Medical Scheme - Clinical Intelligence

Clinical policy making is based on the following principles:

  • Scientific evidence-based criteria
  • Cost-effectiveness and affordability from a scheme perspective
  • The use of ethically principled criteria
  • The consistent application of the above criteria
  • Access to appeal against decisions
  • Communication of decisions to all parties
  • Documentation of decisions
  • Regular review of decisions in the light of new data and experience

Our independent Clinical advisory committee is made up of highly respected leaders in the Healthcare Industry. We are recognised as a global expert in HIV management and have published and presented around the world.

Some examples:

  • South African Health Review
  • Annals of Internal Medicine
  • Journal of Acquired Immune Deficiency Syndromes
  • South African Journal of HIV Medicine
  • AIDS Analysis Africa

The core components of the CDMP are:

  • Case management
  • Medicine review
  • Patient education
  • Health status monitoring
  • Patient compliance
  • Clinical oversight
  • Data analysis and reporting
patient care line
0860 100 646

doctor/pharmacist
0800 227 700

cape town office
+27 (0)21 466 1700

fax
0800 600 773
+27 (0)11 671 3824

Email Address afa@afadm.co.za