Pharmaceutical policies: effects of financial incentives for prescribers

Rashidian, Arash; Omidvari, Amir Houshang; Vali, Yasaman; Sturm, Heidrun; Oxman, Andrew D

doi:10.1002/14651858.cd006731.pub2

Cited by 58 publications

(44 citation statements)

References 140 publications

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“…A meta‐analysis conducted for Cochrane found, based on data from 25 randomized controlled trials, that academic detailing improves compliance with desired prescribing practices . Financial incentives aimed at improving rates of generic prescribing were also shown to be effective, although the evidence base is limited …”

Section: Resultsmentioning

confidence: 99%

Comparing Generic Drug Markets in Europe and the United States: Prices, Volumes, and Spending

2017

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Policy Points: Our study indicates that there are opportunities for cost savings in generic drug markets in Europe and the United States.Regulators should make it easier for generic drugs to reach the market.Regulators and payers should apply measures to stimulate price competition among generic drugmakers and to increase generic drug use.To meaningfully evaluate policy options, it is important to analyze historical context and understand why similar initiatives failed previously. ContextRising drug prices are putting pressure on health care budgets. Policymakers are assessing how they can save money through generic drugs.MethodsWe compared generic drug prices and market shares in 13 European countries, using data from 2013, to assess the amount of variation that exists between countries. To place these results in context, we reviewed evidence from recent studies on the prices and use of generics in Europe and the United States. We also surveyed peer‐reviewed studies, gray literature, and books published since 2000 to (1) outline existing generic drug policies in European countries and the United States; (2) identify ways to increase generic drug use and to promote price competition among generic drug companies; and (3) explore barriers to implementing reform of generic drug policies, using a historical example from the United States as a case study.FindingsThe prices and market shares of generics vary widely across Europe. For example, prices charged by manufacturers in Switzerland are, on average, more than 2.5 times those in Germany and more than 6 times those in the United Kingdom, based on the results of a commonly used price index. The proportion of prescriptions filled with generics ranges from 17% in Switzerland to 83% in the United Kingdom. By comparison, the United States has historically had low generic drug prices and high rates of generic drug use (84% in 2013), but has in recent years experienced sharp price increases for some off‐patent products. There are policy solutions to address issues in Europe and the United States, such as streamlining the generic drug approval process and requiring generic prescribing and substitution where such policies are not yet in place. The history of substitution laws in the United States provides insights into the economic, political, and cultural issues influencing the adoption of generic drug policies.ConclusionsGovernments should apply coherent supply‐ and demand‐side policies in generic drug markets. An immediate priority is to convince more physicians, pharmacists, and patients that generic drugs are bioequivalent to branded products. Special‐interest groups continue to obstruct reform in Europe and the United States.

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Section: Resultsmentioning

confidence: 99%

Comparing Generic Drug Markets in Europe and the United States: Prices, Volumes, and Spending

2017

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“…The present study suggests that at least some of the effect observed by Yip et al was because of the P4P component of the new payment scheme. Second, our study contributes to the small literature undertaking rigorous evaluations of the effects of P4P schemes targeting pharmaceutical use and spending, which, according to Rashidian et al (2015), amounted to just three inconclusive studies to date prior to our study and that of Yip et al Finally, our study contributes to the small but growing literature providing rigorous evaluations of P4P schemes in developing countries. Since Witter et al (2012), several new studies have been undertaken, some of which are prospective experiments and others of which are retrospective evaluations of at-scale schemes (Basinga et al, 2011;Wang et al, 2011;Bonfrer et al, 2014a;Bonfrer et al, 2014b;Celhay et al, 2015;de Walque et al, 2015;Van de Poel et al, 2015).…”

mentioning

confidence: 79%

The Impact of a Pay-for-Performance Scheme on Prescription Quality in Rural China

Sun

Liu

Sun

et al. 2020

World Scientific Series in Global Health Economics and Public Policy

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In this prospective study, conducted in China where providers have traditionally been paid fee-for-service, and where drug spending is high and irrational drug prescribing common, township health centers in two counties were assigned to two groups: in one fee-for-service was replaced by a capitated global budget (CGB); in the other by a mix of CGB and payfor-performance. In the latter, 20% of the CGB was withheld each quarter, with the amount returned depending on points deducted for failure to meet performance targets. Outcomes studied included indicators of rational drug prescribing and prescription cost. Impacts were assessed using differences-in-differences, because political interference led to non-random assignment across the two groups. The combination of capitated global budget and pay-for-performance reduced irrational prescribing substantially relative to capitated global budget but only in the county that started above the penalty targets. Endline rates were still appreciable, however, and no effects were found in either county on out-of-pocket spending. Copyright

