Hopes that private medical aids could acquire Covid-19 vaccines privately in the wake of SA’s slow-moving vaccine rollout have been firmly quashed as schemes confirm they will take the lead from the authorities.
While there has been widespread speculation that medical aids had the financial clout to approach vaccine manufacturers directly, three medical aids confirmed to Sunday Times Daily that this would not happen.
“Pharmaceutical manufacturers globally are still not allowing private players to procure vaccines directly,” said Discovery CEO Adrian Gore in an open letter to scheme members.
“Even if they did, these vaccines would still need to be registered centrally via national regulatory structures.”
Gore said as a result of global vaccine shortages, procurement should be left to the state, though with strong private sector collaboration.
Fedhealth principal officer Jeremy Yatt agreed that the vaccination process was a government and private sector collaboration.
“It will be based on government’s rollout plans and centralised procurement of vaccines through government,” he said.
“No medical aids will be purchasing vaccines directly.”
No medical aids will be purchasing vaccines directly.
— Fedhealth principal officer Jeremy Yatt
However, Profmed CEO Craig Comrie said while manufacturers were not yet willing to sell vaccines directly to private business organisation, the scheme had had discussions with “many” manufacturers.
“We look forward to the time when production is scaled up and [leads] to more vaccines becoming available,” he said.
“This may be later in the year and our suggestion to the government is that at phase three of the rollout plan, the private sector and schemes should be able to also procure and distribute vaccines.”
Medical aid schemes also poured cold water on the idea that they could subsidise vaccinations for people who do not have medical cover.
While it had been mooted that cash-rich private medical schemes could bear the cost of subsidising vaccinations, doing so would be illegal, said Yatt.
“A medical aid works on the same basis as a mutual fund and is a not-for-profit organisation, [and] the funds therefore belong to the members who contribute every month,” he said.
“People need to be clear that medical aids aren’t some cash cow for government, but well-run entities that are designed for the benefit of their members.”
Fedhealth would not be able to use members’ money to fund vaccines for non-members without their approval, he added.
Comrie said Profmed could not support “the illegal use of medical scheme members’ funds to cross-subsidise non-medical scheme members”.
While encouraged to hear that government had confirmed sufficient funding to cover vaccine for non-medical scheme individuals, Comrie was concerned that any shortfall would result in the private sector effectively cross-subsiding the vaccine programme.
“Our members, as well as more than 40% of the market, are not in favour of this type of cross-subsidisation, but would support a more democratic, voluntary donation process to fund vaccines for those who cannot afford them, assuming government’s commitment to cover this cost falls through.”
Health department spokesperson Popo Maja confirmed the government would fund vaccines for all South Africans who are not on medical aid.
“Medical schemes are still obliged to pay for their members’ vaccinations as per the provisions of the prescribed minimum benefit (PMB) regulations, where Covid-19 is now a recognised PMB condition,” he said.
This would include cover for any possible side effects from the jab, he noted.
Discovery, meanwhile, had carried out actuarial and epidemiological modelling to determine how the vaccine rollout would best work.
“In an ideal scenario, we should aim to vaccinate all high-risk groups by the end of June, including people over the age of 60 and people living with multiple comorbidities,” said Gore.
To reach herd immunity, about 29 million people needed to receive the jab.
This would entail vaccinating 250,000 to 300,000 people every day, he said, adding that the target was “feasible and achievable”.
The schemes continued to work with Business for SA (B4SA), national government and the health department on vaccine rollout logistics.
B4SA was helping coordinate the private sector’s plans to set up vaccination sites.
Setting up exclusive facilities for our members would not be efficient for our 75,000 beneficiaries, who are scattered throughout the country.
— Profmed CEO Craig Comrie
About 1,200 sites had been identified, said Stavros Nicolaou, chair of B4SA’s health working group.
“These include independent pharmacies, corporate pharmacies such as Dis-Chem, GPs’ rooms, travel clinics, day clinics and private hospitals,” he said.
Vaccination sites would range from 1,000 small sites capable of vaccinating up to 50 people a day to 10 extra-large sites which could handle 2,000 people a day.
The private sites aimed to vaccinate 150,000 people every day, matching the public sector’s daily target of 150,000 jabs.
As part of its own mass vaccination programme, Discovery planned to deploy more than 500 people and set up 20 large-scale vaccination centres.
The scheme planned to vaccinate three million adult beneficiaries, starting with 550,000 people identified as high-risk who would be vaccinated within a few weeks of the programme’s start.
This would depend on vaccine supply, however, the group said.
Profmed planned to allow members to access vaccines wherever they chose.
“Setting up exclusive facilities for our members would not be efficient for our 75,000 beneficiaries, who are scattered throughout the country,” said Comrie.
As the scheme was made up of many healthcare professionals, it preferred to support local pharmacies, clinics and GPs to get accredited as vaccine centres.
This would broaden the country’s capacity to vaccinate larger volumes of people, Comrie said.
Fedhealth noted that through the AfroCentric Group, of which the scheme’s administrator, Medscheme, was already part, it had capacity to vaccinate 150,000 every day, thanks to its wide network of 3,000 registered nurses.
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