Publication: The Pharmaceutical Sector in Ghana
Loading...
Date
2009-11
ISSN
Published
2009-11
Author(s)
Gyansa-Lutterodt, Martha
Editor(s)
Abstract
Main pharmaceutical policy goals in Ghana are access to essential medicines for everybody, quality assurance for all drugs on the market, a functioning and efficient supply chain as well as rational use of medicines by professionals and patients. There is also a commitment to strengthen the domestic pharmaceutical industry, outlined under health industry in the national health policy. The National Health Insurance System (NHIS) has significantly improved access to medicines for insured patients, measured in increased utilization of facilities and rapidly growing turnover of revolving drug funds. The risk is now that non-rational prescribing and fraud lead to a growing medicine bill that threatens financial sustainability of NHIS. On the other hand, National Health Insurance Authority (NHIA) has the resources and purchasing power to influence provider behavior as well as the market in terms of quality and price. The purpose of this policy note is to provide a compact overview of the situation, trends and opportunities in the pharmaceutical sector in Ghana as relevant to the strategic objectives in the five year program of work. It summarizes data from a number of recent studies and reports that were done by a range of partners inside and outside the country as well as discussions with key stakeholders in the sector. The intent is to give decision makers up-to-date background information and provide some suggestions for specific policy initiatives designed to achieve the work program objectives, with a particular focus on the role health insurance can play to stabilize and improve service delivery, increase access to quality medicines and promote rational use. The overall legal framework for the pharmaceutical sector is set by the Food and Drugs Law from 1992, amended by Act 523 in 1996. It defines the role of the food and drugs board as separate entity under control of the Ministry of Health (MOH), responsible for regulating the sector. The Food and Drugs Board (FDB) also runs the official drug quality control laboratory that is in charge of testing quality samples obtained from manufacturers, importers, distributors or other sources. The FDB is also working on an improvement of its public website in an effort to strengthen communication with the general public to increase transparency and improve governance.
Link to Data Set
Citation
“Gyansa-Lutterodt, Martha; Seiter, Andreas. 2009. The Pharmaceutical Sector in Ghana. © World Bank. http://hdl.handle.net/10986/28117 License: CC BY 3.0 IGO.”
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication Turkey(Ankara, World Bank, 2008)Pharmaceuticals are essential to achieve health outcomes, but are at the same time a major cost factor in every health system. From a patient perspective, access to pharmaceuticals is a proxy for the functioning of the health system. With increasing economic strength, patients become more demanding with regard to access to modern, sophisticated drugs and providers become more aggressive in marketing those drugs. This paper reflects the situation in the pharmaceutical sector in Turkey, identifies critical issues, and discusses policy options based on current trends and the overall policy objectives of the Turkish government. This paper is structured as follows: chapter one gives introduction; chapter two gives overall policy objectives in the pharmaceutical sector in Turkey; chapter three presents institutional and regulatory framework; chapter four presents reimbursement rules; chapter five focuses on governance issues in the pharmaceutical sector; chapter six gives market overview; chapter seven gives payment for pharmaceuticals in Turkey; chapter eight presents prescribing practices - rational use of medicines; and chapter nine gives conclusions and way forward.Publication Financing, Pricing, and Utilization of Pharmaceuticals in China(Washington, DC, 2010)This paper examines the financing, pricing, and utilization of pharmaceuticals in China the pharmaceutical system as it has evolved, and some changes that would improve it in the context of the national health reform process. The present paper builds upon earlier critical reviews and other papers published in the series china health policy notes. The paper is divided into four parts. The first section provides an overview of the Chinese pharmaceutical market: how the sector has grown; China's position in the global market; and size, composition, and trends in the domestic market. The second section examines the evolution and status of China's system of essential medicines, an area emphasized in the government's health reform plan announced in April 2009. It shows how the use of essential medicines has evolved over the two decades since the idea was formally adopted, and discusses why practice has fallen far short of the ideal. The third section looks at the issue that dominates today's debate: managing high pharmaceutical costs. It reviews the components of drug pricing, underscoring the argument that there is considerable scope for reducing prices. It looks at government attempts to control drug prices, and suggests why they did not succeed. Finally, the fourth section suggests measures to re-chart the path to reform.Publication Assessment of Governance and Corruption in the Pharmaceutical Sector : Lessons Learned from Low and Middle Income Countries(World Bank, Washington, DC, 2010-01)Pharmaceuticals are a critical input for the health sector. At the same time, the drug business sustains many individual and corporate livelihoods and produces handsome returns