Lack of common pricing by pharmacies and a number of health insurance companies is forcing patients to pay more for drugs.

Pharmacies have now resorted to not selling drugs to members of some insurance schemes, saying the prices set by the companies are too low.

According to pharmacists, some insurance companies are too selfish, leading to losses to the pharmaceutical companies. This, they said, has forced patients to pay for drugs from their pockets.

“For insurance companies to set the prices of different drugs, they consult the distributors or wholesaler pharmacies whose prices are mostly low and vary depending on the dollar exchange rate,” said Habyarimana Flandrie, president of Rwanda Community Pharmacists Union, (RCPU).

“Pharmacists either withhold the lowly priced drugs especially from insurance card holders or simply explain the situation to the patients and ask them to pay some extra amount for the drugs or have their prescriptions changed,” he added.

“I have gone round different pharmacies looking for a prescribed drug but I was told that it’s not available. When I enquired further, I was told that the drug is available, but I will have to pay an extra Rwf1,000 to get it,” a patient, who asked not be named said.

The affected policy holders are mostly members of the Rwanda Health Insurance Association including RSSB, Soras, MMI, Saham and Radiant, who review their price lists every six months.

A list of reimbursable costs of drugs from the Rwanda Health Insurers Association seen by Rwanda Today include drugs that pharmacies said are lowly priced.

“We have tried to explain to the insurance companies that the low prices are hurting both the pharmacies, which are in business for profit as well as the patients who need the drugs, but all these have fallen on deaf ears. The insurance companies simply won’t negotiate,” said Mr Habyarimana.

Rwanda Health Insurers Association executive secretary Dr Blaise Uhagaze, however, refuted the claims, saying that pharmacists are always involved in the price reviews.

“We always do a price review after every six months, which is approved by the Ministry of Health. Different stakeholders, including pharmacists’ associations, are always invited to take part in the process,” said Dr Uhagaze.

“We consult widely with wholesalers and drug-manufacturing companies abroad to know the current market prices. Before setting the new prices, all the stakeholders have to be in agreement and they even append their signatures to prove it,” he added.

Dr Uhagaze expressed his disappointment with pharmacies that require patients to pay extra amounts in order to purchase prescribed drugs.

“Under no circumstance should patients be required to top-up on prescribed drugs. This is against the law and punitive measures should be taken against any pharmacists practising this,” he said.

The establishment of the National Health Insurance Council by the government is expected to bring sanity in the industry.

Gazetted on January 25, the National Health Insurance Council is mandated to not only supervise the activities of insurance companies, but also to set prices or tariffs for services provided by insurers.

“The Rwanda Health Insurers Association will work hand in hand with the National Health Insurance Council but most of our responsibilities will be transferred to them,” said Dr Uhagaze.

Once launched, the National Health Insurance Council will also protect the interests of the patients who do not know their rights and mostly fall prey to rogue players in the vast healthcare industry.