Why pharmaceutical policy matters for Indonesia’s social health insurance

An in-depth analysis of out-of-pocket payments for medicines and suggestions on the way forward


Ioana Ursu, Mapping Health Ltd
Viktoria Rabovskaja, Social Protection Program, GIZ Indonesia

Published by:

Sector Initiative Social Protection
Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, November 2017

Following a comprehensive assessment of Indonesia’s pharmaceutical policy and medicines management systems, this report presents suggestions how financial deficits of the country’s social health insurance and out-of-pocket payments for medicines could be addressed. A good read for anyone involved in building the institutional and legal frameworks required for UHC.

Indonesia’s social health insurance, titled Jaminan Kesehatan Nasional (JKN), currently covers 170 million people, 91 million of which are classified as poor. The ambitious scheme aims to achieve Universal Health Coverage (UHC) for the country’s entire population of 250 million by 2019. An important challenge is the scheme’s financial sustainability as the fund incurred a 15% deficit at the end of its first year of operation. Another concern is empirical evidence suggesting that health care service providers still charge JKN members, mostly for medicines, which should be covered by the insurance benefit package.

Given that both the deficit and the out-of-pocket payments seem related to Indonesia’s pharmaceutical policy and medicine management system, German Development Cooperation supported a comprehensive system assessment.

Based on a systematic framework, the report presents the strengths, weaknesses, as well as gaps identified, and proposes hands-on solutions how these could be addressed.

While assessment and report focus on the example of Indonesia, the framework and topics it presents are of broader relevance to many other countries working to set up the institutional and legal frameworks needed to make UHC a reality.

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