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  • 1
    Online Resource
    Online Resource
    Paris : OECD Publishing
    Language: English
    Pages: 67 p. , 21 x 29.7cm
    Series Statement: OECD Health Working Papers no.25
    Keywords: Social Issues/Migration/Health ; Mexico
    Abstract: This paper examines aspects of the policy environment and market characteristics of Mexico's pharmaceutical sector, and assesses the degree to which Mexico has achieved certain policy goals. This paper questions the effectiveness of the maximum price regulation. It notes that retail prices for pharmaceuticals are relatively high, although proximity to the United States may have some influence. Although not wholly successful in containing overall drug expenditures, the federal government can claim some measure of success for the public sector market. A high reliance on out-of-pocket spending brings into question the sustainability of financing pharmaceuticals in Mexico. It also contributes to greater inequality, although a new health insurance scheme, the Seguro Popular, is addressing the latter with some success as it endeavours to provide coverage for the half of Mexico's population without health insurance. Finally, the paper acknowledges the government.s efforts in improving efficiency of expenditures and quality of care through new bioequivalency requirements for generics. However, an unintended side-effect of the loss of low cost, non-bioequivalent drugs may be higher average prices for pharmaceuticals.
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  • 2
    Online Resource
    Online Resource
    Paris : OECD Publishing
    Language: English
    Pages: 95 p. , 21 x 29.7cm
    Series Statement: OECD Economics Department Working Papers no.374
    Keywords: Economics
    Abstract: This study reviews health-system reforms in OECD countries over the past several decades and their impact on the following policy goals: ensuring access to services; improving the quality of care and its outcomes; allocating an “appropriate” level of resources to health care (macroeconomic efficiency); and ensuring microeconomic efficiency in service provision. While nearly all OECD countries have achieved universal insurance coverage, initiatives to address persistent disparities in access are now being undertaken in a number of countries. In light of new evidence of serious problems with health-care quality, many countries have recently introduced reforms, but it is too soon to generalise as to the relative effects of alternative approaches. Instruments aimed at cost control have succeeded in slowing the growth of (particularly public) health-care spending over the 1980s and 1990s but health-care spending continues to rise as a share of GDP in most countries. A few countries have ...This paper is also published under OECD Health Working Papers Series.
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  • 3
    Online Resource
    Online Resource
    Paris : OECD Publishing
    Language: English
    Pages: 67 p. , 21 x 29.7cm
    Series Statement: OECD Health Working Papers no.28
    Keywords: Social Issues/Migration/Health ; Sweden
    Abstract: This paper examines aspects of the policy environment and market characteristics of the Swedish pharmaceutical sector, assesses the degree to which Sweden has achieved certain policy goals, and puts forth some key findings and conclusions. Thanks to low mark-ups in the distribution chain and no VAT for prescribed medicines, Sweden's public prices for pharmaceuticals are relatively low, in contrast to average prices received by manufacturers, which are among the highest in Europe. Recent reforms have helped to restrain pharmaceutical expenditure growth, following a period of double digit growth in the 1990s. Pharmaceutical expenditure per capita in Sweden is lower than the OECD average. Only five OECD countries devote less of their national income to pharmaceuticals. What limited evidence exists tends to suggest that relatively low pharmaceutical expenditures in Sweden are due to its low public prices, rather than to low levels of consumption. Sweden introduced a new pricing and reimbursement scheme in 2002. Its main features are the use of cost-effectiveness analysis for determining the reimbursement status of new pharmaceuticals and mandatory substitution of the lowest-cost generic alternative. The use of cost-effectiveness analysis in reimbursement decisions helps to relate the reimbursement price paid to the social value of the product, but does not necessarily result in the lowest possible price.The generic substitution policy has enabled Sweden to achieve fairly high penetration of generic drugs into the market in terms of volume, with a considerably low share of the total value of the market. However, the requirement to substitute only the lowest-priced listed drug risks undermining the competitiveness of the generic drug industry...
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  • 4
    Online Resource
    Online Resource
    Paris : OECD Publishing
    Language: English
    Pages: 99 p. , 21 x 29.7cm
    Series Statement: OECD Health Working Papers no.9
    Keywords: Social Issues/Migration/Health
    Abstract: This study presents a broad overview of health-system reforms in OECD countries over the past several decades. Reforms are assessed according to their impact on the following policy goals: ensuring access to needed health-care services; improving the quality of health care and its outcomes; allocating an “appropriate” level of pubic sector and economy-wide resources to health care (macroeconomic efficiency); and ensuring that services are provided in a cost-efficient and cost-effective manner (microeconomic efficiency).While nearly all OECD countries have achieved universal coverage of health-care risks, initiatives to address persistent disparities in access are now being undertaken in a number of countries. In light of new evidence of serious problems with health-care quality, many countries have recently introduced reforms intended to improve this, but it is too soon to generalise as to the relative effects of alternative approaches. A variety of instruments aimed at ...This paper is also published under OECD Economics Department Working Papers Series.
