Chronic Disease Medicine Prices and Availability Under Indonesia’s National Health Social Security Agency (BPJS): A Cross-sectional Study from Jakarta and Yogyakarta

This study aims to analyze the gap between financing mechanisms and the realities of the medicine market within the National Health Social Security Agency (BPJS) for chronic diseases in Indonesia. The article examines variations in procurement prices and medicine availability, and their implications for the financial sustainability of healthcare facilities and patient access. The cross-sectional study uses secondary data on procurement prices together with observations on the availability of chronic disease medicines in hospitals and pharmacies in Jakarta and Yogyakarta in 2024. The data were analyzed to identify patterns of variation and gaps between procurement prices and BPJS reimbursement levels. The results show price variation between facilities and regions, with medicine availability higher in pharmacies than in hospitals. BPJS reimbursement rates for some medicines do not cover procurement costs, which may cause financial losses for healthcare facilities and threaten supply sustainability. These findings point to weaknesses in BPJS medicine reimbursement and price-negotiation mechanisms. The recommendations call for pricing mechanisms that are more responsive to market dynamics, greater price transparency, and harmonized procurement policies to ensure sustainable access to chronic disease medicines. This Indonesian case study offers lessons for middle-income countries implementing national health insurance to achieve universal health coverage.