Blood pressure sends patients to the doctor in droves
HIGH blood pressure is the leading ailment for which South Africans on medical aid who suffer from a chronic illness are seeking treatment.
When it comes to medicine bought on prescription or over the counter, medical aid beneficiaries are racking up huge expenses on drugs for stomach ulcers, hay fever, depression, pain, inflammation, cancer and even erectile dysfunction.
There are 8.8 million medical aid beneficiaries in South Africa, who face rising private healthcare costs as more people are diagnosed with chronic illnesses and new drugs enter the market, at prohibitive prices.
The Council for Medical Schemes, which regulates 83 registered medical schemes, sounded the alarm this week.
“Without population-wide interventions to address the root causes of these chronic diseases, the upward trend is expected to continue with increasingly severe impacts on schemes,” said registrar Daniel Lehutjo in the council’s latest annual report.
Discovery Health CEO Jonathan Broomberg told the Sunday Times that the burden of chronic illness in South Africa was large and increasing. “Today 21% of the members of the Discovery Health medical scheme are registered for at least one chronic condition. It is more than one in five. Ten years ago it was half that number,” he said.
Nearly 250 000 people claim for high blood pressure treatment through Discovery Health, which has more than 2.5 million beneficiaries.
Among chronic illnesses, the condition they most frequently claim for is hypertension, followed by ailments such as high cholesterol, diabetes, asthma, thyroid disease, heart disease, bipolar mood disorder, epilepsy, rheumatoid arthritis, chronic renal disease and schizophrenia.
Lehutjo voiced concern over the long-term affordability of medical schemes as “increases in salaries may not keep pace with contribution increases”.
Monthly contributions per average scheme member have increased by 53.2% since 2000, according to the council’s report.
Discovery Health paid out R7.2-billion on medicine claims last year, about R1.2-billion of it for hospital medication.
The highest amount spent by the scheme last year on an outof-hospital medicine was for the biological drug Herceptin to treat breast cancer. It is made from living cells cultured in a laboratory.
Nexiam was No 2 on the list, for treating gastrointestinal reflux and stomach ulcers, followed by Concerta for attention deficit hyperactivity disorder. Other medicines were for rheu- matoid arthritis, inflammation and pain, asthma and diabetes.
The top over-the-counter medicines, with or without a prescription, included Corenza C for colds and flu, Deselex for allergies and Cialis for erectile dysfunction.
Broomberg said there had been a sharp uptake of lowerpriced generics over the past decade in South Africa.
Yet, overall, medicine costs were set to rise.
“You’ve got two trends going on: there is a rising tide of chronic disease for which the treatments are not that expensive because they are mostly generics, but the numbers of patients are rising quickly.
“In parallel with that, we see a large increase in new drugs entering the market at very high cost — in some cases, as much as hundreds of thousands to millions [of rands] per treatment course.
“We are very concerned about the convergence of these two trends and their cost impact for medical schemes,” Broomberg said.