The government’s efforts to expand the coverage of health services to all residents in Ghana have yielded positive results as there has been an upward review of the National Health Insurance Scheme (NHIS) medicine and service tariffs.
In accordance with the National Health Insurance Act 852, (Act 2012), the reviewed tariffs signed by the NHIA’s Chief Executive, Dr. Okoe-Boye became operational on July 1, 2022.
This latest development 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.
The current reviewed Medicines List contains a total of Five Hundred and Forty-six (546) formulations. 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 sixteen (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 indices These considerations will improve the availability of all medicines on the NHIS medicine list nationwide. Furthermore, it is expected to minimize 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.
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 1st, 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).
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