for those involved in the trade. Good governance is critical for the sector to maximize returns for public health and minimize risks for patients from ineffective or contaminated drugs. Given the large financial volume of the market, the potential for corruption is significant. Vulnerable points are those at which decisions about market access and purchasing are made. This includes institutional functions such as licensing, inclusion into formularies and public procurement as well as the individual prescriber, who selects drugs for a specific patient. Given the political and institutional resistance against more transparency from the beneficiaries of the status quo, assessment of governance and corruption in the sector is not a straightforward exercise. The authors developed a more indirect approach that relies on a broader assessment of the functioning of the sector and detection of patterns that suggest governance or management problems. From a developmental perspective, the focus is on reducing the impact of bad governance (high drug prices, stock-outs, bad quality of drugs in circulation, irrational use of drugs) rather than identifying the actors and bringing them to justice. Even if the governance level cannot be touched due to political resistance, it may be possible to address the problem from a technical or management angle. For example, electronic procurement platforms and inventory management systems make manipulation more difficult and allow for a faster discovery of irregularities. The assessment framework was applied in eight countries, with adjustments based on client demand and political viability. In most cases, a follow-up after the assessment could be documented, showing that the data provided had relevance and impact in the national policy dialogue. Three of the eight countries signed up to a longer term program to increase transparency in the sector (medicines transparency alliance), others initiated specific projects to address issues that were presented as a result of the initial assessment. In summary, the authors work could demonstrate that it is possible to effectively address pharmaceutical governance issues in the context of a broader sector assessment an approach that may face less political resistance than an inquiry based on a "governance and corruption" labeled instrument.Publication Private Sector Pharmaceutical Supply and Distribution Channels in Africa : A Focus on Ghana, Malawi and Mali(World Bank, Washington, DC, 2011-08)Sustainable access to affordable, high-quality medicines is an important component in all health care systems but remains limited in many African countries. Supply and distribution of medicines are a fundamental aspect of the success of any health system. Disruptions to this supply undermine health outcomes as supply chains have an impact on the availability, cost, and quality of medicines for patients. Common problems associated with the supply and distribution of pharmaceuticals often include poor supply chain management, stock pilfering, insufficient human resources, and limited financing resulting in chronic stock outs. In resource-poor settings where public services fail to meet demand, the private and voluntary sectors are increasingly being called on, prompting some policy makers to consider private mechanisms as alternatives to state-run drug procurement and distribution systems. This study reviews some of the ways in which some countries in Africa organize their private pharmaceutical supply and distribution channels, focusing on three diverse countries: Ghana, Malawi, and Mali. It discusses some of the strengths and challenges associated with such arrangements, as well as relevant options to improve access, availability, quality and affordability of privately supplied pharmaceuticals.Publication The Pharmaceutical Sector of the Western Balkan Countries(World Bank, Washington, DC, 2008-02)There is a strong political will in the Western Balkan states to align the region's pharmaceutical legislation and practice with that of the European Union. Accordingly, recent policy changes were aimed at harmonization of policies with other European countries. Several national drug laws were updated or completely re-written in the last several years. More specifically, provisions were made for the simplification of drug registration requirements, licensing of professionals and businesses in the sector, implementation of ethics standards, price controls and reimbursement of drugs through national health insurance systems. Countries in the region have introduced various measures for cost containment, mostly through positive lists with various co-payment levels or expenditure caps for prescribing physicians. Some institutional buyers are using pooled procurement with open tenders to ensure lower prices. Nevertheless, there are still a number of challenges such as lack of enforcement of rules and standards, limited access to drugs for low income populations, inefficiencies in resource allocation and in the distribution chain, lack of control over physicians prescribing behavior and occasional conflicts between public health and industrial policy objectives. For the foreseeable future, there will be a need for further capacity building in the pharmaceutical sector, with a focus on increased oversight and higher professional standards, more efficient use of limited public resources, equity of access and rational use of medicines. Nevertheless, drug expenditure is set to grow in this region as it did in other countries in Eastern Europe, typically at a rate of about twice GDP growth, due to inevitable factors such as innovation, aging populations, increasing incomes and better access to healthcare.
