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Relief for Dubai Dh600 basic health insurance plan holders on access to medicines

Clear guidelines on what a Basic policy can and does not cover. But some other drugs, including brand-name drugs, could be replenished, health sources say.
Image credit: Virendra Saklani / Gulf News

Dubai: Dubai residents with a basic insurance policy get partial relief. Some of the prescription medicines that have been removed from Dh600’s “Essential Benefits Plan” have been reinstated and others could be added to the list, according to leading health industry sources.

It was in February that the list of eligible drugs at the basic level was reduced from more than 2,000 to about 700. This meant that these policyholders had to pay out of their own pocket if they still wanted to have those drugs. The other, equally expensive option would have been to upgrade their insurance policy.

Now, the authorities “have updated the list on a weekly basis and the current count is 960,” said Bala NS, CEO of Aster Retail, part of the Aster DM Healthcare group. “We understand that the list could be further expanded. You [Dubai healthcare] the authority commits to include a comprehensive form to support patient needs. “

All of this will eliminate a major concern for the policyholders concerned. Many were completely taken aback by the action taken in February. (Bringing in low-cost options from the outside is also next to impossible.)

It also meant that pharmacies were also taking a hit, as the number of basic policyholders remains a sizable chunk of Dubai’s resident population.

Bala NS by Aster Retail

Bala NS of Aster Retail: “Unfortunately, if the required prescription medicine is out of the plan of the basic policyholder, the only option to obtain it is through a self-payment. This may not be desirable …”
Image credit: Virendra Saklani / Gulf News

What next?

According to health industry sources, authorities may even think about adding some brand-name drugs based on it as well.

“The drugs that currently make up the list are mostly generic,” Bala said. “As healthcare providers, we would like to see at least two branded products for the same molecule added to offer physicians and patients more choice. We understand that the manufacturers of branded products are collaborating with the authorities to achieve this.

“If the drug you are requesting is not covered by the basic policy, the only option to obtain it is through self-payment, which may not be desirable. Patients are reluctant to switch from their current medication to generic or replacement medications. This has been a challenge for healthcare professionals.

“There is a serious problem as some of the products on the list are not available in Dubai, which makes it difficult to fill in prescriptions. We expect this to change as more items are listed and drugs are available locally. ”

Rework the list

Vikas Katoch, Chief Operating Officer of Right Health Group, which continues to expand its network of clinics in the UAE, is another who believes there will be further changes on what basic policyholders can and cannot access.

“We are not working directly with DHA on this, but pharmaceutical companies would have adopted the approach as their products or inventory could no longer be in use,” he said. “And this move has also impacted on working-class patients who have to bear this burden to pay out of their own pockets. We are confident that DHA will look into all aspects if any changes are needed. “

Vikas Katoch - Right Health Group

Vikas Katoch of Right Health: “Pharmaceutical companies would have moved closer to DHA as their products or stocks could no longer be in use …”
Image Credit: Antonin Kelian Kallouche / Gulf News

Reasons behind the basic cut

The main reason for the February move was to prevent the misuse of core policies. There are many of these policyholders who could easily afford to take on more value-added coverage, but they wouldn’t. Because paying just Dh600 was such a powerful hook as long as they had access to the medicine they wanted.

This is what the health authority wanted to eradicate. “Insurance companies have also long ago requested the authorities to reduce the number of pharmaceutical formulas covered by the basic plan,” said an insurance industry source.

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