Universal health coverage: the third global health transition?

Rodin, Judith; Ferranti, David de

doi:10.1016/s0140-6736(12)61340-3

Cited by 122 publications

(102 citation statements)

References 5 publications

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“…Given the need to link and integrate HIV and non-HIV services across all age groups, together with the increased global focus on developing NCD services [111] and establishing universal health coverage in these countries [96] , many resource-limited countries need to scale up services and strengthen their healthcare system. For this to be sustainable in the long run, countries will need to draw up realistic and costed national strategic plans, track how resources are used, how expenditure compares with the actual cost of providing services and outcome(s) achieved, and adjust spending needs in light of this information [12,13] .…”

Section: Resultsmentioning

confidence: 99%

Costs and cost–effectiveness of HIV community services: quantity and quality of studies published 1986–2011

Beck¹,

Fasawe

Ongpin

et al. 2013

Expert Review of Pharmacoeconomics & Outcomes Research

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Section: Resultsmentioning

confidence: 99%

Costs and cost–effectiveness of HIV community services: quantity and quality of studies published 1986–2011

Beck¹,

Fasawe

Ongpin

et al. 2013

Expert Review of Pharmacoeconomics & Outcomes Research

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“…These factors clearly compromise the role of this tertiary hospital, which in reality is functioning at a much lower level than its current designation. Achieving universal health coverage has gathered global momentum, 9 and is now a national priority in Nepal. 5 The two pillars needed to reach universal health coverage are coverage with needed health services and protection from fi nancial risk.…”

Section: Discussionmentioning

confidence: 99%

Universal health coverage in a regional Nepali hospital: who is exempted from payment? [Short communication]

Basnet

Shrestha

Nagaraja

et al. 2013

public health action

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“…Touted as a global health transition, third of its kind, Universal Health Coverage (UHC) has entered the health lexicon of low, middle and high-income countries alike [1] . Countries are formulating and implementing their health policies with an eye to UHC.…”

Section: Abstract: Universal Health Coverage Pharmaceutical Pricingmentioning

confidence: 99%

Adapting Pharmaceutical Pricing and Reimbursement Strategies for Achieving Universal Health Coverage in Nepal: Lessons from Selected Low- And Lower-Middle-Income Countries

Acharya¹

2016

IJPS

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Universal health coverage is increasingly being embraced by low-and high-income countries alike, and pharmaceuticals are an integral part of it. With Nepal adopting national health insurance policy and willing to implement the same, guidance regarding pharmaceutical pricing, coverage and reimbursement becomes the order of the day. This study reviews pricing and reimbursement policies and techniques in low-and lower-middle-income countries which are implementing or intend to implement universal health coverage schemes, and provides recommendations on policies and techniques applicable and most pertinent to Nepal. For this, relevant literature on 11 countries was searched. The countries studied here are at different stages of universal health coverage, and they are aligning their pharmaceutical pricing and reimbursement policies and techniques with their universal health coverage policy. Considerable variation exists among these countries in regard to pricing, ranging from ceiling pricing (based on cost-plus, external referencing or market-based technique) to free pricing. All these countries have framed their essential medicines list; few or all of the medicines in the list are provided free of charge to targeted groups. Different universal health coverage schemes are at work in these countries, financing strategy for which span tax-based, premiumbased and payroll deductions. Reimbursement decisions are intricately linked with pricing, with majority of the countries putting into effect a fixed reimbursable amount strategy for reimbursed products. In regard to Nepal, as it is beginning its universal health coverage journey, the ideal approach would be a ceiling price for essential medicines (applicable to both in-insurance and out-insurance) and reference or index pricing for reimbursed products. Key words: Universal health coverage, pharmaceutical pricing, reimbursement, low-and lower-middleincome countriesTouted as a global health transition, third of its kind, Universal Health Coverage (UHC) has entered the health lexicon of low, middle and high-income countries alike [1] . Countries are formulating and implementing their health policies with an eye to UHC. UHC was founded with two core objectives, to provide accessibility to health care services, and to provide financial risk protection for utilization of those services [2] . It encompasses three elements namely health services, population, and proportion of cost [3] . It necessitates a health services package, which is made available to the populace with no or minimal charge (in the form of co-payment, co-insurance or deductibles) at the time of service use [3] . Among different health services covered, or considered to be covered, by the health benefits package, pharmaceuticals pose a peculiar challenge.Coverage of pharmaceuticals entails decisions regarding their pricing and reimbursement. Total pharmaceutical expenditure (TPE) is on the rise globally, accounting for an average 1.5% of global gross domestic product (GDP) in 2006 [4] . TPE has a share of 24....

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Universal health coverage: the third global health transition?

Cited by 122 publications

References 5 publications

Costs and cost–effectiveness of HIV community services: quantity and quality of studies published 1986–2011

Costs and cost–effectiveness of HIV community services: quantity and quality of studies published 1986–2011

Universal health coverage in a regional Nepali hospital: who is exempted from payment? [Short communication]

Adapting Pharmaceutical Pricing and Reimbursement Strategies for Achieving Universal Health Coverage in Nepal: Lessons from Selected Low- And Lower-Middle-Income Countries

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