechnology drugs - which included hormones and enzymes, vaccines and cell therapies - as opposed to simply concentrating on the high cost of the drugs.
Ulf Staginnus, Managing Director of European Health Economics in Spain, said while it was "no secret" that biotechnology drugs were perceived as expensive, they were actually more cost-effective.
He cited the costs of lost productivity and absenteeism as a result of certain illnesses as being relevant in such calculations, while biological drugs were more sophisticated, complex and specialised. He said it was a problem that many cost components that were important were "not considered in discussions around the cost of biotechnology drugs or measured in economic analysis".
Staginnus said it was, therefore, important that "compelling and data-driven" value propositions of biotechnology drugs were conducted.
Posted by: www.SouthAfrica-CarHire.com
News Source: www.iol.co.za
