Pharmacy Act, 1974 (Act No. 53 of 1974)

Board Notices

Rules Relating to the Services for which a Pharmacist may Levy a Fee and Guidelines for Levying such a Fee or Fees

Annexures

Annexure A : Guidelines for Levying a Fee or Fees

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General guidelines governing the determination of a fee or fees

 

1.Definitions

 

"Compounding"

means to the preparing, mixing, combining, packaging and labelling of a medicine for dispensing as a result of a prescription for an individual patient by a pharmacist or a person authorised in terms of Medicines and Related Substances Act, 101 of 1965 ("Medicines Act").

 

"Dispensing"

means the interpretation and evaluation of a prescription, the selection, manipulation or compounding of the medicine, the labelling and supply of the medicine in an appropriate container according to the Medicines Act and the provision of information and instructions by a pharmacist to ensure the safe and effective use of medicine by the patient and "dispense" has a corresponding meaning.

 

"Therapeutic medicine monitoring" means the use of serum medicine concentrations, the mathematical relationship between a medicine dosage regimen and resulting serum concentrations (pharmacokinetics), and the relationship of medicine concentrations at the site of action to pharmacological response (pharmacodynamics) to optimise medicine therapy in individual patients taking into consideration the clinical status of the patient.

 

2.Nature of services provided

A pharmacist may, in charging a fee for professional services rendered by him/her take into account one or more of the following factors—

(a)the nature of the professional service rendered;
(b)the time of day and circumstances under which the service is rendered.

 

3.Call out service, delivery of medicines and after-hour fees
(a)Where a pharmacist is called out from his/her pharmacy, or the pharmacy in which he/she practises, or from his or her residence or other place where he or she may be, a fee including the travelling time and costs according the South African Revenue Services (SARS) travelling reimbursement table as published from time to time, may be charged.
(b)Where a pharmacist is required to deliver a service after normal operating hours, an after-hours fee may be charged. The recommended fee is one and a half times the normal fee for a specific procedure code. The hours of opening of a pharmacy must be clearly displayed.
(c)Where a pharmacist is required by the patient or caregiver to transport a medicine to a patient, the transport costs according the South Africa Revenue Services (SARS) travelling reimbursement table as published from time to time may be charged.
(d)Where a pharmacist is reclaiming expenses, details of the expenses must be individually itemised.

 

4.Collaboration with other health care professionals

Services may be provided in collaboration with a registered nurse or other registered health care professional as agreed to by the Council and other statutory health councils as applicable.

 

5.A pharmacist's guide to fees
5.1Procedures
5.1.1Services for which a fee or fees may be levied shall be divided into procedures as indicated in Annexure B. A separate fee shall be charged for each procedure.
5.1.2The fee per procedure shall be based on a procedure code as listed in Annexure B.
5.1.3The fee for after-hours and/or call-out services must be levied separately as per clause 3 using the designated procedure codes as listed in Annexure B.
5.1.4The fees will be reviewed on an annual basis.
5.1.5All expenses claimed must be indicated separately.

 

6.Pharmacy support personnel

The fee or fees may be levied by a pharmacist whether the service concerned is provided by the pharmacist, any other person registered in terms of the Pharmacy Act or a healthcare professional employed in the pharmacy: Provided that any such person may only provide a service or perform an act which falls within his or her scope of practice.

 

7.Chronic Medicines Authorisation

A fee may be levied by a pharmacist where he/she needs to liaise with a medical scheme, an entity concerned with the management of pharmaceutical benefits and/or a medical practitioner to initiate or renew a chronic medicine authorisation or update a chronic medicine authorisation.

 

8.Guidelines for charging fees where one or more service may be provided

 

The following examples are provided as guidelines:

 

 

Scenario

Fees that may be levied for services provided

Procedure Codes

i.

A patient presents a prescription for dispensing to the pharmacist which requires the compounding of a product.

A professional fee for compounding plus the fee for dispensing may be levied.

Procedure codes

0002 and 0001

ii.

A patient presents a prescription for dispensing to the pharmacist which includes the preparation of a sterile product.

A professional fee for preparation of a sterile product plus the fee for dispensing may be levied.

Procedure codes

0003 and 0001

iii.

A patient presents a prescription for dispensing to the pharmacist which includes the preparation of an intravenous admixture or parenteral solution.

A professional fee for the preparation of an intravenous admixture or parenteral solution plus the fee for dispensing may be levied.

Procedure codes

0004 and 0001

iv.

A patient presents a prescription for dispensing to the pharmacist which includes the preparation of a total parenteral nutrition product

A professional fee for preparation of a total parenteral nutrition product plus the fee for dispensing may be levied.

Procedure codes

0005 and 0001

v.

A patient presents a prescription for dispensing to the pharmacist which includes a cytotoxic preparation.

A professional fee for cytotoxic preparation plus the fee for dispensing may be levied.

Procedure codes

0006 and 0001

vi.

A patient requests information regarding the use of medicine dispensed by another entity authorised to dispense medicines.

A professional fee for provision of information concerning the medicines may be levied.

Procedure code

0008

vii.

A patient presents him/herself to the pharmacist with a prescription for dispensing and requests blood glucose monitoring.

A professional fee for blood glucose monitoring plus the fee for dispensing may be levied.

Procedure codes

0012 and 0001

viii.

A patient presents him/herself to the pharmacist with a prescription for dispensing and requests blood cholesterol and/or triglyceride monitoring.

A professional fee for blood cholesterol and/or triglyceride monitoring plus the fee for dispensing may be levied.

Procedure codes

0013 and 0001

ix.

A patient presents him/herself to the pharmacist with a prescription for dispensing and requests blood pressure monitoring.

A professional fee for blood pressure monitoring plus the dispensing fee may be levied.

Procedure codes

0015 and 0001

x.

A patient presents him/herself to the pharmacist with a prescription for dispensing and requests a peak flow measurement.

A professional fee for peak flow measurement plus the fee for dispensing may be levied.

Procedure codes

0019 and 0001

xi.

A patient requests immunisation.

A professional fee for administration of immunisation plus the fee for dispensing may be levied.

Procedure codes

0022 and 0001

xii.

A patient requests that the medicine on a prescription dispensed in the pharmacy be delivered to a given address.

A delivery fee plus the fee for dispensing may be levied.

Procedure codes

0025 and 0001

xiii.

The pharmacist is called to the pharmacy after hours to dispense a prescription.

A fee for a call out service plus the fee for dispensing may be levied.

Procedure codes

0024 and 0001

xiv.

A patient presents herself to the pharmacist for emergency post coital contraception (EPC).

A professional fee for EPC plus the fee for pharmacist initiated therapy may be levied.

Procedure codes

0027 and 0001

xv.

A patient presents him/herself for pharmacist initiated therapy.

A professional fee for pharmacist initiated therapy plus the fee for dispensing may be levied.

Procedure codes

0028 and 0001