Appolonia Adeyemi 
…laments absence of pharmacists in state’s health insurance scheme
The Association of Community Pharmacists in Nigeria (ACPN), Edo State, has berated the operations of the National Health Insurance Authority (NHIA), calling it an abysmal failure considering that it has achieved15 per cent coverage of civil servants only since its establishment. The Chairman of the ACPN in Edo state, Duke Otite who made this known recently, also lamented the absence of registered pharmacists in the Edo Health Insurance Scheme, EDOHIS, especially in the private accredited hospitals and clinics designated to implement the scheme. He made this known when the ACPN), Edo State held a summit in Edo state recently.
A press release that was signed by the Chairman of the ACPN in Edo state, Otite frowned at the modus operandi of the current NHIA which empowers the physician to be prescriber and dispenser of drugs at the same time contrary to global best practices which forbids a prescriber or dispenser to derive undue economic advantage in the totality of drug management mechanisms.
The summit also clarified that value addition remains jeopardised in NHIA operations till date because what obtains presently is that the physicians who prescribe and dispense only give out drugs in the stock of their clinics which oftentimes is not the best drug of choice from a clinical perspective. Although the association noted that Nigeria was the fifth country with the worst health care services in the world, Otite highlighted some roles that pharmacists can play to increase the level of care that patients receive at the com-munity level.
“Drugs confer credibility on healthcare services to a significant extent which places the community pharmacists in vantage position to facilitate insurance payments, resolve coverage denials, serve as representatives to help select favorable schemes, educate, sensitive and mobilise enrollees to the scheme,” Otite said. With the major services being covered by the insurance scheme being; diagnosis, laboratory procedures, surgery and pharmaceutical care, the ACPN in Edo State complained that the problem was in the non-incorporation of community pharmacies into the insurance scheme as they are the most accessible and affordable link in the value chain of healthcare.
“The value addition remains jeopardised in NHIA operations till date because what is obtained now is that when physicians prescribe and give out drugs, they usually give what they have in their stock in the hospital which may not usually be the best,” he said. The summit pointed out that this was being encouraged by the Federal Ministry of Health (FMoH) and the NHIA as they had developed a payment mechanism that is structured to merge capitation fee for General Practice Physicians (Primary Providers) and thereby negating the lawful payment mechanisms to all other non-physician health workers including pharmacists.
“This prevents the pharmacists from carrying out their professional duties of drug dispensing and counseling,” the press release stated. The statement went on to say that a Apart from taking away the role of the pharmacists, playing the role of dispenser also distracts the physicians from playing their primary role of training, research and specialised care in the teaching hospitals which are forced to manage clinical diseases. The summit also encouraged the federal government to look into the production of drugs locally as a lot of money was being spent on the importation of branded drugs.
“The NHIA should collaborate with the Pharmaceutical Manufacturers Group of Manufacturers Association of Nigeria (PMG-MAN) in a bid to produce bulk generic packs of drugs which will be negotiated to make the totality of service more affordable and accessible to consumers of health in the state and entire country at large,” Otite said. The summit concluded by saying that the strength of any health care system is driven by the primary health care and for the health sector to work, then the government would start to pay attention to the community pharmacies and primary health care in the society.
