NHIF should foot full treatment of NCDs, patients tell Ruto

People living with chronic diseases such as heart ailments, cancer and diabetes have demanded that NHIF covers full treatment.

They said they are saddled with bills because the fund pays only part of the treatment costs.

John Gikonyo, who lives with hypertension and chronic kidney disease, said President William Ruto's Kenya Kwanza manifesto has commitments that should be implemented urgently.

“As the new national and county administrations embark on rolling out their programmes, we urge them to prioritise NCD-specific budgets and allocate adequate resources commensurate with the burden of NCDs,” he said at a press conference in Nairobi.

He also called for the meaningful involvement of persons living with non-communicable diseases (NCDs) in key decision-making processes, including policy, budgeting and implementation as key to NCD response.

“We urge efficient roll-out of UHC nationally, prioritising NCD treatment and care packages clinics in primary healthcare as envisioned under UHC,” Gikonyo said.

He called for the harmonisation of NHIF packages and contracts to include all patients and include lifesaving NCD specialised procedures.

Gikonyo, who heads the Renal Patients Society of Kenya, spoke in Nairobi at a meeting organised by the NCD Alliance Kenya.

There’s no regulation on prices of treatment in Kenya, but NHIF has varying reimbursement rates for public and for private hospitals.

In August this year, the National Cancer Task Force said as part of its recommendation that there is a need to cap cancer treatment and regulate the cost of care.

The Ministry of Health appointed the Taskforce on April 28, 2021, comprising a diverse group of experts across the cancer sector.

It was chaired by the Head, the National Cancer Control Programme Dr Mary Nyangasi, Kenya Society of Hematology and Oncology chairperson Miriam Mutebi (co-chair) and the National Cancer Institute-Kenya CEO Alfred Karagu as the secretary.

NCT was tasked with reviewing the current cancer situation and advising the ministry on how to address cancer prevention and control, governance, coordination and service delivery in the country.

In a report handed over to Health CS Mutahi Kagwe, NCT noted that cancer service delivery in the country is not adequately available, accessible and affordable to the majority of the population hence patients incur high out-of-pocket expenditures.

“There are frequent stockouts of essential cancer medicines, lack of rehabilitative commodities such as colostomy bags at public health facilities even when insurance is available further compromising care and treatment outcomes,” the report reads.

“Access to cancer medicines and health products is often compromised by limited availability, affordability and accessibility.”

The Nyangasi-led team has further noted some of the drivers of the cost are exaggerated and driven purely by greed and vested interests leading to financial catastrophe for individuals and households.

Often, opioids that are required for pain management are out of stock and not covered under NHIF benefits.

In addition, NHIF cover does not address the needs of paediatric cancer patients.

According to the report, the cost of cancer therapy in the country varies with the type of cancer and the stage.

For instance, patients on chemotherapy alone part with an average of Sh138,207.

Those treated with surgery cost an average of Sh128,207, those on radiotherapy Sh119,036.

While it costs an average of Sh333,462 for some patients on a combination of all three.

The cost of treating stage I, II, and III breast cancer in the public sector ranged from Sh160,000 to Sh184,000 while the cost for cervical cancer ranged from Sh100,000 to Sh180,000.

“Breast and cervical cancer treatment in the private sector are generally almost 10 times more expensive than in the public sector," the report reads.

"Palliative care for a six-month period was Sh20,000 and Sh89,000 in the public and private facilities respectively."