Users also downloaded
Showing related downloaded files
Publication Accessing Economic and Political Impacts of Hydrological Variability on Treaties : Case Studies on the Zambezi and Mekong Basins(2012-03-01)International river basins will likely face higher hydrologic variability due to climate change. Increased floods and droughts would have economic and political consequences. Riparians of transboundary basins governed by water treaties could experience non-compliance and inter-state tensions if flow falls below levels presumed in a treaty. Flow information is essential to cope with these challenges through water storage, allocation, and use. This paper demonstrates a simple yet robust method, which measures gauge station runoff with wetness values derived from satellite data (1988-2010), for expanding sub-basin stream flow information to the entire river basin where natural flow information is limited. It demonstrates the approach with flow level data that provide estimates of monthly runoff in near real time in two international river basins: Zambezi and Mekong. The paper includes an economic framework incorporating information on existing institutions to assess potential economic and political impacts and to inform policy on conflict and cooperation between riparians. The authors conclude that satellite data modeled with gauge station runoff reduce the uncertainty inherent in negotiating an international water agreement under increased hydrological variability, and thus can assist policy makers to devise more efficient institutional apparatus.Publication Rwanda Diagnostic Review of Consumer Protection and Financial Literacy(World Bank, Washington, DC, 2013-11)Although the Parliament of Rwanda has passed an impressive array of financial sector laws since 2008, the laws relevant to financial consumer protection are very limited and in some cases overlapping. Consumer protection in Rwandan banking, microfinance, and insurance sectors is fragmented because of insufficiently defined roles and responsibilities among institutions and unclear enforcement capacity. While there are some strong provisions in some areas such as electronic money transfer, electronic transmission, credit information, and market conduct regulation in the insurance industry, many other areas are lagging. Rwandan authorities recognize that a sound financial consumer protection framework is fundamental to improving usage and quality of financial services, access to them, and overall deepening of the financial sector. This World Bank diagnostic review was requested by the National Bank of Rwanda (BNR) in November 2012. Modules on banking and microfinance sectors were developed based on publicly available information and data during the World Bank mission in Rwanda, and the review of the insurance sector was conducted through a desk review using the data obtained from BNR data requests and questionnaires, and the analysis is therefore constrained by it. Volume I of the review summarizes its key findings and recommendations, and volume II provides a detailed assessment against the World Bank’s good practices on financial consumer protection.Publication Improving Access to Medicines in Developing Countries : Application of New Institutional Economics to the Analysis of Manufacturing and Distribution Issues(World Bank, Washington, DC, 2005-03)This paper examines alternative frameworks for empirical analysis of supply side activities, namely, the manufacture and distribution of medicine, through the application of New Institutional Economics (NIE) concepts. Attention is focused particularly upon the potential utility of ideas from agency theory, transaction cost analysis and contemporary ideas from strategy theory. The major purpose of this paper is to use these theoretical frameworks to provide insight for policy makers, when faced with specific situations, whether in an international agency, or a private company, or in defining a national strategy. The analysis attempts to show the importance of distinctions between ideas of 'make' or 'buy', between 'national self sufficiency' and 'international purchasing' strategies, the limitations of contractual agreements under market governance and the crucial linkages between strategy formulation, strategy implementation and the necessary capabilities to achieve successful performance in practice. The current international situation on the investment, location and capacity of pharmaceutical manufacturing is reviewed and likely future scenarios suggested. Correspondingly current patterns of trade in medicines and their likely development within the context of the WTO and bilateral trade agreements are discussed. Against this background the promise and the pitfalls for new forms of public-private partnerships, which may offer attractive alternatives to conventional structures are evaluated. The implications of alternative future strategic options for national governments in setting the balance between health and industrial policies are examined and in particular the extent to which a national manufacturing capability should be developed or sustained. Similarly the scope for improving low cost distribution systems for medicines, based upon a mix of public and private sector channels, is assessed. We conclude with suggestions for further development of a transaction-based framework.Publication Case Study 2 - Andhra Pradesh, India : Participation in Macroeconomic Policy Making and Reform(Washington, DC, 2003-03)For the past six years, the State of Andhra Pradesh in India has been at the vanguard of efforts to modernize the economy and the state while pursuing policies to improve the lives of the poorest. The Chief Minister and head of the ruling Telugu Desam Party (TDP), Mr. Chandra Babu Naidu, is known by some as the "Laptop Minister" for his modernizing initiatives. He has reached out to international organizations and investors but has also maintained his base of support at home, in part through expanded programs in education, health, and rural development. "I have initiated so many things," Naidu said. "They are going on and will pay off after some time. But people need something today." The challenges facing the government are daunting. Andhra Pradesh (AP) is one of the largest and poorest states in India. Its population of almost 80 million approaches that of the Philippines, the 13th most populous country in the world. Even as its high-tech industries develop rapidly, AP's overall literacy rate remains a modest 44% and one-third of the population lives in poverty.Publication Strategic Planning for Poverty Reduction in Vietnam : Progress and Challenges for Meeting the Localized Millennium Development Goals(World Bank, Washington, DC, 2003-01)This paper discusses the progress that Vietnam has made toward meeting a core set of development goals that the government recently adopted as part of its Comprehensive Poverty Reduction and Growth Strategy (CPRGS). These goals are strongly related to the Millennium Development Goals (MDGs), but are adapted and expanded to reflect Vietnam's national challenges and the government's ambitious development plans. For each Vietnam Development Goal, the authors describe recent trends in relation to the trajectories implied by the MDGs, outline the intermediate targets identified by the government, and discuss the challenges involved in meeting these. Relative to other countries of similar per capita expenditures, Vietnam has made rapid progress in a number of key areas. Poverty has halved over the 1990s, enrollment rates in primary education have risen to 91 percent (although there is a quality problem), indicators of gender equity have been strengthened, child mortality has been reduced, maternal health has improved, and real progress has been made in combating malaria and other communicable diseases. In contrast, Vietnam scores worse than other comparable countries in the areas of child malnutrition, access to clean water, and combating HIV/AIDS. A number of important crosscutting issues emerge from this analysis that need to be addressed. One such challenge is improving equity, both in terms of ensuring that the benefits of growth are distributed evenly across the population and in terms of access to public services. This will involve addressing the affordability of education and curative health care for poor households. Improvements in public expenditure planning are needed to align resources better to stated desired outcomes and to link nationally-defined targets to subnational planning and budgeting processes. There is also a need to address capacity and data gaps which will be crucial for effective monitoring.