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Thu 27 May 2004, 17:39 Netcare Joins Industry In Court Action
Netcare Joins Industry In Court Action To Suspend Pricing Regulations           
  NETWORK HEALTHCARE HOLDINGS LIMITED                                             
  (Co. Reg. No. 1996/008242/06)                                                   
  Code: NTC                                                                       
  ISIN number: ZAE000011953                                                       
  (`Netcare` or `the Group`)                                                      
  NETCARE JOINS INDUSTRY IN COURT ACTION TO SUSPEND PRICING REGULATIONS           
  INTRODUCTION                                                                    
  Netcare today announced that it intends to join the Pharmaceutical Society of   
  South Africa (`PSSA`), United South African Pharmacists (`USAP`), New Clicks    
  South Africa (Pty) Limited and other industry players in launching urgent legal 
  proceedings against the Minister of Health (`the Minister`) to suspend the      
  operation of the medicine pricing regulations and to have them set aside and    
  declared invalid.                                                               
  The decision to apply to the high court for release is a measure of last resort.
  It is made in the aftermath of failed attempts to constructively engage with the
  Department of Health (`DOH`) over the content of the regulations.  A recent     
  invitation to the DOH to attempt to resolve the situation in co-operation with  
  industry players has been refused.  Netcare and the other industry players have 
  been left with no choice.                                                       
  THE CURRENT ENVIRONMENT                                                         
  Since the release of the draft regulations and their subsequent promulgation on 
  2 May 2004, the entire healthcare industry has been confronted with untenable   
  uncertainty due to the unworkable regime sought to be introduced by the         
  regulations.                                                                    
  The most important consequence of these regulations is that patient care will be
  compromised.   The promise of savings by the Minister of between 40% and 70%    
  were never achievable as the average industry discount on ethical drugs is      
  approximately 15%.                                                              
  In addition, these regulations will ultimately prejudice accessible, affordable,
  quality healthcare for all South Africans through:                              
  -    insecurity and increased emigration of healthcare professionals (an        
       invaluable national asset);                                                
  -    disruptions to the supply chain, especially in the rural areas;            
  -    closure of retail pharmacies who currently dispense 56% of all             
  prescriptions; and                                                         
  -    increased pressure on the floundering Public healthcare sector.            
  Most of these unfortunate consequences could have been avoided by the           
  introduction of a more transparent and consultative process in the development  
  of a sustainable healthcare policy for all South Africans.                      
  NETCARE`S STANCE                                                                
  Since Netcare`s inception it has been advocating the need to make changes       
  primarily to the flawed third-party payor fee for service reimbursive model     
  which has fuelled significant pharmacy inflation. The Group fully supports the  
  introduction of calculated measures to improve the affordability of healthcare  
  to all South Africans through, inter alia:                                      
  -    Arresting spiralling pharmacy inflation, which the single exit price       
  (`SEP`) will achieve;                                                      
  -    transparency in determining appropriate mechanisms and returns;            
  -    ensuring more affordable quality medicines in both the public and private  
       sectors;                                                                   
  -    mandatory generic substitution with parallel importation of drugs;         
  -    a code of conduct for pharmacy advertising; and importantly, changing the  
       reimbursement model to a per diem rate which already is applied to over 60%
       of all private hospital admissions.                                        
  ISSUES OF PRINCIPLE                                                             
  The industry issues relating to these and other healthcare regulations relate   
  primarily to:                                                                   
  -    the unnecessary licensing and regulating of dispensing doctors who only    
  dispense 13% of prescriptions and offer a cost effective package deal for  
       patients;                                                                  
  -    the constitutionality of setting professional fees;                        
  -    the inappropriateness of the capped dispensing fee which has no regard for 
  the operating cost of the medicine; and                                    
  -    the anticompetitive benefit and price discrimination afforded to the State 
       which is exempt from the SEP                                               
  OTHER FACTORS                                                                   
  Since Netcare supported the doctors protest march on Parliament earlier in the  
  year, the Group has been unfairly targeted by various Government health         
  departments. The Group remains resolute in the defence of its actions and will  
  always be governed by its solid ethical, social and business principles while   
  continuing to exercise its democratic right in support of the healthcare        
  professionals who are the lifeline of our industry.                             
  Netcare has investments valued at over R 6 billion and employs more than 18 000 
  professional healthcare workers (the majority of whom are from previously       
  disadvantaged communities).  The group contributes meaningfully to the fiscus   
  and continues to provide a world class quality healthcare infrastructure and    
  service.                                                                        
  Notably, in a recent survey by a reputable monitoring agency, South Africa`s    
  private healthcare sector ranks in the top five in the world for healthcare     
  performance and quality of outcomes which is fundamental to attracting foreign  
  investment.                                                                     
  Against this backdrop, criticisms made about the level of pricing and `super    
  profits` by hospital providers are misguided and unjustified.  For many years   
  the private healthcare sector has cross-subsidised the price of drugs in the    
  public sector.                                                                  
  Netcare welcomes an independent assessment of the returns on assets and capital 
  achieved by all of the industry players in the healthcare chain as well as the  
  cost structures, governance, quality and outcomes of the public healthcare      
  sector.  Recent studies have indicated that the returns on equity and operating 
  returns on assets of the hospital groups` are well below those of other         
  businesses in the healthcare chain.                                             
  Increased longevity and continuous advances in technology have presented global 
  healthcare markets with the challenge of addressing hyper-medical inflation.    
  South Africa`s unique challenge of dealing with the AIDS pandemic and its high  
  crime/accident rate further compounds this issue.  Governments worldwide are    
  engaging with the private sector (for example the UK and Portugal together with 
  Netcare) to offer innovative solutions to provide accessible, affordable,       
  quality healthcare solutions.   The private healthcare sector is wrongly cast by
  Government as part of the problem instead of as part of the solution.           
  Netcare is mindful of the challenges faced by our Government and pledges its    
  commitment to working together with all stakeholders and calls for a healthcare 
  CODESA between private and public representatives from the Departments of       
  Health, Finance and Trade and Industry to review healthcare policies so as to   
  ensure better care for all South Africans.                                      
  27 May 2004                                                                     
  Sponsor                                                                         
  Merrill Lynch South Africa                                                      
  For further information:                                                        
  Dr Jack Shevel                                                                  
  Tel: (011) 301 0202                                                             
  Date: 27/05/2004 05:12:04 PM Produced by the JSE SENS Department                
                                                                                  
                                                                                  
                                                                                  
  



 
 
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