The impact of Ghana's National Health Insurance Scheme median pharmaceutical pricing methodology and reimbursement policy on the pharmaceutical system

Background Over 10 years after the establishment of the National Health Insurance Scheme (NHIS) in Ghana, the use of a median pricing methodology for pharmaceuticals remains a topic of debate due to its positive and negative outcomes. Residual effects of this pricing methodology include proliferation of low-quality medicines, irrational medicine use, insurance fraud and other untoward outcomes. Of particular interest is the ripple effect of this median pricing policy on the entire pharmaceutical system. Ghana’s pharmaceutical system has limited local production capacity and is heavily dependent on importation. Medicine prices continue to rise and the medicine reimbursement value constitutes an increasingly larger proportion of overall claims values. With finite resources allocated to the NHIS, this presents a sustainability challenge to be addressed promptly.