Beneficiaries of community-based health insurance Mutuelle de Santé have voiced concern over shortage of essential medicines mostly for chronic diseases covered under the scheme in public hospitals increasing their out of pocket expenditure on health.
Others are also concerned about the high cost of drugs prescribed by doctors and not covered under the community-based health insurance.
As a result, some beneficiaries of the scheme mostly from vulnerable households are being forced to spend their meagre incomes to buy prescribed drugs from private pharmacies, which is costly.
The list of drugs whose supply is limited includes prescriptions for chronic diseases including Hepatitis speciality drugs including Thrombate iii Hepagam B Hyperhep B S-D; hypertension drugs like Lopressor with its generic drug metoprolol, and enzyme replacement drugs, Adagen, Aldurazyme Pa, Aralast Pa, Elaprase Pa.
Beneficiaries who spoke to Rwanda Today, are appealing to the government to prioritise stocking pharmacies in health centres and referral hospitals.
Mutuelle de Santé members only pay 10 per cent of the cost of these crucial drugs while the scheme pays the remaining 90 per cent.
The beneficiaries say they need the government to either ensure availability of a variety of drugs in health centres and referral hospitals or negotiate with private pharmacies so they are covered by the community-based health insurance scheme.
However, health officials say despite their best efforts to ensure the availability of generic drugs they still face a challenge due to delays in supply of some brand name drugs, which are imported from countries like China and India.
Hospital authorities also say that the shortage is not significant and that instead the biggest challenge is limited awareness among patients and caregivers about the available options.
According to Richard Tusabe director-general at Rwanda Social Security Board (RSSB), people should stop listening to false information about the efficacy of generic and brand name medicine.
“We know patients get confused about the difference in pricing, where the price of brand name medicine is usually around three to four times more than the price of generic medicine, but this shouldn’t be an issue because they are all made from the same chemical formula,” said Mr Tusabe.
RSSB also blames some doctors for only prescribing brand name drugs, which are costly.
“Patients still lack information about how they can get drugs once the ones recommended are not found in hospital pharmacies.
We also face a challenge of doctors prescribing brand name medicine, which are expensive and rare in the country,” said Theobald Hategekimana, chief consultant and director-general of University Teaching Hospital of Kigali.
While 81 per cent of the population is covered by Mutuelle de Santé, beneficiaries still struggle to access prescribed drugs especially in referral hospitals.
According to a mini-survey carried out by Rwanda Today at Referral University Teaching Hospital of Kigali (CHUK), Masaka Health Centre, and Muhima Medical clinic, it was found that at least 55 per cent of the medicine prescribed by doctors is purchased in private pharmacies.
“My husband had Mutuelle de Santé, but because of insufficient drugs in the CHUK pharmacy we had to purchase them in pharmacies that were not covered by the insurance scheme,” said Christine Mbabazi, a mother of one, adding, “Every week I had to buy medicine costing Rwf48,000 in private pharmacies, instead of paying Rwf4,800 using the insurance cover,” she added.
Dr Hategekimana said the hospital has embarked on raising awareness among doctors to encourage them to prescribe generic medicine instead of the expensive brand name drugs.
“I wouldn’t say that we have enough drugs required by all patients, but we try and ensure that once a patient fails to get them, he/she is transferred to King Faisal Hospital so that they can get the medicine using the insurance sheme,” said Dr Hategekimana.
He said they are working on educating both doctors and patients about generic medicine so that there is a flow of information among them for better services to all.
“The main reason for insufficient drugs in hospitals is due to delayed supply by the manufacturers. If we could produce them locally there wouldn’t be shortages,” Dr Hategekimana added.
According to officials from the ministry of health, despite their efforts to ensure the availability of generic drugs they still face a challenge due to delays in supply of some brand name medicines