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“…22 Insentif finansial juga dianggap sebagai elemen penting dalam mengubah pola resep dokter walaupun dampak kebijakan seperti sistem pay for performance dalam meningkatkan kualitas hasil perawatan dan kesehatan masih belum pasti sehingga perlu penelitian lebih lanjut. 23 Sama halnya pada dokter pelayanan primer, metode pembayaran berpengaruh pada perilaku pelayanan dokter. Dengan metode pembayaran fee for services berdampak lebih banyak kunjungan ke dokter/dokter spesialis dan layanan diagnostik dibandingkan dengan metode pembayaran kapitasi sehingga perubahan dalam pembayaran insentif finansial dapat meningkatkan kualitas pelayanan di pelayanan primer.…”

Section: Pembahasanunclassified

Penerapan Sistem Remunerasi dan Kinerja Pelayanan

Soetisna

Ayuningtyas

Misnaniarti

2015

Kesmas: National Public Health Journal

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AbstrakRemunerasi dapat memengaruhi motivasi pegawai sekaligus meningkatkan kinerjanya. Demikian halnya di rumah sakit sebagai institusi pelayanan kesehatan yang padat modal, sumber daya manusia serta padat ilmu dan teknologi. Penelitian ini bertujuan untuk menganalisis persepsi pegawai terhadap implementasi sistem remunerasi dan kinerja unit pelayanan bedah jantung dewasa (UPBJD) di rumah sakit. Penelitian ini menggunakan pendekatan mixed methods (kuantitatif dan kualitatif). Desain penelitian kuantitatif adalah potong lintang menggunakan instrumen kuesioner self-assessment. Sedangkan desain penelitian kualitatif adalah deskriptif, dilakukan melalui focus group discussion dan telaah dokumen pada data berupa buku jadwal, buku registrasi, catatan keperawatan, dan rekam medis. Pengambilan data dilakukan pada tahun 2013 di salah satu rumah sakit di Jakarta. Responden/informan adalah staf medis fungsional, perawat, dan petugas administrasi berjumlah 29 orang. Data dianalisis secara univariat (metode kuantitatif), dan content analysis (metode kualitatif). Hasil penelitian menunjukkan bahwa sebagian besar staf medik fungsional dan perawat tidak puas (71,2%) dengan beberapa hal dalam penerapan sistem remunerasi, seperti pada sistem penggajian dan penentuan grading. Terlihat kinerja unit pelayanan bedah jantung dewasa mengalami kenaikan setiap tahun sebelum dan setelah penerapan sistem remunerasi. Diharapkan agar rumah sakit ini dapat memperbaiki sistem remunerasi yang sesuai ketentuan kebijakan dan menyusun formulasi insentif dan bonus yang lebih sesuai dengan kondisi saat ini serta perlu dilakukan sosialisasi yang tepat dan evaluasi secara berkala. Penerapan Sistem Remunerasi dan Kinerja Pelayanan Implementation of Remuneration System and Service PerformanceTri Wisesa Soetisna*, Dumilah Ayuningtyas**, Misnaniarti*** system implementation and adult cardiac surgery services unit's performance at hospital. This study used a mixed method approach (quantitative and qualitative). Quantitative study design was cross-sectional using questionnaire for self-assesment. Meanwhile, qualitative study design was descriptive conducted through focus group discussion and document review on data in forms of schedule book, registration book, nursing notes and medical records. Data collection was conducted in 2013 at one hospital in Jakarta. Respondents/informants were functional medical staff, nurses, and administration staff amounted to 29 people. Data was analyzed using univariate and content analysis techniques. Results showed most functional medical staff dan nurse were unsatisfied (71.2%) with several things in remuneration system implementation, such as in payroll system and grading determination. However, adult cardiac surgery services unit's performance is increasing every year before and after the implementation of remuneration system. This hospital is expected to improve the remuneration system in accordance with policy and arrange incentive formulation that is more appropriate with current condition as well as followed with p...

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Pharmaceutical policies: effects of financial incentives for prescribers

Cited by 58 publications

References 140 publications

Comparing Generic Drug Markets in Europe and the United States: Prices, Volumes, and Spending

Comparing Generic Drug Markets in Europe and the United States: Prices, Volumes, and Spending

The Impact of a Pay-for-Performance Scheme on Prescription Quality in Rural China

Penerapan Sistem Remunerasi dan Kinerja Pelayanan

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