Managing Pharmaceutical Costs in Health Systems: A Review of Affordability, Accessibility and Sustainability Strategies

Background: This paper reviews cost containment policies to control pharmaceutical expenditure either by regulating the pharmaceutical industry or targeting the demand side. Methods: The method used was the narrative literature review of studies which assessed the effect of pharmaceutical cost conta...

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Main Authors: Christos Ntais, Michael A. Talias, John Fanourgiakis, Nikolaos Kontodimopoulos
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Journal of Market Access & Health Policy
Subjects:
Online Access:https://www.mdpi.com/2001-6689/12/4/31
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author Christos Ntais
Michael A. Talias
John Fanourgiakis
Nikolaos Kontodimopoulos
author_facet Christos Ntais
Michael A. Talias
John Fanourgiakis
Nikolaos Kontodimopoulos
author_sort Christos Ntais
collection DOAJ
description Background: This paper reviews cost containment policies to control pharmaceutical expenditure either by regulating the pharmaceutical industry or targeting the demand side. Methods: The method used was the narrative literature review of studies which assessed the effect of pharmaceutical cost containment policies. Results: Governments worldwide have implemented a great variety of policy measures to manage pharmaceutical expenditure while ensuring fair access to essential medicines. Cost-sharing schemes, value-based pricing, reimbursement, reference pricing, payback mechanisms and the substitution of original drugs with generics and biosimilars are pivotal in these efforts, albeit with differing effectiveness across healthcare systems. Overall, it appears that any gains may be outweighed by the unfavorable effects of policies impacting patients. Although interventions have been created to improve physicians’ prescribing practice, they often achieve very minor benefits and at considerable cost. Policy measures pertaining to the regulation of the supply side must be supported by thorough evaluation in order to ascertain costs and effects and guarantee that unintended consequences are minimized. Conclusions: Policymakers frequently enact numerous laws and regulations to control pharmaceutical expenditure, even if there is limited evidence that they are cost-effective. The most crucial component of any policy’s success, regardless of the one selected, is its evaluation. Further research is needed to develop context-specific guidance that balances cost containment, equity and sustainability.
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spelling doaj-art-ffe5b20592b74b408af803631f2dd1ab2025-08-20T02:04:35ZengMDPI AGJournal of Market Access & Health Policy2001-66892024-12-0112440341410.3390/jmahp12040031Managing Pharmaceutical Costs in Health Systems: A Review of Affordability, Accessibility and Sustainability StrategiesChristos Ntais0Michael A. Talias1John Fanourgiakis2Nikolaos Kontodimopoulos3Healthcare Management Program, School of Economics & Management, Open University of Cyprus, Nicosia 2220, CyprusHealthcare Management Program, School of Economics & Management, Open University of Cyprus, Nicosia 2220, CyprusDepartment of Management Science and Technology, Hellenic Mediterranean University, 72100 Agios Nikolaos, GreeceDepartment of Economics and Sustainable Development, Harokopio University, 17676 Athens, GreeceBackground: This paper reviews cost containment policies to control pharmaceutical expenditure either by regulating the pharmaceutical industry or targeting the demand side. Methods: The method used was the narrative literature review of studies which assessed the effect of pharmaceutical cost containment policies. Results: Governments worldwide have implemented a great variety of policy measures to manage pharmaceutical expenditure while ensuring fair access to essential medicines. Cost-sharing schemes, value-based pricing, reimbursement, reference pricing, payback mechanisms and the substitution of original drugs with generics and biosimilars are pivotal in these efforts, albeit with differing effectiveness across healthcare systems. Overall, it appears that any gains may be outweighed by the unfavorable effects of policies impacting patients. Although interventions have been created to improve physicians’ prescribing practice, they often achieve very minor benefits and at considerable cost. Policy measures pertaining to the regulation of the supply side must be supported by thorough evaluation in order to ascertain costs and effects and guarantee that unintended consequences are minimized. Conclusions: Policymakers frequently enact numerous laws and regulations to control pharmaceutical expenditure, even if there is limited evidence that they are cost-effective. The most crucial component of any policy’s success, regardless of the one selected, is its evaluation. Further research is needed to develop context-specific guidance that balances cost containment, equity and sustainability.https://www.mdpi.com/2001-6689/12/4/31pharmaceutical expenditurecost containment policiesdrug price regulationcost-sharing schemesclawbackhealth technology assessment
spellingShingle Christos Ntais
Michael A. Talias
John Fanourgiakis
Nikolaos Kontodimopoulos
Managing Pharmaceutical Costs in Health Systems: A Review of Affordability, Accessibility and Sustainability Strategies
Journal of Market Access & Health Policy
pharmaceutical expenditure
cost containment policies
drug price regulation
cost-sharing schemes
clawback
health technology assessment
title Managing Pharmaceutical Costs in Health Systems: A Review of Affordability, Accessibility and Sustainability Strategies
title_full Managing Pharmaceutical Costs in Health Systems: A Review of Affordability, Accessibility and Sustainability Strategies
title_fullStr Managing Pharmaceutical Costs in Health Systems: A Review of Affordability, Accessibility and Sustainability Strategies
title_full_unstemmed Managing Pharmaceutical Costs in Health Systems: A Review of Affordability, Accessibility and Sustainability Strategies
title_short Managing Pharmaceutical Costs in Health Systems: A Review of Affordability, Accessibility and Sustainability Strategies
title_sort managing pharmaceutical costs in health systems a review of affordability accessibility and sustainability strategies
topic pharmaceutical expenditure
cost containment policies
drug price regulation
cost-sharing schemes
clawback
health technology assessment
url https://www.mdpi.com/2001-6689/12/4/31
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AT johnfanourgiakis managingpharmaceuticalcostsinhealthsystemsareviewofaffordabilityaccessibilityandsustainabilitystrategies
AT nikolaoskontodimopoulos managingpharmaceuticalcostsinhealthsystemsareviewofaffordabilityaccessibilityandsustainabilitystrategies