Are You Pregnant? The State Has Plan B

the mystery of the little pill

This little pill would have passed as yet another essential drug that must be procured to keep the nation healthy.

In Brief

  • The Department of Health procured one million emergency contraceptive pills as a last line of defense against rising rates of unwanted and teenage pregnancies
  • uSpiked’s examination of  the R236 million contraceptive contract awarded to various pharmaceutical contractors exposes how some suppliers collude with the department officials to hike the prices soon after awards
  • The price escalation of the morning after pills alone by Litha Pharma (Pty) Ltd cost the public coffers an extra R1.598 million

To a layperson looking at Department of Health’s R29 billion pharmaceuticals shopping list, Levonorgestrel 1.5mg could only be one of the essential drugs needed by the public. But not to our consulting team of medics who revealed to us that Levonorgestrel is an emergency contraceptive a.k.a the morning-after pill.

The department tendered for one million of these pills and contracted Litha Pharma (Pty) Ltd. to supply Escapelle, a brand of morning-after pills manufactured by Hungarian company, Gedeon Richter.

uSpiked team did not find any database showing statistics of the number of women, young or old, who have used the morning-after pill dispensed by state medical clinics. However, given the high rate of teenage pregnancies in South Africa, it seems not many girls are gaining access to these pills that come with a double digit millions price tag or even other options such as condoms.

There were about 99,000 reported cases of teenage pregnancies in the country in 2013. Last September City Press worked the rate to an alarming 271 pregnancies for every day of the year.

The grim statistics beg the questions, what is missing in the department’s preventative health strategy? Have the billons so far spent on contraceptives made any impact?

Litha’s R17 million deal for supply of Escapelle pills was contracted under Contract No HP03-2013FP. The FP on the contract number then stood for ‘Family Planning’, [the name has since been changed in the replacement contract awarded in August 2015].

For the emergency contraceptive pill to work, it has to be taken within 72 hours of having unprotected sex. Due to the administrative challenges that exist in public health facilities, the chance of a woman accessing the pill timeously is reduced.

Going by the 2013 pregnancy figures worked out by City Press, we would be expecting 271 daily demands for the pills at such facilities across the country. Healthcare professionals at the facilities cannot dispense the pills in anticipation of an unprotected sexual act.

One issue we noted with this and other contracts is a scheme devised by some suppliers who quote low prices to win tenders only to increase the cost soon after winning contracts. The practice, we can authoritatively state, seems to be a common practice that defrauds the public and shortchanges other bidders.

When it was awarded the emergency contraceptive pills contract in September 2013, Litha Pharma (Pty) Ltd won the bid based on its price of R15.50 per pill. Early 2014, the supplier sought and obtained permission to increase the price to R17.0928. This escalation cost the public a further R1.598 million.

Soon after Litha’s price increase request was granted, other winning bidders in the contract HP03-2013FP were also allowed to adjust their prices for other contraceptives.

One factor that could precipitate price increases is the exchange rates. On September 3, 2013 when the contract was awarded, the local currency was exchanging at R10.20 to the US dollar. By April 1, 2014 when the request was granted, it was R10.5 to the dollar.

Historical Rand/Dollar Exchange rates showing the underhand dealings by pharma suppliers

When we examined other data extracted from Contract No. HP03-2015CHM awarded on August 28, 2015 for the same products, Litha Pharma (Pty) Ltd landed another one million morning-after pills contract at a quoted price of R14.75 a pill – 75cents less than their contracted price of two years earlier. But at that time, the exchange rates were R12.89 to the US dollar.

Unfortunately for the taxpayers, adjustment of prices is so routine and accepted that come next year, Litha Pharma and other suppliers will likely petition the department to increase the prices of contraceptives.

CLICK HERE for a complete Family Planning pie distribution.