According to Zeeniya, a staggering 56 percent of the Aasandha budget is utilized for pharmaceuticals, presenting a pressing challenge for the sustainable management of the national health insurance policy.
While the national health insurance scheme Aasandha has come a long way in making healthcare affordable for the Maldivians, there are still some pressing issues when it comes to financing the insurance scheme as the cost keeps rising by the year. In a recent parliamentary session, Aasandha Company's Managing Director, Aminath Zeeniya, shed light on the intricate financial dynamics of the government's health insurance scheme, revealing that a significant portion of the budget is allocated to pharmacies.
According to Zeeniya, a staggering 56 percent of the Aasandha budget is utilized for pharmaceuticals, presenting a pressing challenge for the sustainable management of the national health insurance policy.
This, however, is not the first time that the staggering cost of medicine was brought up, as the Government discussed cost-cutting methods in 2022. The Government at the time had discussed setting a price ceiling in addition to medical institutions being urged to prescribe generic medication using their chemical identities rather than their brand names as well as discussions around setting fines for those who did not follow the price ceiling regulations, there was some hope that ‘husnuvaa Aasandha’ would stop costing the Government so much money.
However, it appears that there still needs to be better measures taken in order to cust these costs as Zeeniya pointed out that a bulk of the expenditure under Aasandha goes towards procuring medicines, prompting the implementation of a bulk procurement policy. Zeeniya emphasized that this strategy, currently in effect, aims to offset the substantial costs associated with purchasing medicine. To address the escalating expenses, Aasandha engaged in discussions with the World Health Organization (WHO) to explore cost-cutting approaches and models that could bring about a more efficient allocation of resources.
In addition to the previously discussed measures it appears that Aasandha has taken additional measures in order to cut costs such as identifying 11 high-demand medicines to be brought under the bulk procurement policy, a move aimed at streamlining the acquisition process and potentially reducing overall costs. Zeeniya revealed that discussions with WHO have produced viable models for cost reduction, with plans to implement these strategies within the first three months.
Despite the concerted efforts, it appears that there will be inherent challenges in the pricing of medicines in the Maldives. The managing director pointed out that pharmacies are designated at the policy level, limiting Aasandha's discretion in extending the health insurance scheme to specific outlets.
Another major issue that Aasandha faces, as outlined by Zeeniya is the expenditure that goes towards the procedural expenses of the private hospitals. Noting the difficulties, Zeeniya stated that while the procedural expenses might be affordable, the final invoiced bills often reflect a substantial increase. This discrepancy, she explained, arises due to a lack of control and co-payment agreements with the Ministry of Health for private hospital procedures.
With such major expenses being spent towards Aasandha by the state budget, it is clear that some measures need to be implemented rather than just pointing out possible solutions to the increasing problem. As the Maldives faces challenges in public finance management due to the increased debt of the nation, it has become more important than ever to look into the real issues behind why the Aasandha keeps running over-budget, and setting the needed regulations in place in order to give the residents of the Maldives the national health insurance scheme that is more sustainable.
