How unregulated drug prices hinder access to contraceptives

NorLevo, which is commonly known as morning-after pill, is an oral emergency contraceptive pill prescribed for use within 72 hours of unprotected intercourse to prevent unwanted pregnancy.

According to the Rwanda Health Insurance Association (RHIA) that partners with insurers and the Ministry of Health to regulate drug prices, the pill should cost Rwf4,200.


However, The New Times learnt that some pharmacies in Kigali sell the pill at Rwf10,000 and Rwf15,000.


A pharmacist who operates a pharmacy from Nyarugunga Sector in Kicukiro District, under anonymity request, told this publication that on wholesale, he gets the pill at Rwf3,500 and sells it at Rwf10,000.


“NorLevo has high demand and has no strict price regulations like other drugs. The price differs from pharmacies and demand,” he said.

NorLevo morning-after pill, according to the pharmacist, is on high demand because it has relatively few side effects.

“These pills are sometimes imported without paying taxes and sold on high prices by people who are not pharmacists,” he said.

NorLevo is among the drugs that are not covered by insurance companies, therefore the prices are manipulated by private pharmacists, according to players in this industry.

Setting drug prices is usually under the responsibilities of RHIA, which reviews the prices every six months.

The association brings together health insurance companies, pharmaceutical companies, the Ministry of Health and the Ministry of Finance and Economic Planning.

Dr. Blaise Uhagaze, Executive Secretary of RHIA said that drugs that are not covered by insurance companies in Rwanda are hard to trace their sources of origin and usually regulating their prices is difficult.

“This is a very critical issue. NorLevo is among other drugs that are not paid by health insurances whose prices are easily manipulated,” he said.

He added that the association faces the same challenges every year during the tariff review and that they have started working with the Food and Drugs Authority (FDA) to find solutions.  

Uhagaze admits that the issue inhibits public's access to certain drugs and in this particular case of the morning after pill, may hinder Planned Parenthood.

The same point was echoed by Emery Jocelyne Ingabire, the associate director for community outreach at Health Development Initiative, a local NGO that deals with reproductive health.

“This is a challenge to the accessibility of contraceptives. When the price is unregulated and mostly high, it means people cannot access at market area the drugs and that is when we see the surge in unwanted pregnancies which may result in unsafe abortions,” she explained.

Although emergency contraceptives pills should not replace long-term family planning methods, duty bearers should discuss how prices can be managed and settled.

Food and Drugs Authority which has the mandate to take the necessary measures against pharmacists who manipulate prices but efforts to get a comment from them were futile.

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