The economics of pharmaceuticals and health sector reform in the Americas

Madrid, Yvette; Velásquez, Germán; Fefer, Enrique

doi:10.1590/s1020-49891998000500015

Cited by 4 publications

(6 citation statements)

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“…In countries with left-aligned governments, values such as interculturality, public financing, prevention, and right to health prevail (e.g., Bolivia, Cuba, Ecuador, Venezuela) [ 26 , 79 , 81 – 84 ] External factors • Situational values influence the policy selection when aligned with international recommendations or requirements ◦ Latin America countries have been influenced by international agencies like the World Bank, the International Monetary Fund, WHO, PAHO, and UN. The influence of international agencies has been through a process of policy transfer, sometimes more persuasive and sometimes more coercive, which has resulted in many Latin American countries sharing a number of common characteristics [ 20 , 25 , 28 , 29 , 35 , 45 , 47 , 57 , 59 , 81 , 85 – 87 ] • Situational values are used to prioritize policies to be implemented when aligned with specific situational influences ◦ Perhaps the value that has had the greatest presence in the implementation of health reforms in Latin America has been decentralization, which was one of the key elements of the World Bank recommendations in the 80s and 90s [ 32 , 47 , 57 , 88 ] …”

Section: Resultsmentioning

confidence: 99%

“…◦ Latin America countries have been influenced by international agencies like the World Bank, the International Monetary Fund, WHO, PAHO, and UN. The influence of international agencies has been through a process of policy transfer, sometimes more persuasive and sometimes more coercive, which has resulted in many Latin American countries sharing a number of common characteristics [ 20 , 25 , 28 , 29 , 35 , 45 , 47 , 57 , 59 , 81 , 85 – 87 ]…”

Section: Resultsmentioning

confidence: 99%

“…For example, at the end of the 80s and 90s, virtually all countries in Latin America began the process of reforming their health systems and pursued values promoted by the World Bank and the Inter-American Development Bank, including privatisation, competitiveness and market [20,25,28,29,45,57,85]. Reformers maintained that privatisation would improve other high standard values like accessibility, efficiency, equity, quality and social participation [35,30,47,59,81,86,87].…”

Section: Situational Valuesmentioning

confidence: 99%

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A framework for explaining the role of values in health policy decision-making in Latin America: a critical interpretive synthesis

Vélez

Wilson

Lavis

et al. 2020

Health Res Policy Sys

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Background Although values underpin the goals pursued in health systems, including how health systems benefit the population, it is often not clear how values are incorporated into policy decision-making about health systems. The challenge is to encompass social/citizen values, health system goals, and financial realities and to incorporate them into the policy-making process. This is a challenge for all health systems and of particular importance for Latin American (LA) countries. Our objective was to understand how and under what conditions societal values inform decisions about health system financing in LA countries. Methods A critical interpretive synthesis approach was utilised for this work. We searched 17 databases in December 2016 to identify articles written in English, Spanish or Portuguese that focus on values that inform the policy process for health system financing in LA countries at the macro and meso levels. Two reviewers independently screened records and assessed them for inclusion. One researcher conceptually mapped the included articles, created structured summaries of key findings from each, and selected a purposive sample of articles to thematically synthesise the results across the domains of agenda-setting/prioritisation, policy development and implementation. Results We identified 5925 references, included 199 papers, and synthesised 68 papers. We identified 116 values and developed a framework to explain how values have been used to inform policy decisions about financing in LA countries. This framework has four categories – (1) goal-related values (i.e. guiding principles of the health system); (2) technical values (those incorporated into the instruments adopted by policy-makers to ensure a sustainable and efficient health system); (3) governance values (those applied in the policy process to ensure a transparent and accountable process of decision-making); and (4) situational values (a broad category of values that represent competing strategies to make decisions in the health systems, their influence varying according to the four factors). Conclusions It is an effort to consolidate and explain how different social values are considered and how they support policy decision-making about health system financing. This can help policy-makers to explicitly incorporate values into the policy process and understand how values are supporting the achievement of policy goals in health system financing. Trial registration The protocol was registered with PROSPERO, ID=CRD42017057049.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Situational Valuesmentioning

confidence: 99%

See 1 more Smart Citation

A framework for explaining the role of values in health policy decision-making in Latin America: a critical interpretive synthesis

Vélez

Wilson

Lavis

et al. 2020

Health Res Policy Sys

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“…As a result, those who most need basic health services are increasingly unable to meet their needs. Ministries of health must focus the momentum for change on developing mechanisms to meet such needs, and they must do so by involving both the public and private sectors [18].…”

Section: Health and Pharmaceutical Expendituresmentioning

confidence: 99%

Evaluation of Prescription Pattern and its Economic Losses at Sudan National Medical Supplies

MM¹

2019

JQHE

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Rational: Studies conducted showed that there were gaps regarding the rational use of medicines (RUM).Aims and Objectives: to evaluate of prescriptions pattern and its economic losses at National Medical Supplies Fund (NMSF) Khartoum pharmacy, using WHO indicators. Method:A cross-sectional study was conducted using random sampling method, a total of 100 prescriptions were collected and analyzed from May-July 2016. Index of Rational Drug Prescribing (IRDP), dispensing, health facility and complementary indicators were selected and used as an indicator of RUM.Main Results: the mean values of prescribing indicators of RUM were estimated to be within the WHO optimal values for number of drugs per prescription (2.5 Vs >3) and antibiotics (5% vs. >30%), However, the discrepancy was reported regarding the injections indicator which was found to be more than the WHO optimal value (31% vs. >10%) and generics to be less than the WHO optimal value (30% vs. 100%).The economic loss due to irrational use of injections was high (85%). Conclusions:Strategies and interventions are desirable to promote RUM and minimize the consequences of using injectable medicines.

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“…Según Patricia Danzón y Adrian Towse (Danzon & Towse, 2005) las farmacéuticas tienen bastante cautela al fijar un precio bajo en otros países debido a que los reguladores de países de la OCDE con mecanismos de control de precios pueden tomar dicho precio como "precio de referencia" 31 (Madrid, 1998). Por ejemplo, si las farmacéuticas comercializan un antirretroviral al precio de un centavo la píldora dentro de territorio africano, el regulador de Canadá, podría resistirse a permitir que se comercialice a cien o doscientos dólares la misma píldora en territorio canadiense, incluso si la Junta de Revisión de Precios de Medicamentos -el regulador de precios de Canadá-entiende que las empresas deben recuperar la inversión de millones de dólares en I + D.…”

Section: Discriminación De Preciosunclassified

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The economics of pharmaceuticals and health sector reform in the Americas

Cited by 4 publications

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A framework for explaining the role of values in health policy decision-making in Latin America: a critical interpretive synthesis

A framework for explaining the role of values in health policy decision-making in Latin America: a critical interpretive synthesis

Evaluation of Prescription Pattern and its Economic Losses at Sudan National Medical Supplies

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