Doing a dispensing course and acquiring a dispensing license can open up opportunities for growth in your practice. Due to the higher dispensing fees applicable to pharmacies, patients are turning to their GPs and even specialists to provide cheaper medicines.
Dispensing to your patients also has clinical benefits in that you are able to track your patients’ progress on the medicines you dispensed, without your prescription having been substituted. You now also get first-hand information about each brand’s relative effectiveness, which in turn leads to even better dispensing patterns.
Step 1: Know Your licensing requirements – your dispensing course
The Medicines and Related Substances Act (Act 101 of 1965 as amended), requires you to enlarge your scope of practice by completing a supplementary course in dispensing before you can apply for a license to dispense.
There are about eight accredited dispensing courses you can choose from, and all are registered with the South African Pharmacy Council (SAPC).
All courses broadly follow the same outline, but methods of delivery differ. Some require physical attendance at a workshop; others allow large parts to be completed online. Most require Portfolios of Evidence (PoE), which can be quite time-consuming, so look for ones that do not require this. All that is required of you is to complete a summative (final) assessment, which in some cases is an open-book.
Step 2: Know Your licensing requirements – your dispensing license
Having received your certificate of completion of the dispensing course, you can now apply for your license to dispense from the Department of Health (DoH). Make sure you have the most recent application form, and don’t forget to have a Commissioner of Oaths sign and stamp your application.
Add the following supplementary information (also signed and stamped by the CoA’s:
- Proof of course completion
- Proof of registration with the HPCSA (your practitioner’s card)
- Your ID
- Proof of payment of the application and the first annual fee.
Step 3: Know your license requirements – complying with conditions
For medical practitioners, a dispensing license is a constitutional right; therefore, your license is also valid for life unless it is suspended or revoked by the DG of the DoH in terms of the Medicines Act. Even so, you have to comply with certain conditions.
You have to be a registered practitioner (pay annual registration fee with the HPCSA), pay an annual license fee of R200.00 to the DoH and then also comply with Good Pharmacy Practice (GPP).
Step 4: Know your license requirements – changing address, opening a satellite practice, doing locums
Your license has your name on it, an address, as well as a license number.
This means that you can dispense your own prescriptions from that address after you have consulted and diagnosed a patient. A practice, clinic or facility is never licensed – it is the individual practitioners working from that address.
Working from more than one address necessitates that you get a license for each of those addresses. This is just an admin process, and you need to complete an amendment form in which you indicate that it is an additional address. Your main license’s last digit is a “0” and your additional address will have a “1” as its last digit.
Step 5: Staying compliant – check the status of existing license(s)
One payment of R200.00 per year to the DoH can easily slip your mind. And once the license hangs on your waiting room wall, checking its status can slip your mind.
And now a medical aid or wholesaler suddenly stops paying your claims or refuses to deliver to your current practice address.
The reason is that you either have a pre-2014 license, which still has an expiry date or your address on your license does not correspond with your physical address. This happens when the local municipality decides to change the street name!
Step 6: Profitable dispensing – laying the foundation
Every licensed medical practitioner needs to know if his dispensary is running at a profit, what that gross profit is, and, in essence, if he can “afford” to dispense.
The first step is to mirror the current government-regulated dispensing fee against your stock usage report.
The appropriate dispensing fee as contemplated in Section 22G of the Act to be charged by persons licensed in terms of Section 22C (1) (a) of the Act must be calculated, exclusive of VAT, as follows:
- Where the single exit price of a medicine or scheduled substance is less than one hundred and fifty rand (R150.00), the dispensing fee must not exceed 30% of the single exit price in respect of that medicine or scheduled substance;
- Where the single exit price of a medicine or scheduled substance is equal to or greater than one hundred and fifty rand, the dispensing fee must not exceed forty-five rand (R45.00) in respect of that medicine or scheduled substance.
Step 7 – Profitable dispensing – the first bricks
Understand what the definition of “medicine” is and inform your patients about it.
In South Africa, a medicine is any substance or mix of substances that is intended (or claimed to be suitable) to affect health. This includes products for diagnosing, treating, or preventing disease, or altering bodily or mental functions, in both humans and animals.
The main categories of medicines in South Africa are:
- Human medicines (prescription & OTC),
- Veterinary medicines,
- Biological medicines (including vaccines),
- Traditional & complementary medicines, and
- Combination products / devices with medicinal effects.
You can dispense what you prescribed, and a licensed medical practitioner can prescribe any medicine.
Step 8 – Profitable dispensing – Tracking income and Cash or account
You have empowered your patients through your Patient Information Newsletter, and they can now manage their spending with you much better. Asking you to claim for schedules 3-6, but paying for all other medicines.
Now one can start tracking income on a daily basis and mirroring this against a set of known expenses. In essence, your dispensary is a 2nd business or profit centre, and you need to know how profitable it is.
Eager to make dispensing a successful part of your practice? Explore the steps, keep compliant, and watch your dispensary flourish. Reach out to us today to see how we can support your journey to success.
