Pharmacy price war - relief at last or just another false dawn

Medicine prices have been robbing South Africans blind for years. Finally someone is fighting back. The Competition Commission just gave the green light for more pharmacy chains to open wherever they want. They promise cheaper pills for diabetes, blood pressure and HIV. For once the little guy might win. But hold the celebration. The rand has other plans.

Forex trading apps are blowing up in townships right now. Young people who battle to pay for chronic meds suddenly see USD/ZAR charts moving 50 cents in a day and think they can make quick cash. Brokers say downloads in Gauteng jumped 40 percent since October. Some are winning. Most are losing school-fee money. Meanwhile the same rand chaos is pushing up the real cost of every imported tablet.

Here is the dirty secret the big pharmacies never tell you. More than 70 percent of the ingredients in your pills come from India and China. They get paid in dollars. When the rand fell from R17.80 to R19.40 in November, the price of raw materials shot up overnight. A box of generic blood-pressure pills that cost a factory R28 to make in July now costs closer to R33 before anyone even puts it on the shelf. The Commission can force retail mark-ups down, but it cannot force the rand to behave.

Diabetes is killing us faster than ever. Stats SA says it is now in the top five causes of death for women over 35. A month’s supply of metformin can eat half of a domestic worker’s grocery money. When Dis-Chem and Clicks fight each other the price might drop from R180 to R140. That sounds great until the rand drops another rand and the same box jumps straight back to R190. The war in the aisles feels good for five minutes. Then the exchange rate laughs and takes it all back.

Small independent pharmacies in Soweto and Alexandra are excited about the new rules. They dream of bigger buying power and lower prices for grannies who queue from 6 am. Reality is harsher. The wholesalers still demand dollars for stock. Many of these pharmacies survive on 30-day credit. One bad month of rand weakness and the bank calls in the overdraft. Several owners told me privately they will battle to stay open past March if the currency keeps sliding.

The people who suffer most never make the headlines. A mother in Diepkloof showed me her clinic card last week. She owes the pharmacy R420 for three months of ARVs because the grant money ran out on electricity and transport. She now skips doses to make the pills last. Cheaper pharmacies will not fix that if the rand keeps punishing the poor every week.

There is still hope. The Commission says real competition could cut medicine prices by 15 to 20 percent within two years. That is real money for pensioners and child-support-grant mothers. But hope needs help. The Reserve Bank must keep inflation under control. The government must stop scaring investors with crazy talk about nationalisation. And young people chasing fast rands on trading apps need to hear the truth – most lose more than they ever make.

Until the rand calms down, every price war victory will feel temporary. We cheer when the pills get cheaper on Tuesday. We cry when the exchange rate steals it back by Friday.

The sick cannot keep running this race.