Ապահովագրության շրջանակներում դեղերի փոխհատուցման հիմնական սխեմաների համեմատական վերլուծություն / Comparative Analysis of the Main Drug Reimbursement Schemes in Insurance

Abstract

One component of the health insurance system is drug insurance, which provides full or partial reimbursement for the cost of prescription drugs. Expenditures on pharmaceuticals account for a large proportion of total health care costs. The regular distribution of drugs to people in adequate quantities and with guaranteed quality presents one of the largest challenges for the government of every country. Both developed and developing countries have an extensive experience with the primary insurance based on drug reimbursement programs, making it crucial to evaluate the key characteristics of these programs. The required medical insurance system and its essential component, the drug reimbursement program, have not yet been implemented in the Republic of Armenia, making it a significant and pertinent issue for study. The authors studied and compared the drug reimbursement schemes in selected countries, discussed the criteria for drug reimbursement, the features of the compilation of reimbursement lists, and presented the main approaches to the price policy development in the field of drug reimbursement. The study also analyses the main mechanisms of reimbursement of medicines operating in the RA, population groups and diseases included in the framework of reimbursement. The research examines the primary mechanisms of drug reimbursement in the RA, as well as population groups and diseases covered by the framework of reimbursement. The findings of the study demonstrate the lack of a universal model for drug reimbursement. Instead, developed nations and those with similar economies develop their own public health protection models. These models, while differ in organizational aspects, contain common components including population categories, reimbursement lists, reimbursement rates, price regulation systems, and other components that should serve as a guide when creating the drug insurance model in the RA.