Evaluation of Iran's pharmaceutical policies in the import of drugs and determining the nature of imported drugs using the ABC-VED Method

Abstract

Background: The supply of medicines in every country is vital in any country, and access to appropriate medicines ensures the health of that community by preventingthe spread of smuggling. The present study aimed to evaluate the current policies of Iran to supply medicines through importation and examine the application of the ABC-VED (Always, Better, Control-Vital, Essential, Desirable) method in assisting policymakers in making decisions on the medicine importation. Method: The present research study was conducted in qualitative and quantitative phases. In the qualitative phase, face-to-face interviews were conducted with 13 health experts in the field of production and import of medicine and their "content analysis" was done using MaxQDA 18 software.In the quantitative phase, to determine the nature of imported drug items, the ABC-VED analysis matrix and the information available in the pharmaceutical statistics of 2019 were used. Then, the distribution of drugs in each of the matrix categories was determined. Result: In the qualitative phase of the study, experts pointed to the impact of restrictive policies on importation of medicines, reducing access to medicines, increasing smuggling, reducing innovation, weakening marketing, and reducing the quality and increasing price of domestically produced medicines. In the quantitative phase, it was found that AV category consists of 36, AE 145, AD 85, BV 31, BE 240, CV 126, CE 970, and CD 672 type of medicines using the ABC-VED matrix. Finally, 21.5 % of medicines were categorized in group I belonging to vital and expensive medicines, 7.2 % in group II that are essential medicnies with moderate prices, and finaly 1 % were categorized in group III which are desirable medicines with lower prices. Conclusion: According to the opinions of experts in the country pharmaceutical industry, Iran's policy on drug importations has always been contractionary. Although it has led to lower prices and increased patients' access to medicines, it made side effects on the pharmaceutical system. Thses side effects includ sectional medical shortages over time. Policymakers can restrict the import of expensive and small quantities of drugs and allocate more funds to the supply of vital drugs. The analyses used cannot be the criterion for decision alone and can only indicate drug priorities in budget shortages and must make decisions within a multi-criteria decision framework.