As discussions around the payment structure for professional services under the National Health Insurance Authority (NHIA) continue, the Lagos Chapter of the Association of Community Pharmacists of Nigeria (ACPN) has voiced its concerns. On Tuesday, the ACPN criticized the existing payment system, urging the adoption of the Lagos State Health Insurance Management Agency (LASHIMA) model across the country.
The LASHIMA model distinguishes between fees for professional services and capitation payments for other primary care services. At a press conference held in Lagos as part of the Pharmaceutical Society of Nigeria (PSN) Scientific Week, ACPN Chairman, Pharm. Tolu Ajayi, argued that simplifying the payment structure is crucial for Nigeria to achieve the Sustainable Development Goal (SDG) of Universal Health Coverage.
Ajayi emphasized that direct payments to community pharmacy practitioners, as practiced in Lagos, enhance transparency and accountability—key factors for the efficiency and sustainability of the health insurance scheme. He advocated for the nationwide adoption of this model, which would eliminate payment delays and ensure that pharmacists are promptly compensated for their services.
Ajayi highlighted the negative impact of routing payments through Health Maintenance Organizations (HMOs), stating that it often leaves pharmacists at the mercy of these organizations, leading to delayed payments. Such financial delays can demoralize service providers, hinder their operations, and prevent them from replenishing their stock, ultimately affecting the quality of care.
“The fees for services rendered by pharmacists should be paid directly to them,” Ajayi said. “When payments are routed through HMOs, it leaves pharmacists at the mercy of HMOs, who may delay payments. Financial delays can demoralize service providers, hinder their operations, and prevent them from replenishing their stocks. The solution is for all states and the national scheme to adopt the direct payment model used in Lagos.”
In addition to payment structure reforms, Ajayi called for an improved drug distribution system. He urged state governors to replicate the Coordinated Wholesale Centre model established in Kano to combat the distribution of fake drugs. By strengthening the drug distribution network, the ACPN believes that the overall quality of healthcare delivery can be significantly improved.
The call from the Lagos ACPN reflects growing concerns about the sustainability and effectiveness of the current NHIA payment system, with a push for reforms that could benefit both healthcare providers and patients across Nigeria.
