Health Funders Association welcomes Competition Tribunal finding on PCR test pricing case

The Health Funders Association (HFA) welcomes the outcome of the Exceptions hearing by the Competition Tribunal, which ruled in its favour on eight of the nine grounds of exception raised by the pathology laboratories in the case concerning the pricing of COVID-19 PCR tests during the COVID pandemic in 2020–2021.

HFA, a representative organisation for medical schemes, has pursued this case in the broader interest of medical scheme members, on behalf of 36 schemes and 5.6 million beneficiaries. Medical schemes operate on a not-for-profit basis, meaning that all funds—beyond mandatory reserves and capped administrative costs—must be allocated to members’ healthcare. Scheme trustees have a fiduciary duty to recover any funds paid out inappropriately, on behalf of their members. Once recovered, these funds will go back to providing healthcare benefits for the members of medical schemes.

Commenting on the ruling, HFA CEO Thoneshan Naidoo said: "The cost of healthcare directly impacts medical scheme contributions and overall affordability. The higher prices for PCR tests during the pandemic contributed to healthcare inflation, driving up contributions and placing additional financial strain on members. We believe that this decision by the Competition Tribunal bodes well for the hearing on the merits of the case.”