A system dynamics model for national drug policy

Abdollahiasl, Akbar; Kebriaeezadeh, Abbas; Dinarvand, Rassoul; Abdollahi, Mohammad; Cheraghali, Abdol Majid; Jaberidoost, Mona; Nikfar, Shekoufeh

doi:10.1186/2008-2231-22-34

Cited by 16 publications

(23 citation statements)

References 24 publications

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“…This finding is also consistent with the previous studies (15,16). In the majority of countries, the price of originator brands is higher than those of the two other forms (17,18).…”

Section: Research Articlesupporting

confidence: 93%

Availability, pricing and affordability of selected medicines for noncommunicable diseases

Heidari

Varmaghani

Abdollahiasl

2019

East Mediterr Health J

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Background:The global and national burden of noncommunicable diseases continues to rise, thus making access to medicines increasingly important. Aims: The objective of this study was to evaluate the availability, pricing, and affordability of selected medicines for noncommunicable diseases in the Islamic Republic of Iran used in 2014 based on the World Health Organization (WHO)/ Health Action International (HAI) methodology. Methods: The price and availability data for 54 selected medicines were collected from public and private retail pharmacies as well as private pharmacies located in public hospitals in six cities of the Islamic Republic of Iran on the basis of the standardized methodology developed by WHO and HAI. The outcome measures were percentage availability of medicines, ratios of medicine prices to the international reference prices, and the affordability. Affordability was defined as the number of days' wages needed by the lowest-paid unskilled government worker to afford one month of chronic treatment. Results: The procurement price of the surveyed Lowest Priced Generic and Most Sold Generic medicines was 1.19 times the international reference price. The patient price was not significantly different among different pharmacy retail settings compared with the international reference prices. Moreover, the overall mean availability of the surveyed Lowest Priced Generic medicines in public, private, and other settings was 75.5%, 83.3% and 80.3%, respectively. All the treatment costs for the high burden noncommunicable diseases were less than one day's wages of the lowest-paid government worker. Conclusions: This study indicated that procurement prices of the surveyed medicines were reasonable in comparison with the international reference price. Moreover, the availability of generic forms of the surveyed medicines was good but originator brand medicines were significantly low in all the three settings. Citation: Heidari E; Varmaghani M; Abdollahiasl A. Availability, pricing and affordability of selected medicines for noncommunicable diseases. East Mediterr Health J. 2019;25 (7):473-480. https://doi.

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“…This finding is also consistent with the previous studies (15,16). In the majority of countries, the price of originator brands is higher than those of the two other forms (17,18).…”

Section: Research Articlesupporting

confidence: 93%

Availability, pricing and affordability of selected medicines for noncommunicable diseases

Heidari

Varmaghani

Abdollahiasl

2019

East Mediterr Health J

Self Cite

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“…In [24] a system dynamics simulation model is developed. In the study authors propose a simulation model studying the different variables that are associated with the drug policies in India.…”

Section: Related Literaturementioning

confidence: 99%

A simulation model to evaluate pharmaceutical supply chain costs in hospitals: the case of a Colombian hospital

Franco

2018

DARU J Pharm Sci

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Background Healthcare costs is one of the most studied issue in our days because of increasing demand and the aging of population. Final costs of medicines is one of the most important issue in patient treatment and determine its real value is an important task within hospitals. Simulation models and in this case system dynamics allows to build representations of reality considering the interaction of the whole variables that affect the system where first a causal loop diagram allows to represent and identify the interaction between variables for develop a stock flow diagram to determine the final results. Objective Develop a simulation model that allows decision makers in Hospitals and Governments to identify the variables that affect the final cost of medicines and to determine the legal reimbursement allowed by national agencies. Methods This paper presents a conceptual modeling framework using a causal loop diagram and a dynamic simulation model in the real case of a hospital in Colombia to explore how different internal charges for medicines affect the behavior of the final unitdose cost of medicines, considering the complexity of the pharmaceutical system. We developed a simulation model to represent and characterize the pharmaceutical supply chain in a hospital and by using real data we validate the results of the model and conclude about the supply chain of medicines in Colombia using the legal regulations as a main factor of analysis. Results and conclusions We found that in some cases the maximum reimbursement value is less than the final cost of medicines within the hospital, which means that hospitals lose money on the administration of medicines to patients. The benefit of this model is that with the result the hospital can determine the real final monetary value of medicines, including the different processes starting from the reception of the medicines, ending with the administration to patients.

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“… 10 Despite the importance of medicines and pharmaceutical services in health systems, system thinking approaches are still new in this field. 11 In Brazil the interrelation among healthcare, innovation, industry and market has been widely discussed, constituting a focus for policy study known as the ‘health economic industrial complex’, 12 although industrial and market issues are more at the core. Discussions that seek to understand the different interfaces of a pharmaceutical policy at distinct levels of the health system are still rare.…”

Section: Introductionmentioning

confidence: 99%

Applying a health system perspective to the evolving Farmácia Popular medicines access programme in Brazil

et al. 2018

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The Farmácia Popular Program (FPP) launched a subsidy system in Brazil, but in coexistence with the ongoing regular governmental access to medicines (Unified Health System (SUS) dispensings) mechanisms, causing overlaps in terms of financing and target population. This characteristic is quite different from most countries with medicines cost-sharing schemes. This paper aims to analyse the FPP under a health systems perspective considering the different health system levels. We analysed the findings from the study ‘Impact of consecutive subsidies policies on access to and use of medicines in Brazil – ISAUM-Br’, designed with the objective of describing and evaluating the impact of the government medicines subsidy policies implemented between 2004 and 2011. Patient share of copayment increased with the implementation of the intervention, which decreased the reference price and decreased with SNP (Saúde Não Tem Preço; zero copayment for patients). There was an increased number of FPP dispensations over time, but SUS dispensings remained the most important source for medicines, especially for hypertension and diabetes. FPP allowed the establishment of a well-designed pharmaceutical information system in the country. Despite the improvement on control mechanism, fraud remained a problem. There were important effects on the pharmaceutical market and sales of generic medicines. FPP has proven to be a very important policy for promoting access to medicines for hypertension and diabetes in Brazil. Examining this policy with a health system perspective has allowed us to highlight many of its important consequences, including for the first time a broad and consistent information system on access to medicines in the country.

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A system dynamics model for national drug policy

Cited by 16 publications

References 24 publications

Availability, pricing and affordability of selected medicines for noncommunicable diseases

Availability, pricing and affordability of selected medicines for noncommunicable diseases

A simulation model to evaluate pharmaceutical supply chain costs in hospitals: the case of a Colombian hospital

Applying a health system perspective to the evolving Farmácia Popular medicines access programme in Brazil

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