Discovery on sourcing Covid-19 vaccines privately – and why you can’t just skip the queue

Discovery chief executive Adrian Gore has outlined the company’s role in the distribution of Covid-19 vaccines in South Africa and dismissed some of the mistruths around the programme.

Discovery Health Medical Scheme (DHMS) is the largest open medical scheme in the country, and the like other medical aids will be directly involved in the financing and distribution of Covid-19 vaccines in the country.

In a letter sent to clients on Monday (15 February), Gore said that almost 5,000 Discovery Health administered scheme members, and 12 of the company’s own staff, had succumbed to Covid-19.

He added that there have been approximately 120,000 excess natural deaths in South Africa during the period of the pandemic – most of which are almost certainly attributable to Covid-19.

“In this context, we are often asked why we don’t just procure the vaccines ourselves for our DHMS members, and rapidly vaccinate them. There are two important constraints that make this narrow approach problematic,” he said.

“First, there is a global shortage of vaccines, and the pharmaceutical companies manufacturing the vaccines will currently sell only to national governments, and not to any other entities.

“Second, there are specific risk factors that make some people more susceptible than others to severe illness and death should they contract Covid-19.”

This means that to be both fair and effective, the vaccination programme must be planned and implemented at a country level, according to a schedule that prioritises high-risk individuals first, and matches appropriate vaccines to at-risk groups according to clinical and scientific guidelines, Gore said.

Not following this process would mean low-risk people get vaccinated before the clinically vulnerable, resulting in unnecessary illness and death. This cannot and should not happen, he said.

Still not clear whether centralised distribution will be used

Gore said that Discovery has been working closely with the National Department of Health (NDoH), Business for South Africa, Business Leadership SA, and other stakeholders, on many aspects of the national vaccination programme.

“Our team has been involved in supporting the population analytics, research-supported procurement processes, distribution planning and system development that has been taking place,” he said.

“There will no doubt be learnings as we implement the vaccination programme to frontline healthcare workers – a containable and well-defined group – potentially as early as this week, and these lessons will be applied as the programme is scaled up.”

Gore said that uncertainty still exists with regard to whether a centralised model of distribution will be pursued – whereby government leads on procurement and coordinates distribution – or whether there will be more active involvement of the private sector in some, or all, of these elements of the programme.

Discovery ready to buy privately if allowed

Irrespective of how a vaccine is distributed, Gore said that scheme members will be covered and protected

He added that Discovery has been engaging directly with several of the key vaccine manufacturers since Q3 2020 and remain in active contact with them.

“Should their position of selling only to governments change in the near future, we will rapidly engage with the NDoH to agree on a role for Discovery and other private sector players to become directly involved in procurement and distribution.”

Gore said the Discovery Medical Scheme has budgeted for sufficient funding to fully cover vaccines  – whichever vaccines are procured – for all of its members.

We stand ready to fund their vaccination and are also confident that the private healthcare sector’s robust medicine supply chain is ideally positioned for a rapid and efficient rollout of vaccines to members of all Discovery Health client schemes.

Not true that Discovery has agreed to cross-subsidisation

While there has been talk that DHMS has already agreed to finance vaccines for non-members through a cross-subsidisation agreement – this is simply not true, said Gore.

“Schemes are awaiting clarity from government on exactly how vaccines will be funded, and what the legislated Single Exit Price will be.

“Any arrangement will be subject to the supporting legislation, to oversight by the Council for Medical Schemes and to consideration and approval by each Scheme’s Board of Trustees.”

While the detail of the rollout is yet to be confirmed, Gore said that he optimistic that the priority groups identified for early vaccination will receive their vaccines during the first half of 2021.

“We are actively supporting this project with our resources and expertise and are working tirelessly to contribute towards the best outcome for the country, while ensuring that you and your family always have access to the best possible care.

“I recognise that this note does not answer all of the questions that you may currently have in mind. We undertake to write to you regularly, to keep you fully updated as the details of our country’s Covid-19 vaccination project become clearer.”

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Discovery on sourcing Covid-19 vaccines privately – and why you can’t just skip the queue