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NHIS To Pay 30% More For Medicines

THE NATIONAL Health Insurance Authority (NHIA) has carried out upward adjustment to National Health Insurance Scheme (NHIS) medicine and service tariffs as government strives to expand the coverage of health services to all residents.

In accordance with the National Health Insurance Act 852, (Act 2012), the upward review tariffs signed by the NHIA’s Chief Executive, Dr. Bernard Okoe-Boye, takes effect from July 1, 2022.

This latest development was done in consultation with the NHIA accredited healthcare service providers and other critical stakeholders in the health sector.

Per the mandate of the NHIA, the reviews are done periodically, following a very rigorous scientific process.

The current reviewed medicines list contains a total of 546 formulations.

A national survey of medicine prices was undertaken using the methodology of the World Health Organisation and Health Action International (HAI). Pricing data was collected from manufacturers, wholesale distributors, private pharmacies, government, mission, and private health facilities located in all the 16 regions in the country.

The output of the Framework Contract Agreement of the Ministry of Health was also factored into the pricing of the formulations within the contract arrangement.

The prices provided are those agreed upon by the National Health Insurance Authority (NHIA) and stakeholders as the reimbursable price for medicines supplied under the scheme, and show a 30% increment of the data collected.

The NHIA Board commissioned a multi-stakeholder team to conduct a costing exercise of healthcare services that would inform the next service tariff review. The output of the costing exercise was used to determine reviewed tariff rates.

In line with standard practice, all key stakeholders were involved in the process of review.  The average impact of the service tariffs, across all provider types in the public sector, is about a 35% increment from the previous service tariffs.

These adjustments have been made in consultation with all stakeholders, taking into consideration all economic factors indicated.

These considerations will improve the availability of all medicines on the NHIS medicine list nationwide. Furthermore, it is expected to minimise out-of-pocket payments (unauthorised fees) charged to NHIS members at the point of healthcare delivery and increase the public’s confidence in the scheme.

The reviewed medicines and tariffs include treatment of the newly added four Childhood Cancers, Clinical Family Planning Services, Hydroxyurea for Sickle Cell Anaemia, and other new formulations, and take effect from July 1, 2022.

“Management of the NHIA wishes to assure all Ghanaians, that the NHIS continues to be the vehicle and the road towards the attainment of Universal Health Coverage (UHC),” a statement issued by the NHIA Corporate Affairs Directorate said.

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