The National Health Insurance Authority (NHIA) has reviewed upwards the prices of medicines and services paid to providers and suppliers on the health insurance scheme. This came in effect yesterday.
It has also reviewed the list of medicines on the scheme to include, Artemether Injection 50mg/ml, which is widely used for the treatment of uncomplicated malaria (Plasmodium falciparum), and Levofloxacin Infusion, a drug used to treat bacterial infections in different parts of the body.
Providing details of the review to the Daily Graphic, the Chief Executive of the NHIA, Dr Bernard Okoe Boye, said the prices of framework medicines had been increased by 80 per cent, while non-framework medicines had been reviewed upwards by 20 per cent.
He described framework medicines as those used by the scheme and ascribed fixed prices that had been negotiated and agreed upon by stakeholders, such as manufacturers and the Ministry of Health, together with the NHIA.
Non-framework medicines, on the other hand, are medicines outside the framework box.
Dr Okoe Boye said the negotiations for the revision facilitated a 50 per cent increment in framework medicine prices, which reflected production cost.
However, the NHIA added 30 per cent to cover other expenses in the delivery of the medicines to bring their prices on the National Health Insurance Scheme (NHIS) closer to market prices.
He said all medicines outside the framework box, also known as non-framework medicines, which could be supplied by any dealer or manufacturer, in line with provisions of the law, had also been increased by 20 per cent.
Also, fees paid to service providers for all services rendered under the scheme, such as surgical processes, had also been increased by 10 per cent across the board, he said.
“The approved list will be disseminated through the respective provider associations. I hope that these reviewed documents will be implemented by your respective groupings according to the contractual arrangements in place,” Dr Okoe Boye told service providers.
He added that the reviews were in accordance with the National Health Insurance Act, 2012 (Act 852), explaining that they were necessary to enhance service delivery for subscribers and give providers value for money to avoid certain gaps in access to medications and services under the scheme.
He indicated that if market prices of medicines were higher than what the NHIS was paying, service providers would prescribe the medicines but would not dispense them to patients to avoid making losses.