Jubilee Insurance wants to cut out hospitals from dispensing drugs in a drive meant to lower the cost of healthcare claims.
The biggest health insurer will directly certify private pharmacies which will then be encouraged to give clients the option between originator brands and generics.
Medicines make up 40 per cent of an average Kenyans' hospital bills and insurance companies have blamed some hospitals of pushing original brands even where there are cheaper generic options. “Next month you will start seeing Jubilee Insurance accredited pharmacies,” Chairman Nizar Juma said yesterday.
The firm plans to woo low-cost income earners with offers for free medical care, including blood tests and blood pressure tests. They will also train and keep pharmacists on site as well as pharmacy technical graduates.
Mr Juma said the company faced about 40 per cent fraudulent claims from identity theft, collusion and overpricing. Data seen by The Standard shows that 70 per cent of all prescriptions by hospitals were originator brands and only 30 per cent were generic.
Insurers, however, say they have been pressuring hospitals to re-look the approach, which has seen the ratios come down to 57 per cent originator brands, 43 per cent generic drugs in some hospitals.
“We are facing a lot of resistance from hospitals and pharmacies that are thinking about turnover because the same drug will go for a fifth the price. But what we are saying is that it will only be for a year and volumes will go up, that is the future,” Mr Juma said.
He said generics are not different from originator brands, adding that the price difference only denotes the cost of research and development for the patent holder.
The firm says this model will lower the cost of healthcare and expand medical cove.
The insurer also wants to push penetration via mobile phones in Kenya.
