E-drug: Re: Per capita allocation for medicines
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Dear Friends:
I want to participate in the discussion about per capita allocation for
drugs. As Hildbrands says, in Bolivia we are implementing the national
insurance system, and drugs is a mayor concern in the design. We chose one
system: the insurance will pay to the facilities, only drugs of the
essential drugs list of Bolivia, and the cost of each one is calculated
based on the CEASS price list.
Ceass is the National central supply system and its prices are really low.
It seems very rational and economic. But the problem that the system faces
is this: doctors and patients think that these drugs are less effective and
of lower quality, and they prefer other drugs: registered marks, high prices
etc. What a surprise!!!!.
Result: the national spending for drugs increases, but the public system can't
detect it. And the poorest people pay for them, not only the richest.
We are conducting an interesting study: using an IMS market study, we want to
know the % of the spending invested in ineffective, but safe(?) drugs, the % in
ineffective but dangerous drugs, and the % in essential drugs.
In other words we think that spending in drugs are largely related to
rational use. Any efforts, especially in order to obtain universal
accessibility, need similar efforts in promotion of rational use. Or you can
lose time, money and energy.
We will appreciate so much your comments
Dr. Francisco Rossi
frossi@salud.ops.org.bo
[Note from moderator: Can't be cheap to use IMS data, but probably worth it
if the data are useful for planning actions? KM]
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