NHIS Launches E-Pharmacy Initiative to Combat Illegal Charges and Improve Access to Medications

The National Health Insurance Scheme (NHIS) is utilizing the Ghana National Electronic Pharmacy Platform (E-Pharmacy) to combat illegal charges, often referred to as co-payments.

Dr. Da-Costa Aboagye, Chief Executive of the NHIA, shared this update during staff engagements held nationwide, including the latest session at the Authority’s head office in Accra on November 4, 2024.

He urged all accredited facilities and personnel to join his efforts in eliminating illegal charges.

Dr. Aboagye explained that the E-Pharmacy initiative mandates that if a credentialed pharmacy—whether part of a healthcare facility or standalone—lacks a prescribed medication, it must upload the prescription to the E-Pharmacy platform.\

This allows the system to identify another accredited facility nearby that has the medication available, directing the patient to that location for pickup or arranging home delivery using a property addressing system.

Currently being piloted in northern regions, the E-Pharmacy will soon be rolled out nationwide.

Dr. Aboagye emphasized that integrating this digital platform with the NHIS will significantly reduce the chances of illegal charges on medications that should be covered, as members will be able to verify real-time availability, thus avoiding unauthorized payments.

“This initiative aligns with our mandate to protect beneficiaries and ensure all services under the scheme are free at the point of delivery,” he asserted, adding that it promotes collaboration among pharmacies and enables patients to receive their medications promptly.

The E-Pharmacy initiative will also utilize real-time data to track medication dispensing patterns across pharmacies, helping the NHIS identify and address discrepancies related to co-payments more effectively.

Dr. Aboagye noted that centralizing pharmacy services will enable the NHIA to quickly respond to compliance issues among accredited facilities, maintaining the integrity of the Scheme.

He acknowledged that the timing of this initiative is crucial as the NHIA aims to enhance the NHIS’s effectiveness and sustainability, which is designed to provide comprehensive healthcare coverage to all citizens.

Co-payment has become a significant challenge for the NHIS, with many members reporting frequent charges at hospitals and pharmacies.

Dr. Aboagye attributed some of these illegal charges to health facilities citing delays in claim payments and low medication tariffs compared to market prices. He asserted that no justification exists for such practices, and the NHIS is committed to addressing these concerns.

The government has invested heavily to improve payment processes and service provider tariffs, ensuring healthcare facilities can operate sustainably without resorting to illegal charges.

Dr. Aboagye confirmed that all vetted claims are being paid promptly, stating, “We have worked hard to ensure no outstanding claims as of now.”

Regarding tariff concerns, Dr. Aboagye mentioned that the NHIA is actively collaborating with stakeholders to review and adjust tariffs, aiming for an automatic adjustment policy that addresses service providers’ concerns.

The E-Pharmacy Platform, which launched in January 2023 after a successful six-month pilot, has been positively received by both the government and pharmaceutical stakeholders. Vice President Dr. Mahamudu Bawumia, who was instrumental in its development, expressed excitement about the convenience it will provide for Ghanaians. The platform allows registered pharmacies to streamline the process of uploading and purchasing prescribed medications, which can then be delivered directly to patients’ homes upon registration with their Ghana Cards.