The National Health Insurance Authority (NHIA) has made an upward review of the National Health Insurance Scheme (NHIS) medicine and service tariffs to expand the coverage of health services to all citizens.
It includes treatment of newly added four Childhood Cancers, Clinical Family Planning services, Hydroxyurea for Sickle Cell Anaemia, and other new formulations.
In accordance with the National Health Insurance Act 852, (Act 2012), a statement from the Authority, copied to the Ghana News Agency, said the reviewed tariffs signed by the NHIA’s Chief Executive, Dr. Bernard Okoe-Boye, became operational on July 1, 2022.
The review, it said, was done in consultation with the NHIA credentialled 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 and the current reviewed Medicines List contain a total of 546 formulations,” the statement said.
It noted that a national survey of medicine prices was undertaken using the methodology of the World Health Organization 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 statement disclosed.
The prices are, therefore, those agreed upon by the NHIA and stakeholders as the reimbursable price for medicines supplied under the Scheme and show a 30 per cent increment of the data collected.
The NHIA Board also commissioned a multi-stakeholder team to conduct a costing exercise of healthcare services that would inform the next service tariff review.
The costing exercise, the statement said, was used to determine the reviewed tariff rates.
In line with standard practice, all key stakeholders were involved in the process of review and the average impact of the service tariffs across all provider types in the public sector was about a 35 per cent increment from the previous service tariffs.
“These adjustments have been made in consultation with all stakeholders, taking into consideration all economic indices. 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 (Unauthorized fees) charged to NHIS members at the point of healthcare delivery and increase the public’s confidence in the Scheme,” it explained.
“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),” the statement added.