Adopt Value-Based Care Model to Achieve Universal Health Coverage, Pharmacists tell FG

Pharmacists under the aegis of Association of Community Pharmacists of Nigeria (ACPN) have advised the Federal Government to adopt Value-Based Community Pharmacy as a road map to achieve Universal Health Coverage (UHC) for the nation.

According to ACPN, the objective of the Universal Health Coverage as a concept for effective health care delivery in the country has failed due to fragmented health care systems without access to care and haphazard rising costs.

This was one of the highpoints of the communiqué of the 42nd Annual National Scientific Conference of the ACPN held in Delta State, signed by the National Chairman, Adewale Oladigbolu and the National Secretary, Ambrose Ezeh, respectively.

The ACPN observed with concern that Nigeria has the highest out-of-pocket spending on healthcare in the world, with citizens being responsible for more than 70 per cent of their healthcare costs. It insisted that the undesirable development including very high treatment expenses, with people not knowing what is wrong with them can be resolved by operating the Values-Based Pharmacy Care Model.

The document stated that analyses of the out-of-pocket spending on healthcare in the world shows that South Africa has the least whereas Nigeria has the highest, with the patient being responsible for more than 70% of his or her healthcare costs.

“Poor treatment outcomes, characterized by people not getting better after incurring very high treatment expenses, with people not knowing what is wrong with them, can be resolved by operating the Values-Based Pharmacy Care Model,’’ the body noted.

ACPN said ‘’Universal Health Coverage (UHC) in Nigeria faces the challenge of a fragmented Health Care System which is costly, broken, and disconnected, with no access to care, and haphazardly rising costs of health care that significantly escalate within a five-year period; something the Value-Based Community Pharmacy model can resolve.’’

It emphasized the building of effective Community Pharmacy (CP) services as the way to achieve Universal Health Coverage with the “Pharmacist-Led Care Team model” grounded in Value-Based Care ((VBC), which focuses on professionalism and knowledge-based pharmacy practice.

The pharmacists therefore, opined that the solution to bridging the gaps in healthcare in Nigeria and the achievement of universal healthcare lies with the Pharmacy profession, adding that ‘’Community Pharmacy services can make up for the shortage of healthcare personnel, resulting in effective healthcare coverage in the country, through the management of chronic diseases such as hypertension, diabetes, asthma, kidney disease, etc.

The communiqué posited that there was a need to ‘’re-invent healthcare in Nigeria, and change the trajectory of care, to form a new kind of network, where providers of healthcare are reimbursed; properly and decently; and well remunerated for the retention and sustainability of quality healthcare services, adding that healthcare professionals must be rewarded for their contribution to healthcare provision.

ACPN reasoned that the ‘’Community Pharmacy represents the front door to a re-imagined healthcare system in Nigeria through the Value-based Care Model; a pharmacist-driven healthcare system. This involves ‘’helping the patient understand his health challenge, identify and articulate his care needs as well as helping the patient control costs through targeted knowledgeable and informed care.’’

The body further stressed on ‘’the need for the patients to be involved in their own care through a values-based care model in Community Pharmacies, where the patient is educated about his or her condition and the indices of improvement. This is a model that has worked in Mexico and Chile with very similar healthcare structures to Nigeria.’’

It listed some of the benefits of value-based care model to include ‘’good treatment outcomes for the patient, less spending by the patient, compared to the previous year, as a result of collaboration with a dedicated Community Pharmacist care provider.’’

Furthermore, it also results in ‘’encouraging knowledgeable patients who know how to help themselves and understand the intricacies of their disease as well as patients who work towards getting better through knowledge of the parameters of their illness which they can improve through lifestyle modifications, diet, and other changes.’’

The ACPN therefore ‘’encourages the Community Pharmacist to co-opt the patient into setting treatment goals through improved health indices which are discussed, jointly agreed upon, and monitored, forming a Pharmacist-patient coalition.’’ According to the communiqué, a therapeutic goal is set; a treatment outcome stated, with a timeline and a goal-defined matrix is drawn up. By doing so, the Community Pharmacist helps the patient achieve that goal and the patient understands the inconveniences and impending complications of their disease condition if it is allowed to fester.

The Conference ‘’reminded stakeholders in health advocacy that Pharmacists must of necessity be the leading providers in re-imagining the local healthcare well-being for all. According to ACPN, the Community Pharmacist is best positioned to drive this model of care because they are accessible, have enough knowledge and training, and are more affordable with low acuity care. They are positioned to support the patient across the continuum of care and highly qualified healthcare professionals.’’

While it advocated diversity through training in different areas as a way of empowering and boosting the Community Pharmacists’ knowledge and ability to meet the needs of patients, ACPN called for a curriculum for the training of Community Pharmacists and pharmacy students in Traditional Complementary and Alternative Medicines (TCAM) to be developed in collaboration with the Pharmacists Council of Nigeria (PCN).

It recommended new strategies to boost Universal Health Coverage including the involvement of Community Pharmacies in the HIV self-testing (HIVST) distribution model, through the rural network, which has increased access and reduced the cost of HIV testing.

Also the involvement of Community Pharmacies in immunization services which has increased Universal Health Coverage due to patients’ convenience.