National drug provision policy for Armenia: compulsory household drug coverage

Abstract

As most transition economies of the former Soviet Union, Armenia has undergone substantial changes in the socio-economic infrastructure and capabilities. The average Income of the population has dropped drastically since independence acquired in 1991. Naturally, health care system, being totally dependent on governmental subsidies, has been one of the areas to suffer the most. Socio-economic hardships have depressed consumption of health care services by the population. In particular, outpatient pharmaceutical treatment is currently hard to afford, especially if speaking about long-term treatments. The low affordability of outpatient drugs restrains people from initiating a treatment or forces them to discontinue one and is recognized by the current paper as a public health problem. The pervasiveness of socio-economic difficulties for the general population shows the nationwide magnitude of the problem, which needs to be solved. The proposed Compulsory Household Drug Coverage (CHDC) program aims at helping people to get needed pharmaceutical treatment in outpatient settings, because the Basic Benefit Package (BBP) designed by the government of Armenia covers medications presumably for in-hospital acute cases. Enrollment eligibility is indiscriminate for the whole population of Armenia. The program initiation should start with an appropriate political decision and creation of a solid legislative basis for the program. Next, it is necessary to establish an accumulative CHDC Fund, where the residual financial resources at the end of each calendar year will not be subject to neutralization. Finally, formularies should be developed that would include diseases/health conditions and drugs to be covered. The program will be evaluated annually, with regard to the following: a) the extent of actual population coverage, b) whether the planned budget was met, c) pharmacists’ and physicians’ compliance with the Fund policy and, finally, d) satisfaction of the covered.