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January 7, 2003

Rare diseases medical scheme planned

From: IAfrica South African News, South Africa - 07 Jan 2003

The representative body for medical schemes, the Board of Healthcare Funders, has proposed a special fund for rare diseases in which medical schemes share the risk associated with covering these conditions.

Business Day reports the idea would involve medical schemes paying a contribution per member into the fund, which would pay for expensive medical treatment for rare illnesses which would otherwise cripple medical schemes.

Conditions such as Gaucher disease, haemophilia, cystic fibrosis, cochlear implants, bionic ears, interferon-treated multiple sclerosis and chronic myeloid leukaemia would be on the list.

HIV/Aids may also be included in the list, according to the paper.

The costs of treating Gaucher disease is up to R700 000 per year, which would cause difficulties for small schemes.

The idea is still at an early stage, and would require the support of all medical schemes to get it off the ground, the Board of Healthcare Funders said, according to Business Day.

Shaun Matisonn, principal officer of Discovery Health, said the industry-wide fund would protect schemes from “adverse selection fallout” by offering a standard treatment protocol for rare conditions.

The pool fund would also be able to negotiate cheaper drugs and treatments because of its bulk buying power, he said.

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