2nd Conference | South Africa

Universal Health Coverage: Considerations in Designing Medicines Benefits Policies and Programs

Cape Town, South Africa
September 28-30, 2014

The goal of universal health coverage (UHC) is to improve equitable access to health services while protecting households from impoverishing out-of-pocket health spending. In principle, UHC is meant to assure that lifesaving treatment will be accessible and affordable for people in need. In practice, many national UHC plans do not prioritize the importance of medicines management; in fact, in many cases, medicines and the coverage of medicines costs are not acknowledged at all. However, medicines are responsible for a large proportion of total health care expenditures in low- and middle-income countries. Most medicines are paid for out-of-pocket—up to an astonishing 77% in some low-income countries.[1] Additionally, financing UHC has been a major challenge for many countries, compounding the problem of inadequate coverage of medicines in insurance schemes.

Given that medicines have been largely missing in global UHC conversations, in June 2013, Management Sciences for Health (MSH) brought together a range of stakeholders from countries around the world to start a dialogue on medicines and UHC. A major outcome of the June 2013 meeting was unanimous agreement that regional technical meetings on medicines management needed to take place. Therefore, the September 2014 Cape Town meeting focused on practical approaches to designing and managing medicines benefits in the context of UHC roll-out. The meeting focused on designing and managing medicines benefits under UHC, including use of evidence-based data for decision making.

The meeting objectives encompassed:

  • Sharing successful and unsuccessful experiences in how countries have incorporated medicines into their UHC strategies
  • Creating a shared understanding on how sound medicines benefits design and management can contribute to cost control
  • Building a case for use of evidence-based decision making in medicines benefits design and management
  • Sharing the pilot experiences of Namibia and South Africa as they implemented a new tool on medicines benefits management

[1] Lu et al., Medicine expenditures. In: The World Medicines Situation. 2011. Geneva: World Health Organization.