AMIPS

Description

Improving equitable access to essential medicines in Ghana through bridging the gaps in implementing medicines pricing policy

Background

Ensuring availability and accessibility of medicines and supplies is an important mechanism by which national health systems equitably address the health needs of the population including the poorest and most vulnerable. In Ghana, this is a recognised policy priority. Between 2012 and 2017 the government introduced four policies to improve access to medicines through medicine price regulation, and ultimately health outcomes and quality of life. These policies, currently at different implementation stages, are: (i) supply chain master plan, (ii) framework contracting for high demand medicines, (iii) value added tax (VAT) exemptions for essential medicines and (iv) ring-fencing medicines for local manufacturing. Despite these efforts, medicine prices have remained high and continue to rise. Our core focus is therefore to understand, together with policymakers, why these presumed effective policies are not producing anticipated effects on medicine price reduction.

Malaria pilot vaccine in Ghana  © World Health Organization/F.Combrink/2019 

Study objectives and questions

Our core question is “Why are these presumed effective medicine price control policies not producing the anticipated effects in implementation in the Ghanaian context?”. More specifically, this project aims to work closely with key policymakers and other stakeholders to:

  1. Develop an in-depth understanding of major determinants of effectiveness of implementing medicine pricing policies in different contexts
  2. Develop a shared understanding of main facilitators and barriers to the implementation of medicine pricing policies in the Ghanaian context;
  3. Drawing on the results of No1 and 2, facilitate: (a) development of a feasible action plan to improve implementation of the four key policies to improve access to essential medicines and (b) co-production of policy-relevant research agenda to address the information needs of key policymakers.

Methods

The proposed study will comprise two inter-related and overlapping phases. In the first phase, we deepen our understanding of key influences on implementation of medicines pricing policies (a) internationally, through a systematic review of key determinants of effectiveness of implementation of medicines pricing policies and (b) within Ghanaian context, through review of key policy and regulatory documents, prospective participant observations of key policy events and 15-20 in-depth interviews with key stakeholders in a situational analysis of key health systems facilitators and barriers.