Community Pharmacy Policy and Procedures: Health Insurance System

Objectives: This study aims to delve into the unique aspects and significance of the Health Insurance policy in community pharmacy practice in Saudi Arabia. This novel initiative will significantly impact and enhance pharmaceutical care activities, promising a positive transformation in the field. Methods: A meticulous narrative review of the community pharmacy policy of Health Insurance was conducted. Extensive literature searches were performed in reputable databases, including PubMed, Medline, and Google Scholar, covering specific Health Insurance policies and procedures in pharmacy practice from the 1960s until October 2024. The search was conducted in English and included a narrative review, systemic review, Meta-analysis, and guidelines. All hospital or community pharmacy services were included in the search term. National and international guidelines for general health insurance in hospital practice were also considered. The committee of pharmacy health insurance was formulated and consisted of various expert members, including expert community pharmacists, clinical pharmacists, and Health Insurance Services pharmacist specialists. The guidelines of the policy draft by one member and the second member were reviewed and corrected. The health insurance specialist did the third revision. The topic is pharmacy health insurance policies and procedures. Results: The Community Pharmacy Health Insurance policy is a comprehensive framework covering many aspects. It includes Health Insurance for prescribed medication, over-the-counter medications, medical devices, approved indications, drug formulary, and drug utilization. Additionally, it provides health insurance services for tourists, ensuring broad coverage. Conclusion: The community pharmacy health insurance policy is a new initiative in which services are part of pharmaceutical care activities and performances. It is a new system to control prescriptions with approved indications, keep all medications at an appropriate cost, and calculate the cost of diseases and drug therapy. Besides, it provides tourists with health insurance services. Therefore, the community pharmacy Health Insurance policy is highly curtailed and recommended for implementation in ambulatory care settings.

Keywords: Competency, Health Insurance, Pharmacy, Policy, Saudi Arabia. 

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