Stock Out of Essential Medicines among Patients on Health Insurance: Implications for Quality of Care

Background: The constant availability of essential medicines to patients on health insurance coverage is one of the many objectives of sustainable development goals. Health insurance coverage was implemented to improve access to medicines at costs that affordable to contributors of the scheme. Medicine stock outs remain an endemic symptom of poor availability of medicines in health facilities, a challenge that national health insurance scheme (NHIS) is intended to address. There are questions as to whether medicine stock outs has significantly declined with health insurance coverage. This study therefore aim to evaluate the prevalence of medicine stock outs among patients on NHIS and identify drugs frequently affected.

Methods: A retrospective review of 2560 prescriptions randomly selected prescription records from NHIS pharmacy between January and December 2021. Medicines approved on the health insurance list that were not dispensed due to non-availability were identified and recorded accordingly. Data was entered into SPSS version 21 and analyzed using descriptive statistics.

Results: Stock out of medicines was widespread affecting all drugs therapeutic classes with prevalence of between 1.4 to 75.5% within the study period. The most frequently class of drugs were cardiovascular drugs (75.5%), antibiotics (49.4%), antidiabetics (33.9%), antilipidaemics (22.6%) and narcotic analgesics (20.9%). The resulting out of pocket medicine expenditure could worsen clinical, humanistic and economic outcomes of therapy.

Conclusion: The high level of medicine stock out threatens the achievement of easy and affordable access to life saving medicines among patients whose primary reason for enrollment is healthcare cost savings.