Using the WHO Essential Medicines List to Assess the Appropriateness of Insurance Coverage Decisions: A Case Study of the Croatian National Medicine Reimbursement List

Kadić, Antonia Jeličić; Žanić, Maja; Škaričić, Nataša; Marušić, Ana

doi:10.1371/journal.pone.0111474

Cited by 14 publications

(6 citation statements)

References 10 publications

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“…Regarding healthcare, changes in supply, access and funding have been highlighted [ 60 ], and from the perspective of health financing, the most important is the compulsory health insurance for all citizens [ 59 ]. Although citizens benefit from compulsory insurance, the introduction of taxes for using public and private facilities has led to an increase in the costs supported by the population [ 61 ], and some patients risking falling into ‘the medical poverty trap’ [ 62 ]. Therefore, it is necessary to rationalize spending so as to ensure wider and better access to medicines [ 63 ], mainly for low-income countries.…”

Section: Methodsmentioning

confidence: 99%

Shedding Light on the Main Characteristics and Perspectives of Romanian Medicinal Oxygen Market

2021

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Medicinal oxygen plays an important role in healthcare, being essential for the existence and maintenance of the health of millions of people, who depend on medicinal oxygen every day, both in hospitals and at home. Medicinal oxygen is the primary treatment administrated to the majority of patients suffering from respiratory problems and low levels of oxygen in the blood, and in the context of the actual health crisis caused by the new COVID-19, the challenge is represented by increasing the supply of medicinal oxygen while reducing cost so that it is accessible where it is needed most, free at the point of use. It will take increased investment and commitment to put oxygen at the center of strategies for universal health coverage. In this context, it becomes essential to investigate the main characteristics of the Romanian market of medicinal oxygen, highlighting top key players, market development, key driving factors, types of products, market perspectives as well as shedding light on the segmentation of this particular market based on considerations regarding regions, hospital competence class and hospital specialization. Also, the research aims to explore the regional disparities in the decision of using O93%medicinal oxygen, revealing the main factors related to the usage of this type of product among Romanian public hospitals. The research relies on the first quantitative survey regarding medicinal oxygen usage among 121 public hospital units from a total of 461 public hospitals in 2018, which meet the specific requirements: includes the entire population according to the list published on the website of the Ministry of Health, is the most recent data and does not show repetition. The sampling was of probabilistic stage-type stratification, with the following sampling layers: hospital county distribution, hospital competence class officially assigned by the Ministry of Health and also area of residence (urban/rural). In order to analyze the main characteristics of the Romanian oxygen market, the following methods have been used: analysis of variance (ANOVA) together with Kruskal–Wallis, Pearson correlation coefficient as well as Goodman and Kruskal gamma, Kendall’s tau-b and Cramer’s V, as well as multilevel logistic regression analysis using hierarchical data (hospitals grouped in regions). The Romanian market of medicinal oxygen is rather an oligopoly market characterized by the existence of a small number of producers and two types of products currently used for the same medical purpose and having a substitutable character: medicinal oxygen O99.5%, and medicinal oxygen O93%. An overwhelming proportion of public hospitals agree that both types of medicinal oxygen serve the same therapeutic purpose. The Romanian market of medicinal oxygen highlighted a significant segmentation on considerations based on regions, hospital competence class and hospital specialization. Regarding the main perspectives, the Romanian market of medical oxygen keeps the growth trend registered globally, with development perspectives for competitors. Exploring the regional disparities in the decision of using O93 medicinal oxygen, the empirical results acknowledged the important role of unitary price, hospital capacity and the relevance of this product seen as a medicine. Medicinal oxygen is vital in sustaining life, proving its utility mainly in the context of the actual health crisis. In this context, the Romanian local market exhibits prospects for further development, being characterized by an important segmentation depending on regions, hospital competence class and hospital specialization.

