Abstract
BackgroundRapidly evolving socioeconomic and technological trends make it challenging to improve access, effectiveness and efficiency in the use of pharmaceuticals. This paper identifies and systematically classifies the prevailing pharmaceutical policies worldwide in relation to a country’s income status.MethodsA literature search was undertaken to identify and taxonomize prevailing policies worldwide. Countries that apply those policies and those that do not were then grouped by income status.ResultsPharmaceutical policies are linked to a country’s socioeconomics. Developed countries have universal coverage and control pharmaceuticals with external and internal price referencing systems, and indirect price–cost controls; they carry out health technology assessments and demand utilization controls. Price-volume and risk-sharing agreements are also evolving. Developing countries are underperforming in terms of coverage and they rely mostly on restrictive state controls to regulate prices and expenditure.ConclusionsThere are significant disparities worldwide in the access to pharmaceuticals, their use, and the reimbursement of costs. The challenge in high-income countries is to maintain access to care whilst dealing with trends in technology and aging. Essential drugs should be available to all; however, many low- and middle-income countries still provide most of their population with only poor access to medicines. As economies grow, there should be greater investment in pharmaceutical care, looking to the policies of high-income countries to increase efficiency. Pharmaceutical companies could also develop special access schemes with low prices to facilitate coverage in low-income countries.
Highlights
Evolving socioeconomic and technological trends make it challenging to improve access, effectiveness and efficiency in the use of pharmaceuticals
A literature search was undertaken using internet search engines such as Google, electronic article databases such as Medline and Embase, and the web sites of relevant organizations such as the WHO (World Health Organization) and ÖBIG (Österreichisches Bundesinstitut für Gesundheitswesen), the OECD, the European Commission and ISPOR
Price setting policies and trends Regarding the pricing policies applied in different countries, the review of the literature indicated that pharmaceuticals are treated differently, mainly depending on whether they are on patent, off patent or generics
Summary
Evolving socioeconomic and technological trends make it challenging to improve access, effectiveness and efficiency in the use of pharmaceuticals. Modern healthcare systems aspire to provide accessible, effective and efficient healthcare services for all individuals living in any given county Attaining these objectives is Maniadakis et al BMC Health Services Research (2017) 17:371 increasingly challenging in the context of an environment with financial constraints, increasing demand due to better coverage, rising expectations and population aging, and rapidly emerging new technologies alongside scientific advances that impact the organization and cost of delivering care [1, 2]. Another reason for the increasing challenges facing health authorities and payers is the continuous increase in the price of new technologies, and medicines. Countries have often been found to pay too much for generics, especially that many standard medicines available in this form, with prices of generic medicines and biosimilars varying by up to 30-fold between different countries [12, 13]
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