Ground-breaking new research suggests that dramatically lower doses or shorter courses of revolutionary immunotherapy drugs could be highly effective. This finding may eventually pave the way for wider global access to life-saving cancer treatments. Lower-dose immunotherapy trials are showing promising potential. Drugs like Merck & Co’s Keytruda and Bristol Myers Squibb Co’s Opdivo have transformed oncology. They boost survival rates…
Tag: healthcare costs
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Discovery Defers Contribution Increase Until April
Discovery Health Medical Scheme (DHMS) has announced a significant decision. It will defer its 2026 contribution increase for three months. This move will return about R1.5 billion to its members. This deferral provides welcome financial relief for many families. It is possible because of the scheme’s strong financial position./h Understanding the 2026 Contribution Increase Deferral Members will not see a…
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Mediscor Medicines Review 2024: Key Insights Revealed
The Mediscor Medicines Review 2024 reveals a significant 5.0% increase in medicine expenditure. This marks the most substantial rise in the past three years, presenting a complex challenge for South Africa’s healthcare sector. As a leading pharmaceutical benefits management (PBM) organisation covering over 2.6 million lives, Mediscor’s annual analysis provides a critical barometer for the industry. The 2024 report highlights…
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Medical Aid Premiums to Continue Outpacing Inflation
Multiple sources are warning South African consumers to brace for continued high increases in their medical aid premiums. Experts expect costs to keep rising significantly faster than general inflation. The caution comes from Adrian Gore, CEO of Discovery, the country’s largest medical scheme administrator. He suggests that the underlying drivers of medical inflation continue to be a persistent challenge for…
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Billions Lost to Fraud and Waste Cripple SA’s Private Healthcare
South Africa’s private healthcare sector is haemorrhaging up to R28 billion a year due to rampant fraud, waste, and abuse (FWA). This directly threatens the quality of care and financial stability of medical cover for millions of citizens. The stark warning comes from the Health Funders Association (HFA), which estimates the losses represent a staggering 15% to 20% of all…
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Gems Premium Hike: Unions Demand Single Digits
South Africa’s largest medical scheme for public servants, Gems, is facing mounting pressure from unions. They want to limit its 2026 premium increase to single digits. This follows a controversial 13.4% hike this year. Following several years of modest increases, the double-digit rise for 2025 drew strong opposition from public sector unions. These include the Public Servants Association (PSA) and…
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Trade Tariffs and Their Impact on Pharmaceuticals
The pharmaceutical industry is bracing for a significant financial blow. Analysts forecast costs of between $13 billion and $19 billion following a new transatlantic trade deal. This deal will subject branded medicines to a hefty 15% tariff. Officials confirmed the landmark trade agreement between the European Union and the United States on Sunday. It marks the end of the historic…
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Discovery Health’s Top Claims of 2024 Revealed
Discovery Health Medical Scheme (DHMS) has revealed the immense scale of its 2024 claims. It paid out a total of R83 billion last year. The scheme highlighted its ten highest individual claims, which alone amounted to R70.5 million. This underscores the critical role of medical cover in managing catastrophic health events. Presenting at the scheme’s Annual General Meeting (AGM), DHMS…
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Bestmed’s Innovative AI Solution Against Fraud
Bestmed Medical Scheme, South Africa’s fourth-largest open medical scheme, is preparing to integrate Artificial Intelligence (AI) into its systems. This initiative aims to combat the growing scourge of fraudulent claims plaguing the healthcare industry. Protecting members’ funds and ensuring the scheme’s long-term sustainability amidst rising operational pressures are also goals. Bestmed CEO and Principal Officer Leo Dlamini confirmed that the…
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Medical Scheme Solvency Issues Impacting Members
Three medical aid schemes – Medihelp, Sizwe Hosmed Medical Scheme, and Transmed Medical Fund – did not maintain their medical scheme solvency ratios at or above the statutory minimum of 25% in 2023. This was a key finding in the Council for Medical Schemes (CMS) Financial Performance Industry Report 2023, released last week. While the total number of medical aid…
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Low-Cost Benefit Options Extended Until 2027
The medical schemes regulator has extended low-cost benefit options (LCBOs) for health insurance companies until March 31, 2027. This enables affordable coverage for lower-income households while a formal regulatory framework is still pending. The medical schemes regulator has granted health insurance companies a two-year extension until March 31, 2027. This allows them to operate under a framework that permits low-cost…
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GLP-1 drugs increase healthcare costs for obese patients
GLP-1 drugs, such as Novo Nordisk’s Wegovy, have become popular for weight loss among US patients struggling with obesity. Despite significant weight-loss benefits, an analysis of US health insurance claims reveals that these medications may drive healthcare costs higher rather than reducing obesity-related expenses. According to data from Prime Therapeutics, a pharmacy benefits manager, US patients’ average annual medical expenses…