Medicine Price List (MPL) is a reference pricing system used in conjunction with formularies and pre-authorisation as a tool. MPL was developed by Medscheme and is applied by your medical aid to control medicine prices.
This reference pricing system does not restrict the choice of medicines – it controls the cost of medication. The system uses a benchmark for generically similar products to limit the amount that will be paid in medicine prices. You are free to use any item which appears on the MPL. However, if the price is more than the reference price, you will be required to pay the difference.
Reducing the cost of medication
There is always at least one medicine available that will not require a co-payment, so make sure you discuss your options with your doctor. It will help if your doctor prescribes the active ingredient rather than trade name, or states on the script whether a generic substitution is permitted.
MPL groups are created for:
- Items that are the generic equivalent, i.e. same ingredients, same strength or same formulation
- Products which are generically similar and contain the same active ingredients, at the same effective strength, but the formulation may differ, e.g. tablets vs capsules
The MPL list is reviewed monthly by a Pricing Committee and decisions are based on clinical expertise, market experience and business input. The products listed are from reputable companies to reduce the possibility of any particular product shortages to ensure that you can access quality care with no co-payments.
In the healthcare environment, there is an increase in costly chronic diseases, and medical aid membership contributions are rising faster than general inflation. For this reason, the implementation of a price management tool plays a major role in managing medicine prices within available Scheme benefits.