Access to quality drugs forms an integral part of any successful healthcare system. The high cost of drugs, however, remains a barrier to accessibility and improved health to the majority of Rwandans who depend on Mutuelle de Sante.
Most Rwandans are worried and concerned about rising out-of-pocket expenditure on health in particular those with chronic illnesses.
This is partly because medicine recommended by doctors is not only expensive but also sometimes not available in public pharmacies.
While officials are quick to dismiss talk of a shortage of supply of these medicines, the existence of complaints shows that something is not right about our medical supply chain. For instance, why should stock run out when health officials know they need to import these drugs? Why not place sufficient orders in advance? And perhaps monitor stocks to order in advance to avoid shortages? There is a need to investigate why some public pharmacies are understocked while others are stocked yet procurement for public hospitals is centralised.
There is also an issue of negative perception and attitude towards the use of generic drugs. However, this is mostly due to lack of awareness among patients who perceive generic drugs as fake and not effective.
Several studies show that a patient’s acceptance of generics is influenced by age, educational level, perceived seriousness of illness, generic drug information, and doctor and pharmacist perceptions. In addition, research shows participants with lower incomes and lower levels of education tend to hold poorer attitudes toward generic drugs. Individuals with tertiary education were found to have a more positive attitude towards generics than individuals with no tertiary education.
Free generic medication, issued by public health facilities, are viewed as inferior, treated with suspicion and regarded as being of poor quality.
It is disturbing to note that despite officials being aware of this negative perception, inadequate attention is paid to consumer perceptions yet it affects behavior and consumption patterns. One would have expected health officials to have already launched campaigns to educate the public as it would allow vulnerable households to save their meagre income.
Therefore, there is a need for the Ministry of Health to intensify public awareness campaigns to improve perceptions and acceptance of generic drugs, which are cost effective particularly for those at the bottom of the wealth pyramid. The Ministry of Health has to be vigilant and encourage health workers to beproactive, explain to patients that generic drugs are safe and of an acceptable quality.
And perhaps more important, there is a need to ensure that pharmacies are stocked with quality medication to improve confidence among patients.
Action has to be taken to ensure that public pharmacies are well stocked to minimise increasing the financial burden on already vulnerable households.