Subsidy of NHF on Per Tablet Basis not on Per Prescription


Minister of Health, John Junor has pointed out that the subsidy provided on prescription drugs under the National Health Fund (NHF), was on a per tablet basis and not on a per prescription basis, thereby maximising the benefit to patients who suffered from chronic diseases covered by the Fund.
Mr. Junor was responding to concerns raised by Opposition Spokesman on Health, Dr. Kenneth Baugh in the House of Representatives on Tuesday (November 2), that there were complaints that some discount benefits were too low and were not worth the effort.
“The basis on which the subsidy is arrived at is on what is the active ingredient in the prescription, not what the name of the drug is. It is a way to encourage our prescribers to look at generic alternatives, which the world knows are cheaper and deliver essentially the same drug,” the Minister said.
“If the patient is not able to tolerate a particular generic drug and has to be prescribed a brand name outside of the list, we encourage them to appeal with supporting documentation from their doctor and the medial review committee will consider it,” he added.
Responding to Dr. Baugh’s claim that some pharmacies preferred to give patients a 10 per cent discount instead of claiming for the NHF discount, which could be as low as 10 per cent in some instances, Minister Junor said that if their intention “is really to help the patient and give them a 10 per cent discount and there is a further 10 per cent discount that is offered by the NHF, why not give a 20 per cent discount?”
Mr. Junor said there would be no difficulty in recovering the 10 per cent, because “we turn around the claims made in less time than any other health care provider. No other health care provider guarantees you a nine-day turnaround time”.
To more effectively communicate the range and extent of subsidies provided as individual benefits, the NHF has also introduced a booklet, which is to be available to the public at pharmacies, health clinics, supermarkets, churches and doctors’ offices.
The booklet provides information on the various pharmaceuticals covered and the level of subsidy given on each item. The NHF recently announced that it had increased the number of prescription drugs it provided coverage for to its subscribers from 500 to more than 800 drugs, effective November 1. The NHF has also increased the subsidy it provides from an average 35 per cent to an average 50 per cent for all items on its list.
On the level of participation, Mr. Junor said at the outset of the NHF, projections had been made that the subscriber rate would have reached 165,000 by now. “What we can say is that the Drug for the Elderly Programme, which we have absorbed into this programme, but on the same basis that the programme existed before, with both of those combined, the projected 165,000 to be registered by now is some 45,000 short”.
Mr. Junor pointed out that one of the factors that had caused the shortfall was the fact that many people were reluctant to be medicated for certain of these conditions. This, he said, was particularly so in the case of men who were hypertensive, as some of the drugs used to treat this condition had a negative impact on potency.
The Minister explained that the NHF was a first step in the process toward a national health insurance scheme, and remained a commitment of the government. “I might also point out that in pursuance of that, we in fact as a government, introduced a programme of full coverage that deals with hospitalisation, pharmaceuticals and diagnostics under the NI Gold programme, which covers some 70,000 pensioners in our country,” he added, noting that the NHF was now gearing up to absorb that programme.

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