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Cape Town – A Western Cape High Court ruling in favour of the Independent Community Pharmacy Association (ICPA) in its David versus Goliath case against the Clicks Group must lead to a larger conversation about medicine dispensing in the country, the SA Medical Association (Sama) says.
The high court last week found that groups with interests in both dispensing and manufacturing pharmacies are in contravention of the Pharmacy Act.
The judgment noted that by having an interest in both retail and manufacturing, a pharmacy would gain financially if the product was promoted by pharmacists in the chain’s network over other products.
The Clicks Group, which owns Clicks retail pharmacies and Unicorn Pharmaceuticals through one of its subsidiaries, has since indicated it will be appealing the decision.
Sama said apart from contravening the Pharmacy Act, in their view, this practice was also unethical.
“Our members have for a long time raised concerns about this system, which takes the control of medicating patients out of the hands of medical professionals and places it at the discretion of pharmacists and pharmacies who have a vested financial interest in specific drugs,” said Sama chairperson Dr Angelique Coetzee.
The judgment was significant because it also raised issues around the dispensing of pharmaceuticals, she said.
While not mentioning the involvement of medical aid schemes, Sama believes the ruling should serve as a starting point for discussions.
“If a doctor, for instance, prescribes chronic medication, co-payments are required when patients have these filled at pharmacies. In contrast, no – or lower – co-payments are required when these scripts are filled at larger pharmacies.
"This forces patients to go to these groups at the expense of community pharmacies. The low dispensing fee for doctors also discourages doctors from keeping chronic meds at their practices, which, in our
opinion, again disadvantages patients,” Coetzee said.
At the same time, pharmacies have the right to extend the chronic medication scripts of patients without these patients having to first consult their doctors. Medical aid schemes can also prescribe what medicines patients receive, similarly without them first consulting their doctor, she said.
“Doctors make decisions based on years of study and experience. They evaluate which medications are most appropriate for their patients after thorough clinical examinations, by reviewing essential patient data, and after considering a number of other critical factors, including the patient’s medical history.
“These medically based conclusions and recommendations cannot be made by outside parties who are driven by financial interests, and who have no context for the doctor’s decisions,” she said.