Effects of co-payment on drug rational use and cost recovery at governmental primary health care in Gaza

The irrational use of drugs leads to wasting of resources and serious health hazards as well. This study aims to ascertain the effect of co-payment on drugs consumption and also to assess drugs’ cost recovery at the governmental primary health care sector in the Gaza Strip. A descriptive, analytical, cross sectional design using a retrospective multi-stage sampling approach were utilized with a sample of 1620 prescriptions randomly selected from 15 PHC clinics; 108 prescriptions from each designated clinic. Additionally, the researcher reviewed the pharmacy registry at the targeted clinics to ascertain drug costs and drugs availability. The study showed that, there are drugs exploitation particularly for fee-exempted patients, where the average number of drugs prescribed per prescription is 2.9 (4.5 for exempted, 2.2 for under 3 years non-exempted, and 2 for over 3 years non-exempted). The average percent of prescriptions which included antibiotics per clinic was 64% (79.1% for exempted, 66.3% for under 3 years and 47% for over 3 years). The availability of key drugs is reported in 82.8%. The average drug cost recovery through the currently in-use drug co-payment scheme is 84%, and the average prescription cost is 4.9 NIS (1.4 US). The study concluded that the introduction of co-payment scheme promotes the rational use of drug, generates additional in-house resources and promotes financial sustainability.