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Section: Methodsmentioning

confidence: 99%

Shedding Light on the Main Characteristics and Perspectives of Romanian Medicinal Oxygen Market

2021

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“…There are also encouragements to supply policy-making process with stylised facts. Jelicic Kadic et al ( 2014 )call for using high-quality evidence in Croatian health care policy to rationalize expenditures and to ensure wider and better access to medicines. Zhang et al ( 2015 ) consider China’s National Reimbursement Ratio as a helpful quantitative indication in assessing and predicting national health insurance system.…”

Section: Introductionmentioning

confidence: 99%

Be rich or don’t be sick: estimating Vietnamese patients’ risk of falling into destitution

Vuong

2015

SpringerPlus

100

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This paper represents the first research attempt to estimate the probabilities of Vietnamese patients falling into destitution due to financial burdens occurring during a curative hospital stay. The study models risk against such factors as level of insurance coverage, residency status of patient, and cost of treatment, among others. The results show that very high probabilities of destitution, approximately 70 %, apply to a large group of patients, who are non-residents, poor and ineligible for significant insurance coverage. There is also a probability of 58 % that seriously ill low-income patients who face higher health care costs would quit their treatment. These facts put the Vietnamese government’s ambitious plan of increasing both universal coverage (UC) to 100 % of expenditure and the rate of UC beneficiaries to 100 %, to a serious test. The current study also raises issues of asymmetric information and alternative financing options for the poor, who are most exposed to risk of destitution following market-based health care reforms.Electronic supplementary materialThe online version of this article (doi:10.1186/s40064-015-1279-x) contains supplementary material, which is available to authorized users.

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“…The alignment of the WHO EML with the national reimbursement list of medicines was studied in Croatia and the Federation of Bosnia and Hercegovina (Kadic et al, 2014 ; Mahmić-Kaknjo and Marušić 2015 ). The WHO Essential Medicines List was used as a tool to assess the appropriateness of Insurance Coverage Decisions in the Croatian National Medicine Reimbursement List in 2014.…”

Section: Discussionmentioning

confidence: 99%

“…From the 2012 Croatian Institute of Health Insurance Basic list (CIHI list) 9 ATC categories with the highest expenditures were compared with the 2011 WHO EML. The result of the study showed that, of the 9 ATC categories compared, the lists shared 188 medicines (52.4% of the WHO EML and 36.9% of the CIHI list) (Kadic et al, 2014 ). A study conducted in 2015 in Bosnia and Hercegovina compared the Basic Medicines Lists of the Federation of Bosnia and Hercegovina (FBH Basic Lists (FBLs)) with the WHO Essential Medicines list and the evidence supporting the inclusion of additional medicines on the FBLs.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of alignment of the reimbursement medicines list for children in Albania with the WHO essential medicines list for children

Petro,

Perumal-Pillay,

Mantel-Teeuwisse

et al. 2023

Journal of Pharmaceutical Policy and Practice

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Background: The WHO Essential Medicine List for Children was released on the 30th anniversary of the general Essential Medicine List in 2007, to recognise special needs for medicines in children, and to promote the inclusion of paediatric medicines in national procurement programmes. This study aimed to investigate the alignment of the medicines included in the Albanian reimbursement medicines list of the Mandatory Healthcare Insurance Fund (AMHIF) and the Essential Medicine List for Children. Methods: A quantitative evaluation was performed to compare the paediatric medicines included in the 2022 list of the AMHIF and the 2021 WHO Essential Medicine List for Children. In addition, vaccines in the Albanian vaccination programmes for children were compared to the ones listed on the WHO Essential Medicine List for Children. Results: Both lists had a total of 284 active ingredients in common, whereas 14 of 24 vaccines were found to be in common in the Essential Medicine List for Children list and the Albanian vaccination programmes. Conclusions: This is the first study in Albania to investigate the alignment of the WHO EMLc and AMHIF list. In case of the same active ingredient there were many deviations in terms of dosage form, strength and indication.

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Using the WHO Essential Medicines List to Assess the Appropriateness of Insurance Coverage Decisions: A Case Study of the Croatian National Medicine Reimbursement List

Cited by 14 publications

References 10 publications

Shedding Light on the Main Characteristics and Perspectives of Romanian Medicinal Oxygen Market

Shedding Light on the Main Characteristics and Perspectives of Romanian Medicinal Oxygen Market

Be rich or don’t be sick: estimating Vietnamese patients’ risk of falling into destitution

Evaluation of alignment of the reimbursement medicines list for children in Albania with the WHO essential medicines list for children

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