Private hospitals in Kenya are riding on public trust and the poor shape of public facilities, charging hapless patients up to 500 per cent more for drugs and simple tests.
There are also concerns that some of those facilities are prescribing excess drugs from specific pharmaceuticals in a well calculated profiteering script to push sales.
Although the high cost of medication is working against the Universal Health Coverage (UHC), one of President William Ruto’s legacy plans, his government is doing little to protect patients from this exploitation.
AAR HealthCare, a health cover provider which also operates health facilities in major cities in the country is for instance charging at least Sh880 for Emitino Oral Suspension, a syrup to treat nausea and vomiting.
The Kenya Medical Supplies Authority (KEMSA)’s recommended prices for medical supplies prescribed in essential health packages and national referral hospitals rate the same syrup at Sh180, a staggering Sh700 less compared to that of AAR.
Invoices from The Mater Hospital, Aga Khan, MP Shah and Guru Nanak show the drug is going for Sh850, 830, Sh810 and 780 respectively.
Even so, Cachet Pharmaceutical, the Indian-based producer of Emitino Oral Suspension is selling the syrup at 26.71 Indian Rupee (Sh39.5), meaning, private facilities mentioned have hiked their prices by over 2000 per cent.
In another instance, AAR is selling 10 tablets of Dazolic 500 mg used to treat infections caused by protozoa and certain strains of anaerobic bacteria at Sh416.
A spot check by The Business Standard shows three pharmaceutical shops along Tea Room in Nairobi CBD are selling the same at between Sh380 and 400.
Although the drug is not on Kemsa’s list, an online search shows the Indian manufacturer Sun Pharma Laboratories Ltd is selling it at 95.2 Rupees, equivalent to Sh140.
Consumer Downtown Association says the issue of overpricing drugs is a big problem facing this country.
According to the consumer lobby’s executive director Japheth Ogutu, those in this sector are taking advantage of ignorant and desperate consumers who have little information about drugs and prices.
‘’The problem is not only on drugs but also on things like gloves where patients are billed for the entire box when only one or two pairs are used by medics,’’ Ogutu said.
He added that there is a need for the government to make public standard drugs prices as recommended by the World Health Organisation (WHO) and KEMSA and where possible make this list on all notice boards in health facilities and pharmacies for consumers to make informed choices from a point of information.
An official at Kemsa referred the Business Standard to Pharmacy and Poisons Board for a comment on irregular drug pricing in private hospitals but said there was urgent need for a regulation.
‘’The price of drugs is not regulated in the country. The person responsible is the Pharmacy and Poisons Board. We sell our products at tender prices and put in more markup for the cost of operation. Do check our prices and compare how much hospitals sell at,” the official who spoke on condition of anonymity said.
Our queries to the Pharmacy and Poisons Board had not been responded to by the time of going to press.
A report by the Ethics and Anti-Corruption Commission(EACC) in August 2018 revealed that hospitals are charging patients up to 5,000 per cent the original price.
A Helicobacter Pylori kit (H. Pylori) used to treat bacterial infection to the stomach was found going for Sh2,400 in Nakuru County Referral Hospital yet it was bought at Sh480 from Kemsa.
Another study commissioned by WHO revealed that at public sector facilities, patient prices for the lowest priced generic medicines were 1.99 times international reference prices.
Patient prices ranged from 0.26 times (or 74 per cent less than) the international reference price for amoxicillin + clavulanic acid. Prices for the same drugs were five times higher than the recommended rate.
At least 45 medicines were surveyed in the 53 public health facilities; 57 private sector outlets and 47 mission/NGO health facilities.
Five years ago, the Ministry of Health promised to set price index, similar to what Thailand is using, that every supplier of medical consumables and non-consumables should adhere to.
As it stands, suppliers of pharmaceuticals have a free play ground which allows them to quote exorbitant prices for hospitals. It is no surprise that 40 per cent of health care costs are driven by pharmaceuticals,’’ Kariuki said.
Apart from overpricing, especially for patients paying using health cards, there are complaints about some of those facilities prescribing loads of drugs to their clients for simple illness like flu ostensibly to clear stock.
‘’I recently had my all time ‘expensive’ flu. Imagine paying Nairobi Hospital Sh12300 for flu medication, something I normally treat using Sh20 celestamine? I felt robbed,’’ Ken, a IT specialist at a local telco told the Business Standard.
‘’I was given loads of antibiotics…you may think it is a stock for a village pharmaceutical,’’ he said cheeky.
This kind of patient exploitation was recently a topic of discussion in a group of communication specialists who shared some of their worst experiences.
One of them (name withheld) detailed how Gertrude Hospital wrongly diagnosed his daughter with asthma and sold her a bag full of drugs and equipment.
The daughter went to the facility along Othaya Road after catching the flu but was instead prescribed asthma drugs, deducting a lot of money from her dad’s insurance cover.
According to a communication specialist, his family has no asthmatic history. He confronted the hospital and returned the drugs. The daughter is asthma free 13 years later.
A 24 hour twitter survey by the Business Standard seeking public opinion on overpricing of drugs by private hospitals saw 64 per cent of respondents respond in affirmative while 23 per cent said they don’t know. Only 13 per cent said no.
A Facebook user Mohammed Abdulahi said those hospitals recommend expensive and strong drugs for very small illnesses like scanty malaria and urine infections.
''It is very true. They are also giving out fake medicines and generics,'' another Facebook user Prince Charles said.
