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1. What is an interchangeable multi-source pharmaceutical product?
An interchangeable multi-source
pharmaceutical product is a product that has exactly the same active
ingredient/s and salt/s combination, strength of the active ingredient/s and
dosage form (for example tablets versus capsules) as other pharmaceutical products
that can be obtained from manufacturers or suppliers.
2. Is MMAP® formulary based?
No, it is not. A maximum price
for a category of pharmaceutical products is determined, but MMAP® does not
aim to stipulate the specific pharmaceutical product to be dispensed.
3. Is MMAP® a tender system?
No, it is not. All clinically
appropriate pharmaceutical products are considered by the MediKredit Clinical
Committee when determining MMAP®.
4. Are any pharmaceutical products excluded from consideration for the
MMAP® process?
Products are excluded from the
MMAP® listing if they are designated as non-substitutable by the South
African Health Products Regulatory Authority (SAHPRA), as well as substitutability data from
international sources such as Australia, USA (FDA) and Europe.
5. How are MMAP® categories of products determined?
The MediKredit Clinical Committee
reviews each potential and existing MMAP® category based on a series of
inclusion and exclusion criteria. For example, MediKredit will take the
severity of the indicated illness/condition/s into consideration and/or
whether the treated conditions are acute or chronic. The individual MMAP®
categories are defined by which pharmaceutical products can be regarded as
being generically equivalent.
6. How often are the MMAP® categories and prices reviewed?
MMAP categories and prices are monitored
throughout the year and updated accordingly as a result of:
·
Price changes of pharmaceutical products within an
existing category; and/or
·
The launch of new pharmaceutical products that
prompt the creation of new categories; and/or
·
The discontinuation of pharmaceutical products
and/or withdrawal of pharmaceutical products within an existing category
requiring the deletion of the category.
MMAP Listings are done annually. Manufacturers/suppliers of registered
pharmaceutical products are invited to submit their products and approved SEP
(Single Exit Price) for potential inclusion in the MMAP® Listing. Although
not all manufacturers/suppliers elect to have their products listed on MMAP®,
all available products within a specific category are taken into
consideration when the MMAP price is determined.
7. How is the Maximum Medical Aid Price determined?
Prices are determined to allow
flexibility when selecting a pharmaceutical product. It is also important to
note that the MMAP® price levels do not necessarily equate to the prices of
any specific pharmaceutical product brands.
8. Where can the latest MMAP® Listing be viewed?
The most updated version of the
MMAP® listing can be accessed from the download below.
9. How are the categories of pharmaceutical products listed?
The MMAP® listing is a numbered
list of items sorted alphabetically by active ingredient with accompanying
strength, dosage form and where appropriate, salt. Each individual category
then lists pharmaceutical products that are available in such category in the
event that the pharmaceutical manufacturer or supplier has agreed to listing.
The maximum allowable price per pack size, inclusive of 15% VAT but exclusive
of any professional or dispensing fees which may be chargeable at the point
of dispensing, is indicated on the list.
10. How does MMAP® impact on the patient?
The doctor or pharmacy must
charge the actual price of the brand supplied to the patient and not the
MMAP® amount. The doctor or pharmacy is entitled by law to supply any
alternative interchangeable multi-source pharmaceutical product (“generic substitution”)
unless:
·
Specifically indicated otherwise by the prescribing
doctor; or
·
Expressly forbidden by the patient to do so; or
·
If the price of the interchangeable multi-source
pharmaceutical product is higher than that of the prescribed medicine.
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