Cancer treatment cost challenges
the pool when I started not feeling well and collapsed. My blood pressure dropped away and my heart rate dropped. I didn’t think I would survive,” said Botha.
He was tested for possible allergies and treated with antihistamine and cortisone. But that day was followed by eight more similar attacks, including a severe one on Christmas Day. By that time he had lost 20kg and was fearful of eating, not knowing what he could be allergic to and when he would suffer another attack.
“I never knew when I was going to see another end to the day, it was stressful,” he said.
He was referred to a paediatric allergy specialist, who immediately diagnosed a carcinoid reaction.
After further scans confirming stage 4 carcinoid cancer, which invades many parts of the body from the feet up to the brain and with the biggest concentration in his liver, Botha underwent surgery to have two growths removed.
Now undergoing further treatment with injections, there has been a further positive reduction of cancer in his body. While 80% of the cost are covered by his medical aid, Botha is battling to cover the 20% co-payments, which already run into thousands of rand and will continue to escalate. He was medically boarded and his wife, Anneli, resigned from her job to look after him.
“The results from this medication are very positive and in my opinion, a
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miracle. Emotionally as a family, we are in a good place.
“I need to continue this treatment which costs R89000 every eight weeks. It’s a case of pay it or die,” said Botha. He has to cover 20% of that cost, with his last account being more than R15000.
The 2017 Cancer Medicines Report analysed the patent status, affordability and accessibility to 24 cancer medicines – of these, 15 were available in India for less than half the price in the South African private sector.
The report also found that 10 medicines not available in the South African public sector, likely because of high cost, were available in India for less than half the price in the South African private sector.
Cancer Alliance and Access to Medicine Campaign’s project manager, Salome Meyer, said 84% of the population could only access cancer treatment from the public sector, which is available at 10 treatment centres across the country.
The remaining 14% access private health care and “many patients, when diagnosed, are faced with the reality that their scheme’s benefits are not enough and have to face exorbitant cost from their own pocket,” she said. She added that “most of the schemes, if not all, have not increased their benefit for the last five years or more, while the cost of treatment has increased”.
Of key concern to the Access to Medicine Campaign is the issue of patents, most of which are for 20 years and shut out competition from other medicines. If more medicines were allowed, it would lower prices. This is exacerbated by secondary patents, which are granted under a minor modification to, or new uses of, existing medicines. One medicine often has multiple secondary patents, each providing 20 years of further patent protection.
For example, the primary patent on rituximab expired in 2004, but it will be protected by secondary patents until at least 2030 – or 42 years after the first patent was granted in South Africa. If a pending secondary patent application is granted, the monopoly protection will extend to 2036 for a total of 48 years.
While the patent holder is the only provider of the treatment, they maintain a monopoly and can charge what they want for the medicine.
“They come with the police on the basis that they represent companies and want to check for counterfeit products.
“All we see in the footage is the police destroying cameras and stuffing money into their bags.”
Sibanda explained that similar violence broke in June but authorities have failed to act.
Not a single shopkeeper or vendor, he claimed, had been arrested for selling counterfeit goods and search warrants were not produced.
Other vendors claimed the confiscated goods were sold back to them.
Vendors claimed the brand ambassadors had been raiding their premises for years.
“Recently, these visits have become more frequent. They are visiting three to four times a week, and are particularly active over weekends,” said another trader.
Mashaba and Sun urged the traders to lay criminal charges, and implored them to point out the culprits behind Thursday’s violence.
“Criminals are making a barrier between the Ethiopian community and law enforcement agencies.
“We understand this thing is not creating a good image for us,” said Yemane, who along with other community representatives pledged to co-operate with the city leadership.
But Sun retorted: “Don’t even speak of image. You are running chaos in our city. We are not going to sit back and tolerate it. That’s why we are here today.”
Mashaba said that the city “was against criminality” and he was pushing the Department of Home Affairs to be accountable for properly documenting “who is in the city”.
“Those who qualify must be here, those who don’t and are here for the wrong reasons must be sent back where they come from… Whether it takes a week or a month, we’ll intensify our efforts to make sure criminals are taken off the streets…
“The images I saw yesterday on national TV and social media platforms were totally unacceptable.
“No country in the world can allow their law enforcement to be attacked in such a fashion.
“I’m angry because the consequences of this lawlessness are going to lead to more unemployment.
“Can you imagine those images flooded all over the world. We are looking to revitalise the city but how can we with this type of chaos?”
Chief Superintendent Wayne Minnaar said a JMPD patrol van and JMPD Nyala were again stoned when officers arrived there.
On the street, signs of Thursday’s mayhem still littered the area: giant rocks, shattered glass and shuttered shops. “They don’t see us as human beings,” said one trader, who did not want to be named. “They see us as animals.”