Assessing the Feasibility and Sustainability of a 100% Drug Prescription-fill Policy at the University of Benin Teaching Hospital, Nigeria: Implications for National Health and Drug Policies

Aims: To determine the feasibility and sustainability of the 100% drug prescription-fill policy goals and compare its achievements with the alternate policy in fulfilling the national Health policies. Study Design: The study was limited to staff who are five years and above in the Hospital, and also patients and clients who have attended their clinics for four weeks and above. Place and Duration of Study: This research was carried out at the University of Benin Teaching Hospital, Benin City, Nigeria between January 2014 and December 2022 with ethical approval of the Health Research Ethics Committee of the Hospital, vide protocol Number: ADM/E 22/A/Vol.VII/1483011857. Methodology: Data for five years and four years respectively for new and old policies were obtained from staff, patients & clients (through structured written questionnaires). The questionnaires were filled and scored out of free will by the respondents on a scale of 0-5. The questionnaires sought to ascertain how much importance they assign to each policy goals factor with respect to feasibility and sustainability. The frequency of scores for each was calculated and this was multiplied by the respective scoring factor to obtain the feasibility powers. The data for dispensing panels, staff strength and salaries were obtained from the Hospital records at the Pharmacy and Accounts departments respectively. The policy goals factors were represented by: A= Adequate & ethical provision of public goods/services; B= Reducing/resolving externalities; C= Minimizing monopolies of drug supply by market forces; D= Minimizing information asymmetry to patients by market forces; E= Ensuring proper management of available resources; F= More equitable distribution of drugs/ services to patients. Results: The two-way ANOVA of the Graph Prism 6 was used in the analysis of variance, and it shows that there are significant differences in the feasibility powers among the various policy goals factors (column factors) at α = .05, and total variation of 14%. On the roll, there is a significant difference among the treatment factors at α = .05, with a variation of 68%. The dispensing panels and staff strength, staff remuneration and work-out-put efficiency were analyzed using the unpaired t-test (parametric). It shows that there is a significant difference between the two policies in terms of the number of : prescriptions treated, drug items prescribed, drug items dispensed, the frequency of 'Not-Available' drugs, percentage of 'Not-Available' drugs to patients, drugs-availability and accessibility, staff- strength, staff salaries and work-out-put efficiency, at P = .05 with respective variations of 85%, 81%, 82%,i 64%, 70%, 83%, 68%, 80%, and 75%. The Null hypothesis was rejected in each scenario. There is no significant difference between the two policies with respect to number of: Not-funded drugs by patients and percentage of funding-ability by patients at P= .05. Conclusion: In the new policy, more prescriptions were treated, more drug items were prescribed and dispensed to the patients, and these culminated in increase in internally generated revenue for the Hospital. There was a significant reduction in the frequency of occurrences of "Not-Available drugs", "Not-funded drugs" by patients, and the percentage of "Not-Available drugs". The new policy further shows a significant improvement in the "Funding-Ability" of drugs by patients, "drug-Availability” and it's percentage thereof, and work-out-put efficiency by the staff. These evaluation indicators indicate a significantly enhanced quantity and quality of care to the patients and clients through implementation of the 100% drug prescription-fill policy at University of Benin Teaching Hospital. There were significant differences between the old and new policies regarding feasibility and sustainability powers, in favour of the new policy. The new policy, therefore reasonably satisfies the stated goals & objectives of National Health & Drug Policies better than the older alternative policy.