Medical aid schemes say cost of Covid-19 vaccine will be covered

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Medical aid schemes say cost of Covid-19 vaccine will be covered

By Karen Singh Time of article published 27m ago

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Durban – Two medical aid schemes have said the cost of Covid-19 vaccines will be covered for members and beneficiaries.

The medical schemes were commenting after the government’s vaccine roll-out strategy was unveiled by Health Minister Zweli Mkhize on Sunday.

Mkhize said the government was aiming to vaccinate at least 67% of the country's population or 40 million people, starting with the 1.2 million front-line health-care workers.

He said talks were at an advanced and sensitive stage with several vaccine producers, so that the vaccine would be ready for use a month earlier than the April deadline set by President Cyril Ramaphosa.

Mkhize also said that the government had embarked on public-private partnerships with good outcomes and had approached medical aids to be part of the co-financing.

“The process is now at a stage where the Council for Medical Schemes has engaged various medical schemes and I have signed amendments of regulations to allow for vaccines and other therapeutics to be part of the prescribed minimum benefits.”

Bonitas Medical Fund said yesterday it would ensure that vaccines for Covid19 were funded as a key priority for members and beneficiaries.

“The scheme is financially stable and sound, thus we have set aside funds to ensure that we can cover Covid19 vaccines for our members – in line with specific prioritisation criteria,” said Bonitas spokesperson Lee Callakoppen.

Callakoppen added that as of yesterday, Bonitas had not been contacted or engaged by any party, or the regulator of the medical schemes with regard to co-financing vaccines.

He said the fund remained open to engaging and collaborating with public and private stakeholders to secure a vaccine.

He added that the scheme was awaiting more “substantive direction and transparency regarding the procurement process for the Covid-19 vaccine as well as the measures regarding the rollout thereof and prioritisation of need in particular”.

Damian McHugh, executive head for marketing at Momentum Health Solutions, said the costs of the vaccines would be covered by the medical schemes as part of an expanded prescribed minimum benefits offering.

However, McHugh said each medical scheme would have their own methodology in covering the costs of the vaccines, as the costs for each vaccine would vary.

“Some of the vaccines require more than one dose, so it will be important to assess the cost of each type of vaccine that will be available in South Africa,” he said.

For example, he said that if a medical scheme had 250 000 beneficiaries who required the vaccine at a cost of R200 for the administration, the total cost for the scheme would be R50 million annually.

If a member required two doses, that cost doubled, he said.

“It is also likely to be an annual cost, similar to the flu vaccine, as the coronavirus can mutate into different strains,” said McHugh.

He added that schemes would need to manage the financial implications and might implement a reference price methodology.

“The scheme pays up to a certain price and if a member would like a more expensive vaccine, the additional cost may be a member cost,” said McHugh.

He said Momentum supported the government in its phased approach and believed that front-line health workers and high-risk citizens should have first access to the vaccine.

“It is important that during a pandemic, we ensure that the vaccines are available to the most at-risk members of our population,” said McHugh.

Other medical schemes, which were contacted for comment yesterday, said they would only be able to comment later this week.

Professor Glenda Gray, president of the SA Medical Research Council, said she was glad that the government had seen the importance and role a vaccine would play in controlling the deadly pandemic.

Gray said the government needed to make the vaccine roll-out a priority to ensure health care workers were safe.

“To be successful in the roll-out, the government needs to have all hands on deck and work with all sectors to achieve the scale they are talking about,” she said.

Professor Shabir Madhi, a vaccinologist from Wits University, said the vaccine roll-out was more of an aspirational goal rather than a strategy.

Madhi said the logistical scale of trying to vaccinate 40 million people would be a major mission which had never been done before.

“You would need to vaccinate 150 000 people each day, seven days a week for the first month.

“After that 100 000 people would need to be vaccinated each day until the end of the year to get to 40 million people, and that is not going to happen,” he said.

Very few countries were going to be able to reach two-thirds of the population to start off with, he said.

“I think it is not useful to set a goal that is not sustainable and very few countries are trying to achieve that,” said Madhi.

Madhi said the government should have been engaging with companies and bilaterals six months ago and not six weeks ago.

He said an on-the-ground plan to deploy the vaccines which takes staff into account should be implemented immediately.

“This is planning that should have started already, and in fact, should right now be near finalisation rather than simply a PowerPoint presentation that says what the strategy is going to be,” said Madhi.

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The Mercury

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