South Africa’s Independent Community Pharmacy Association, with some 1 200 members, is fuming after the national Health Department’s refusal to cover the costs of them squeezing out a seventh dose from the multi-dose Pfizer COVID-19 vaccines.
Private sector pharmacies have played an integral role in the government’s vaccination programme, inoculating both state patients and medical scheme members, with more than 10.5m of the 37.5m jabs administered to date provided at private sector sites.
Business Day reports that when the vaccines were in short supply in 2021, some pharmacies extracted an extra, seventh dose from vials of Pfizer’s COVID-19 shots to meet demand. This was in line with US Food and Drug Administration (FDA) guidance, saying it was acceptable to use every full dose obtainable from a vial of the Pfizer vaccine.
“At the time, when vaccines were scarce, these seventh doses saved lives and we should be reimbursed for them. As the vaccine programme was rolled out on a cost recovery basis, if the national Health Department refuses to pay for the administration of the seventh dose our pharmacies will make a financial loss,” said Jackie Maiman, CEO of the Independent Community Pharmacy Association – of whose members, 272 provided COVID-19 vaccinations.
However, the Health Department has justified its refusal to pay by saying the vaccination programme was designed around extracting six doses only from Pfizer’s vaccine vials, and there is no mechanism to pay for a seventh.
“The vaccine is registered (in SA) for six doses per vial. No instruction nor permission was given to stretch this to seven,” said the department’s deputy director-general for National Health Insurance Nicholas Crisp, who is also in charge of the vaccination programme.
“It appears some private providers decided to follow an FDA notice (which is not valid in SA). Be that as it may, NDOH (the national department of health) cannot reconcile to seven doses when the system is set to six per vial when calculating waste. If we did, we would contravene the law and our own standard operating procedures. How then would we account for the discrepancy in our audit?”
The vaccines are free at the point of service, and private sector sites seek reimbursement from medical schemes and the Health Department for the cost of the jabs plus a R70 (without VAT) admin fee.
The payment tussle for the extra doses from Pfizer vials comes against the backdrop of waning demand for shots. Both public and private sector providers have scaled back since peak demand in August last year.
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