NHF Helps to Make Drugs for Chronic Diseases Affordable


Being diagnosed with cancer can be a rather harrowing experience. The immediate reaction for many, as is human nature, is to try to get rid of it. Cancer treatment of any kind requires adequate financial planning, and can prove burdensome, even for the more affluent.
But, for persons with prostate and breast cancer who subscribe to the National Health Fund (NHF), this experience is made a lot easier through the subsidised drugs provided through the Fund.
When General Medical Practitioner, Dr. Audley Betton, learned that he had prostate cancer, he was in a state of shock. He notes, however, that he quickly sought the advice of his urologist on the recommended course of treatment, and got to work, implementing his survival plan.
He recounts that treating the cancer was costly, but was made manageable with the drug subsidy provided by his membership of the National Health Fund (NHF). Dr. Betton took the advice that he had preached daily to his patients, year after year. He has not only insisted, but has ensured that patients with chronic illnesses sign up with the NHF.
“The NHF, phenomenally, reduced the cost of getting the zoladex injections. Because of the NHF, I only paid $6,000 for an injection, which at the time cost $56,000. I was able to save $400,000 over two years,” he related his own rewarding experience.
Extolling the immense financial relief that the NHF offers to persons with chronic illnesses, the high- spirited cancer survivor urges fellow medical professionals to introduce the NHF to their patients, so that more persons can begin to access the benefits.
Breast cancer survivor and Jamaica Reach for Recovery member, Inet Clarke, speaks glowingly of the savings the NHF offers. Now 73 years old, she was diagnosed with breast cancer in 2001. Flabbergasted at the thought, she recalls her despondency lasted only a day.
Miss Clarke notes that with the help of the NHF she was able, at the time, to save up to $4,000 each time she purchased the drug anastrozole, sold under the label Arimidex.
She too encourages persons to sign up with the NHF, as she believes that it offers persons of limited means access to affordable health care.
According to NHF’s Individual Benefits Manager, Ann Logan, of approximately 500, 000 members of the NHF, approximately three per cent have benefited from provisions made for persons living with cancer. Currently, the NHF only caters to prostate and breast cancer.
She explains that there are 11 active ingredients and 51 drugs on the NHF Drug List for breast cancer, while for prostate cancer there are 10 active ingredients and 35 drugs for prostate cancer.
“Once an indiviudal is enrolled for either of these conditions, they can benefit accordingly,” informs Ms. Logan.
Unlike some health insurance schemes, the subsidy is not calculated as a percentage of the retail price, but is based on the active ingredient and is a fixed amount paid by the Fund for a particular drug, she notes.
“The beneficiary can access the benefit by presenting his/her card at the pharmacy, along with their prescription. The subsidy provided for the drug is deducted from the retail cost of the particular drug at the pharmacy, and the beneficiary makes a co- payment, which is a difference between the subsidy and the cost of that drug,” she explains.
NHF members diagnosed with breast or prostate cancer subsequent to confirming membership are also elegible for the subisidized drugs. This simply requires an update of their record which, she points out, is a fairly easy procedure.
“The individual would be required to submit a Change Form, completed by the applicant and certified by the doctor, to indicate that the beneficiary now has cancer. Once our database is updated with the information, the beneficiary can access the cancer benefits using their existing cards at the pharmacies,” notes Ms. Logan.
Though pleased with the number of beneficiaries enrolled with the NHF, Ann Logan bemoans the high incidence of chronic diseases among Jamaicans.
She notes that approximately 26 per cent of NHF beneficiaries are enrolled for hypertension related illnesses. Arthritis accounts for 16 per cent, diabetes for 14 per cent and high cholesterol for 13 per cent.
“Forty four per cent of claims paid out relates to anti-hypertensive drug.
For diabetes, we have paid out 25.6 per cent of total claims. In terms of subsidy payments, diabetes and hypertension combined, accounts for 45 per cent of total subsidy,” she added.
Ms. Logan informs JIS News that the NHF is satisfied with the level of membership, while persons continue to sign up for the programme. She encourages persons to contact their health care providers or local pharmacies for application forms.
A total of 15 chronic illnesses are covered under NHF Individual Benefits Programme. These are: arthritis, asthma, benign prostatic hyperplasia or enlarged prostate, diabetes, ischemic heart disease, breast cancer, epilepsy, high cholesterol, major depression, rheumatic heart disease, glaucoma, prostate cancer, psychosis, vascular disease, and hypertension.
NHF Individual Benefits Manager, Ann Logan, explains that to qualify for membership under the Individual Benefits Programme, the applicant must be a Jamaican, who resides in the country for at least six months of the year, possess a tax registration number (TRN) and should be living with one or more of the chronic diseases covered. All ages are eligible.

JIS Social