The relevance of systematic reviews on pharmaceutical policy to low- and middle-income countries

Gray, Andy; Suleman, Fátima

doi:10.1007/s11096-015-0156-6

Cited by 17 publications

(18 citation statements)

References 22 publications

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“…Based on existing WHO guidance, [144][145][146][147] assessment of the relevance of pharmaceutical policies to low-income and middle-income countries. 148,149 factors to consider include the degrees to which an established local pharmaceutical market or reliance on imported medicines exists, the extent to which medicines are patented, and the extent of reliance on donor funding for purchasing essential medicines. WHO off ers guidance to countries on a wide range of medicines pricing policy options available to governments and health systems.…”

Section: Trade-related Aspects Of Intellectual Property Rights Fl Eximentioning

confidence: 99%

Essential medicines for universal health coverage

et al. 2017

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Section: Trade-related Aspects Of Intellectual Property Rights Fl Eximentioning

confidence: 99%

Essential medicines for universal health coverage

et al. 2017

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“…Significantly, research on impact evaluation of pricing and reimbursement policies is severely limited and more research is warranted in this regard. Studies on such policies and their effect on price, availability and affordability of medicines abound for high-income countries; however, extrapolation of the results to LLMIC has been questioned [47] . Nevertheless, organizations such as World Health Organization (WHO) and Health Action International (HAI) and researchers at academic institutions are striving to generate evidences in these countries.…”

Section: Resultsmentioning

confidence: 99%

Adapting Pharmaceutical Pricing and Reimbursement Strategies for Achieving Universal Health Coverage in Nepal: Lessons from Selected Low- And Lower-Middle-Income Countries

Acharya¹

2016

IJPS

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Universal health coverage is increasingly being embraced by low-and high-income countries alike, and pharmaceuticals are an integral part of it. With Nepal adopting national health insurance policy and willing to implement the same, guidance regarding pharmaceutical pricing, coverage and reimbursement becomes the order of the day. This study reviews pricing and reimbursement policies and techniques in low-and lower-middle-income countries which are implementing or intend to implement universal health coverage schemes, and provides recommendations on policies and techniques applicable and most pertinent to Nepal. For this, relevant literature on 11 countries was searched. The countries studied here are at different stages of universal health coverage, and they are aligning their pharmaceutical pricing and reimbursement policies and techniques with their universal health coverage policy. Considerable variation exists among these countries in regard to pricing, ranging from ceiling pricing (based on cost-plus, external referencing or market-based technique) to free pricing. All these countries have framed their essential medicines list; few or all of the medicines in the list are provided free of charge to targeted groups. Different universal health coverage schemes are at work in these countries, financing strategy for which span tax-based, premiumbased and payroll deductions. Reimbursement decisions are intricately linked with pricing, with majority of the countries putting into effect a fixed reimbursable amount strategy for reimbursed products. In regard to Nepal, as it is beginning its universal health coverage journey, the ideal approach would be a ceiling price for essential medicines (applicable to both in-insurance and out-insurance) and reference or index pricing for reimbursed products. Key words: Universal health coverage, pharmaceutical pricing, reimbursement, low-and lower-middleincome countriesTouted as a global health transition, third of its kind, Universal Health Coverage (UHC) has entered the health lexicon of low, middle and high-income countries alike [1] . Countries are formulating and implementing their health policies with an eye to UHC. UHC was founded with two core objectives, to provide accessibility to health care services, and to provide financial risk protection for utilization of those services [2] . It encompasses three elements namely health services, population, and proportion of cost [3] . It necessitates a health services package, which is made available to the populace with no or minimal charge (in the form of co-payment, co-insurance or deductibles) at the time of service use [3] . Among different health services covered, or considered to be covered, by the health benefits package, pharmaceuticals pose a peculiar challenge.Coverage of pharmaceuticals entails decisions regarding their pricing and reimbursement. Total pharmaceutical expenditure (TPE) is on the rise globally, accounting for an average 1.5% of global gross domestic product (GDP) in 2006 [4] . TPE has a share of 24....

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“…Sixteen systematic reviews were also extracted from the review by Gray and Suleman [22]. A total of 707 references were categorized, based on screening through each article, according to the list of priority policy issues in ATM (Table 3).…”

Section: Resultsmentioning

confidence: 99%

Health policy and systems research in access to medicines: a prioritized agenda for low- and middle-income countries

Bigdeli

Javadi

Hoebert

et al. 2013

Health Res Policy Sys

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ObjectivesTo identify priority policy issues in access to medicines (ATM) relevant for low- and middle-income countries, to identify research questions that would help address these policy issues, and to prioritize these research questions in a health policy and systems research (HPSR) agenda.MethodsThe study involved i) country- and regional-level priority-setting exercises performed in 17 countries across five regions, with a desk review of relevant grey and published literature combined with mapping and interviews of national and regional stakeholders; ii) interviews with global-level stakeholders; iii) a scoping of published literature; and iv) a consensus building exercise with global stakeholders which resulted in the formulation and ranking of HPSR questions in the field of ATM.ResultsA list of 18 priority policy issues was established following analysis of country-, regional-, and global-level exercises. Eighteen research questions were formulated during the global stakeholders’ meeting and ranked according to four ranking criteria (innovation, impact on health and health systems, equity, and lack of research). The top three research questions were: i) In risk protection schemes, which innovations and policies improve equitable access to and appropriate use of medicines, sustainability of the insurance system, and financial impact on the insured? ii) How can stakeholders use the information available in the system, e.g., price, availability, quality, utilization, registration, procurement, in a transparent way towards improving access and use of medicines? and iii) How do policies and other interventions into private markets, such as information, subsidies, price controls, donation, regulatory mechanisms, promotion practices, etc., impact on access to and appropriate use of medicines?ConclusionsOur HPSR agenda adopts a health systems perspective and will guide relevant, innovative research, likely to bear an impact on health, health systems and equity.

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The relevance of systematic reviews on pharmaceutical policy to low- and middle-income countries

Cited by 17 publications

References 22 publications

Essential medicines for universal health coverage

Essential medicines for universal health coverage

Adapting Pharmaceutical Pricing and Reimbursement Strategies for Achieving Universal Health Coverage in Nepal: Lessons from Selected Low- And Lower-Middle-Income Countries

Health policy and systems research in access to medicines: a prioritized agenda for low- and middle-income countries

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