The Fund applies reference pricing known as the Metropolitan Health Reference Price (MetRef) - previously known as the Qualsa Maximum Price (QMP). This means that there is a preset maximum price that the Fund will pay for your medication, equivalent to the average price of the generic alternatives in that range. The MetRef List contains products that are considered to be generically identical i.e. the generic medication is identical to the original, brand name medication in dosage, strength, consumption, quality, safety, efficacy and intended usage. Although they are chemically identical, generic medication is typically much cheaper and therefore allows you to use your chronic medication benefit in a more cost-effective way.
In the event that an original brand name medication (e.g. Panado®) has one or more suitable generic alternatives available (e.g. Dolorol®, Painamol® and Adco-Paracetamol®), then MetRef will be applied. Should you wish to use the original medication, you will be liable for the co-payment (calculated as the difference in price between the average generic and the original) at the point of sale. You are therefore encouraged to make use of generic medication instead of the more expensive, original brand name medication.
The prices in the MetRef List are fixed for a period of one month, after which they are recalculated based on the latest prices.