Assessing Sustainability of Outsourcing Medication Services at Ghana Ports and Harbours Authority Clinic

Abstract

Introduction: Outsourcing of medication services is an alternative form of health financing and an ingenious way of managing medication costs and improving service delivery in most developed countries today. Ghana Ports and Harbors Authority clinic, Tema outsources medication services to Top up pharmacy. However the cost of outsourcing medication services appears to be rising steadily. Objective of study: The aim of this study is to assess the sustainability of outsourcing medication services as a cost minimization intervention. Methodology: Secondary data from claim invoices and purchase invoices from January to September 2018, were reviewed and a cross-sectional descriptive-comparative analysis of the mean unit costs of all medications based on outsource status (outsourced formulary and matched purchased formulary medications) were used to investigate any difference at a statistically significant level. This comparison was done using a Paired T - test. Also the average cost per medication and frequency of prescription of outsourced medications was used to establish an inclusion criterion for expansion of the local formulary. Results: The cost of purchased medications was found to be statistically significantly less than the cost of outsourced medications, t (92) = -7.55, p≤ 0.001. Seven (7) medications were identified to meet the inclusion criterion for formulary expansion. It may be sustainable to outsource because to 73% of outsourcing cost is still due to 800 non formulary medication which will be impractical stock immediately, despite the higher comparative cost Conclusion: The findings indicate that the cost of outsourced medication was higher than purchased medications at GPHA Clinic. However, sustainability of outsourcing medication services is significantly impacted by the outsourcing of a vital few expensive non formulary and formulary medications. The inclusion criterion is critical to gradually update the local formulary to allow for improving infrastructural capacity to expand the formulary.