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  • 5
    Language: English
    Pages: 64 p. , 21 x 29.7cm
    Series Statement: OECD Economics Department Working Papers no.350
    Keywords: Economics ; United States
    Abstract: This paper assesses the performance of the United States health system in an international context and discusses potential directions for reform. The US health system is unique among OECD countries in its heavy reliance on the private sector for both financing and delivery of health care. The public sector plays a not-insignificant role, providing coverage for the elderly, disabled and poor, and spending as much on health as a share of GDP as is spent in total by many OECD countries. The system is considered highly flexible, capable of evolving quickly to address the changing preferences of consumers and the incentives put in place by the requirements of payers and government regulation. It is also characterised by excellent access by the insured population to the latest advances in medical technology. However, 14 per cent of Americans lack insurance coverage, and the decentralised, multi-payer approach to financing and regulation provides relatively few levers to control ...
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  • 6
    Language: English
    Pages: 56 p. , 21 x 29.7cm
    Series Statement: OECD Health Working Papers no.31
    Keywords: Social Issues/Migration/Health ; Slovak Republic
    Abstract: This paper examines aspects of the policy environment and market characteristics of Slovakia's pharmaceutical sector, and assesses the degree to which Slovakia has achieved certain policy goals. Pharmaceutical expenditure in Slovakia accounts for a higher share of total health expenditure than it does in any other OECD country, and the share of national income going to pharmaceuticals is exceeded only in Hungary. Although its relatively low national income is a partial explanation for Slovakia's status in this respect, this review finds that Slovakia has scope to reduce its expenditures and the rapid rate of growth in its pharmaceutical spending. Financing of pharmaceutical expenditure in Slovakia rests more heavily on the public sector than is typical in the OECD, with out-of-pocket spending accounting for just a quarter of total expenditure. The effectiveness of international price referencing in limiting Slovak prices for on-patent pharmaceutical products is questionable. For products that have gone off-patent and for those with similar chemical structure, a reference-pricing scheme and competition among generic alternatives results in effective price control, although incentives for generic substitution are weak (for patients) and misaligned (for pharmacists). When deciding whether a drug will be reimbursed through the social insurance scheme, the cost-effectiveness of new pharmaceuticals is not assessed. On the other hand, certain policy goals have been achieved. The accessibility and availability of medicines--including the most innovative products--is good; affordability is supported by relatively low average co-payment levels. While more expensive drugs usually have higher cost-sharing, drugs are not excluded from coverage on affordability grounds.
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  • 7
    Language: English
    Pages: 62 p. , 21 x 29.7cm
    Series Statement: OECD Health Working Papers no.27
    Keywords: Social Issues/Migration/Health ; Switzerland
    Abstract: This paper examines aspects of the policy environment and market characteristics of the Swiss pharmaceutical sector, and assesses the degree to which Switzerland has achieved certain policy goals. In Switzerland, pharmaceutical spending has not been growing faster than health expenditure as a whole, as has been the case in many other OECD countries. Swiss pharmaceutical spending per capita and as a share of GDP is modest by OECD standards. This in part reflects relatively low levels of pharmaceutical consumption, given that public prices are among the highest in Europe and the Swiss tend to be early adopters of new pharmaceutical products. Switzerland’s regulation of prices for reimbursed drugs, based on referencing across countries and within the therapeutic class for products with comparators, appears to result in prices lower than what would be obtained absent regulation. Although ex-manufacturer prices are somewhat high relative to other European countries, recent reforms have reduced the differential. While costs are under control, Switzerland has scope to improve the cost-effectiveness of its expenditures in the pharmaceutical area. Generic penetration of the market is increasing but falls short of what has been achieved elsewhere and the prices of generic products are higher than what is found in other countries. Relatively high mark-ups over ex-factory prices suggest that the distribution chain is a source of further potential efficiencies, although high costs could also reflect characteristics of the Swiss economy...
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  • 8
    Online Resource
    Online Resource
    Paris : OECD Publishing
    Language: English
    Pages: 66 p. , 21 x 29.7cm
    Series Statement: OECD Health Working Papers no.39
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  • 9
    Online Resource
    Online Resource
    Paris : OECD Publishing
    ISBN: 9264015566
    Language: English
    Pages: Online-Ressource
    Series Statement: The OECD Health Project
    Series Statement: The OECD health project
    Parallel Title: Druckausg. u.d.T. Docteur, Elizabeth; Towards high performing health systems
    Parallel Title: Franz. Ausg. u.d.T. Docteur, Elizabeth; Vers des systèmes de santé plus performants
    Parallel Title: Parallelausg. Vers des systèmes de santé plus performants
    Keywords: OECD ; Gesundheitswesen ; Gesundheitspolitik ; Internationaler Vergleich
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  • 10
    Online Resource
    Online Resource
    Paris : OECD Publishing
    Language: English
    Pages: 91 p. , 21 x 29.7cm
    Series Statement: OECD Health Working Papers no.24
    Keywords: Social Issues/Migration/Health ; Canada
    Abstract: This paper describes and assesses pharmaceutical pricing and reimbursement policies in Canada, considering them in the context of the broader policy and market environment in which they operate, and investigating their role in contributing to Canada’s achievements in meeting a range of objectives relating to the pharmaceutical policy. The federal government regulates prices of patented pharmaceutical products with the objective of protecting consumers against excessive prices. Regulation has very likely been responsible for bringing Canada’s prices for patented medicines roughly in line with European comparators. Prices of generic products, which are not regulated, are relatively high although high...
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