Monday 25 June 2018

DISCOVERY HEALTH ONCOLOGY BENEFIT 2018 - Introducing a pharmacy network

Introducing a pharmacy network for the Discovery Health Medical Scheme Oncology Benefit for 2018

Through its Oncology Benefit, Discovery Health Medical Scheme provides members with comprehensive benefits to treat cancer. These include treatment plans that prescribe biologics, a new kind of medicine.
Due to the Oncology Benefit, more than 96% of cancer patients had no co-payments on their treatments in 2017.

Pharmacy network to be the designated service provider to supply oncology medicine

From 1 July 2018 we will introduce a network of pharmacies that will supply oncology medicine. The network will both enhance service and provide significant cost efficiencies, which can extend the cover for members receiving treatment.

The extensive coverage of the pharmacy network also lets the Scheme make it a designated service provider that will supply oncology medicine to newly registered members on the Oncology Benefit.

  • For medicine administered in the doctor’s rooms:
    • Medicine like chemotherapy should be obtained from a network pharmacy. Most oncology practices already work with these network pharmacies. We are working with oncologists to extend this to all oncology practices
    • Members should confirm with their oncologists that they use the designated service provider.
  • For medicine scripted and dispensed at a retail pharmacy:
    • Supportive medicine and oral chemotherapy can be obtained from any MedXpress network pharmacy, which includes more than 1 500 retail pharmacies with broad national coverage
    • Members should consult the MedXpress network list available on the Discovery website to find the closest MedXpress network pharmacy.
How introducing the pharmacy network will impact members

  • All approved oncology medicine should be dispensed from the oncology pharmacy network:
    • For newly diagnosed patients that register on the Oncology Programme after 1 July 2018
    • From 1 January 2019, for diagnosed patients that registered on the Oncology Programme before 1 July 2018.
  • Medicines dispensed by a non-network provider for oncology treatment (both in-rooms or dispensed by a retail pharmacy) will mean a 20% co-payment for all members on the Oncology Programme.
Members can find information about the pharmacy network, as the designated service provider, in our Oncology Benefit brochure for 2018. We will also send notifications about the pharmacy network to both new and existing members on the benefit.

If a member applies for the oncology benefit but gets treatment at an oncology practice that does not use the designated service providers we will notify the member of the applicable co-payment.

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