Rational use of Medicines & NHIS

Prescription Policy

presented by

Attah-Adjepong Bismark
(Director of Pharmacy)

CCTH conference room

on 15
th
Oct, 2014


Presentation Outline
Definition of RUM
Problems of Irrational Drug use
Effects of Irrational Drug use
Reasons for Irrational Drug use
Interventions to promote RUM
Prescribing Guidelines for NHIS Tariff
Implementation
Conclusion


Definition Rational Use of medicines


RUM requires that Patients receive Medication
appropriate to their Clinical needs, in Doses that
meet their own individual requirements, for
Adequate period of time and of the Lowest Cost
to them and their community (WHO, 1985).

Problems of irrational use of medicines

Poly-pharmacy
Inappropriate use of antibiotics
Over-use of Injections
Failure to prescribe in accordance to clinical
guidelines
Prescription without diagnosis
Inapt self-medication, often of prescription
only medicines( controlled drugs)


Effects of irrational medicines use.

Reduced medicine access (Stock outs)
Reduced OPD attendance due to medicines
stock out
Loss of revenue to the institution due to
rejection of NHIS claims submitted
Loss of confidence in the health system.

Reasons for Irrational drug use
Lack of knowledge, skills and information on
RUM
Overwork of health staff
Inappropriate promotion of medicines by
pharmaceutical companies
Profit motive from selling medicine
Unrestricted availability of medicines


Interventions to promote RUM
Clinical guidelines- Standard Treatment Guidelines
Essential medicines list based on treatments of
choice
Strengthening Medicines and therapeutics
committees
Independent information on medicines- Drug
Information Center
Avoidance of perverse financial incentives
Appropriate and enforced regulation on medicines
Prescribing Guidelines for NHIS
Tariff Implementation
All NHIS prescriptions should be written on approved
prescription forms and in approved formats.
Only medicines on NHIS Medicines List shall be permitted
for reimbursement

All prescriptions should fulfill the following criteria:

Conformity with Ghanaian laws including Medical and Dental
Council Decree 1972 (NRCD 91), Pharmacy Act 1994 (Act
489) and the Nurses and Midwives Decree 1972 (NRCD 117)
Written legibly in ink or otherwise so as to be indelible
Written by the prescriber and not left for another person to
complete should be dated

Prescribing Guidelines Contd
Full name and address of the patient should be stated
The age and weight (in the case of children) of the
patient being treated should be specified
The diagnosis being treated should be stated

The prescription should also contain the following:

Dosage form, generic name of medication, strength,
dose and dosage schedule
Exact quantity of medication to be supplied
The signature of the prescriber (which should be in ink)

CONCLUSION
Management of CCTH expects you to foster
promotion rational medicines use by
Prescribing according to standard treatment
guidelines
Adhere to NHIS prescribing guidelines
Prescribe medicines from the NHIS medicines list
only
Consult other members of health care team
especially the pharmacist for advice on medicines
when necessary.



THANK YOU