Relatively equitable financing of the NHIF, High turnover in leadership and frequent Review the BBP to improve with cross-subsidization. changes in legislation fragment decision effectiveness of existing spending, starting making, misaligning responsibility, with medicines. Possible access to EU Structural Funds. authority, and expertise. Develop skills to monitor and to project Insufficient weight is given to cost (using actuarial methods, analysis of effectiveness in deciding the benefit NHIF claim data) package, medicines, technologies, and Perform cost-effectiveness and other clinical algorithms. economic evaluation studies. Hospital admissions are escalating. Structural reforms for service delivery are lagging behind. Financial protection National health insurance with near The poor are disproportionately less likely Regularly generate the information universal coverage, single purchaser having to be insured, and pay higher OOP for required to understand and monitor OOP diversified set of revenues which promotes health. payments so as to develop target policies redistribution and cross-subsidization. for improving financial protection. OOP payments are outstandingly high Coverage is subsidized separately for against internationally acceptable Develop policies to ensure coverage of the numerous “needy” or high-priority groups. standards and peers. uninsured. Benefit package is comprehensive and Medicines account for some three-quarters Promulgate options to reduce the size, and inclusive of modern technologies and of OOP costs, raising concerns about increase the clarity and predictability of, innovative medicines. effectiveness of NHIF’s BBP pharmaceutical copayments, with priority emphasis on the coverage, as well as its copayment and medicines included in the BBP. pricing policies. Pharmaceutical policy and practice Regulatory processes are in line with There is no overarching national medicines Develop an integrated national medicines European standards. policy to establish agreed priorities and policy that explicitly defines priorities and guide consistent policy development. guides future policy settings. The PDL is comprehensive.
Relatively equitable financing of the NHIF, with cross-subsidization. Possible access to EU Structural Funds. High turnover in leadership and frequent changes in legislation fragment decision making, misaligning responsibility, authority, and expertise. Insufficient weight is given to in deciding the benefit package, medicines, technologies, and clinical algorithms. Hospital admissions are escalating. Structural reforms for service delivery are lagging behind. Review the BBP to improve of existing spending, starting with medicines. Develop skills to monitor and to project cost (using actuarial methods, analysis of NHIF claim data) Perform cost-effectiveness and other economic evaluation studies. Financial protection National health insurance with near universal coverage, single purchaser having diversified set of revenues which promotes redistribution and cross-subsidization. Coverage is subsidized separately for numerous “needy” or high-priority groups. Benefit package is comprehensive and inclusive of modern technologies and innovative medicines. The poor are disproportionately less likely to be insured, and pay higher OOP for health. OOP payments are outstandingly high against internationally acceptable standards and peers. Medicines account for some three-quarters of OOP costs, raising concerns about effectiveness of NHIF’s BBP pharmaceutical coverage, as well as its copayment and pricing policies. Regularly generate the information required to understand and monitor OOP payments so as to develop target policies for improving financial protection. Develop policies to ensure coverage of the uninsured. Promulgate options to reduce the size, and increase the clarity and predictability of, copayments, with priority emphasis on the medicines included in the BBP. Pharmaceutical policy and practice Regulatory processes are in line with European standards. The PDL is comprehensive. There is no overarching national medicines policy to establish agreed priorities and guide consistent policy development. Develop an integrated national medicines policy that explicitly defines priorities and guides future policy settings. effectiveness effectiveness
Full-RAS-report-May-22-with-cover-page.docx