who medicines strategy - libdoc.who.int - World Health Organization

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WHO MEDICINES STRATEGY 2004-2007 | 64EO 3.4Medicines benefits promotedwithin social health insurance andprepayment schemesRationaleDifferent forms of prepayment schemes involvingthe use of pooled resources are used by healthpolicy-makers to develop an organized healthsystem 28 . Direct public funding, expansion ofhealth insurance coverage and pharmaceuticalbenefits, extension of employer roles in healthand drug financing, support from NGOs, andcommunity financing sources have the potentialboth to increase the level of resources availablefor health and to promote equitable access.Prepayment schemes allow the healthy tosubsidize the sick and, through income-basedpremiums, the rich to subsidize the poor. Bothshifts imply that health care becomes moreaffordable for the poor and the sick.ProgressSocial and private health insurance coverage hasled to expanded medicine benefits in countriesas diverse as Argentina, the People’s Republicof China, Egypt, Georgia, India, the IslamicRepublic of Iran, Kyrgyzstan, South Africa,Thailand and Viet Nam. Some of these havespecial arrangements for rural and low-incomepopulations, and medicines represent 25%-70%of total costs for these schemes. Each country’ssocial and economic context defines the mostsuitable routes toward broader and deeperinsurance protection. In Western and CentralEurope, countries are increasingly collaboratingin the exchange of information and experienceson cost-containment measures, and in the use ofcost-effectiveness analysis as an aid to medicinesreimbursement decisions (including a WHOreview of the technology appraisal programme ofthe National Institute For Clinical Excellence inthe UK). WHO is working with such programmesto address the issue of medicines managementwithin health insurance.Challenges remainingThe development of widespread health insurancemechanisms is a capacity-intensive processwhich typically takes many years to reach fullimplementation and even then requires activemanagement. A country’s overall economicperformance in this period is a major enabling orconstraining factor. Most low- and middle-incomecountries start with a diverse set of health andmedicine financing mechanisms, with prepaymentsometimes accounting for only a minority shareof total health or medicine spending. Equitablesharing of financial risks and protection amongthe population is thus often very limited,particularly in relation to the cost of medicines.
COMPONENTS OF THE STRATEGY | 65Meeting the challenges 2004-2007Over the next four years WHO will:> support countries in all regions in reviewingthe state of national and sub-nationalprepayment and insurance arrangements, andassessing their impact and potential in termsof access to medicines.> compile and disseminate lessons fromindividual countries.> advocate for the adoption of health insuranceand prepayment schemes and provideexperience-based policy guidance tocountries.(These activities will be carried out insynchronization with those under EO 3.2)OUTCOME INDICATORS1999 2003 2007No. of countries with public health insurance covering thecost of medicines#REPORTING % TARGET#REPORTING % TARGET71/111 64% 70% 79/117 68% 73%
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MEDICINESAND PUBLIC HEALTH
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REFERENCES
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REFERENCES | 1471Annual report 2000
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REFERENCES | 14912 th Model List of
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