NHIA asked to improve ways of reimbursing pharmacies


Pharmaceutical Society of Ghana (PSGh), has suggested to the National Health Insurance Authority (NHIA), to develop more innovative ways of reimbursing accredited community pharmacies to bolster pharmaceutical services delivery in the country.

This, it said, could be done by designing an on-line submission of claims by the pharmacies in order to reduce the delay in the reimbursement, which usually created serious financial challenges in terms of capital lock up and increased cost of investment.

The Society said a study it conducted recently, indicated that the delay in the reimbursement of claims has a turnaround effect on service providers? ability to provide quality service to insured patients, to help engender the viability of the National Health Insurance Scheme (NHIS).

Giving an in-sight into the study at a stakeholders? meeting in Kumasi, Dr Berko Anto, the Lead Consultant, said there was the need to consciously work towards a balance between access and quality pharmaceutical care delivery in the country.

The study that was undertaken between August and November, last year, was funded by the Business Sector Advocacy Challenge (BUSAC) Fund.

It covered three regions representing the southern, middle and northern sectors of Ghana.

Greater Accra represented the southern sector, Ashanti Region, the middle sector and Northern, Upper West and East Regions together represented the northern sector.

Respondents were selected from NHIS clients and accredited community pharmacies.

In all, 2, 400 clients and 170 providers were interviewed in the three sectors.

The study aimed at identifying challenges facing community pharmacy practice in Ghana under the NHIS.

The project was on the theme: ?Mainstreaming Pharmaceutical Practice for a Comprehensive Healthcare Delivery in Ghana.?

Dr Anto said the study established that reimbursement time for community pharmacies in the Greater Accra Region, for instance, averaged three months as against six months in the Ashanti Region.

This scenario makes it difficult for them to improve on their medicine stock to put them in the position to providing the full range of medicines prescribed as in most cases they are only able to fill 80 per cent of the prescriptions.

In a few cases, some accredited pharmacies underperformed and were able to fill only 20 per cent.

Dr Anto said delayed claims payment was uppermost in the reasons why the NHIS was not meeting the expectations of accredited community pharmacies and providers.

Most of them, he said, were trying to rise up to the challenge and the opportunity presented by the NHIS by contracting bank loans to improve on their medicine stock and also by having more spacious pharmacies.

Mr James Ohemeng Kyei, President of the PSGh, said the non-involvement of community pharmacy practitioners in the design and implementation of capitation as an option for financing healthcare in Ghana should be a worry to stakeholders.

To ignore them, he said, could endanger the success of the programme.

Mr Kyei said though the level of awareness on the NHIS was high, there was still the need for the NHIA to intensify education about the scheme, especially the right of patients to exercise the option of being served at a facility prescribing, and dispensing at the same time or going to an accredited community pharmacy to be served.

Professor Emeritus Kwame Sarpong, former Dean of the Faculty of Pharmacy, Kwame Nkrumah University of Science and Technology, said given the increasing demand for healthcare as a result of population growth, it was in the national interest that community pharmacy practice was equipped to build up capacity to beef up its role in the provision of healthcare.

Source: GNA

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