Affiliations 

  • 1 Strathclyde Institute of Pharmacy & Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK
  • 2 Department of Pharmacology & Therapeutics, Ekiti State University, Ado-Ekiti, Nigeria
  • 3 Division of Biology and Public Health, Mokwon University, Daejeon, Korea
  • 4 Graduate Program in Public Health, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
  • 5 Institute of Health & Biological Studies - Universidade Federal do Sul e Sudeste do Pará, Avenida dos Ipês, s/n, Cidade Universitária, Cidade Jardim, Marabá, Pará, Brazil
  • 6 Department of Pharmacy Practice & Policy, Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
  • 7 Department of Pharmacy, Faculty of Medicine, University of Medicine Tirana, Albania
  • 8 Department of Pharmaceutics & Pharmacy Practice, School of Pharmacy, University of Nairobi, Nairobi, Kenya
  • 9 Faculty of Pharmacy, University of Lahore, Lahore, Pakistan
  • 10 Department of Nutrition & Drug Research, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
  • 11 Department of Social Pharmacy, University of Banja Luka, Faculty of Medicine, Banja Luka, Republic of Srpska, Bosnia & Herzegovina
  • 12 "Carol Davila" University of Medicine & Pharmacy, Bucharest, Romania
  • 13 Department of Pharmacy, University of Zambia, Lusaka, Zambia
  • 14 Centre for Primary Care, Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, M13 9PL, UK
  • 15 Istituto di Ricerche Farmacologiche 'Mario Negri' IRCCS, Milan, Italy
  • 16 Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
  • 17 Faculty of Health & Life Sciences, The University of Liverpool, Brownlow Hill, Liverpool, L69 3BX, UK
  • 18 School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
J Comp Eff Res, 2021 Aug;10(12):1019-1052.
PMID: 34241546 DOI: 10.2217/cer-2020-0273

Abstract

Aim: Global expenditure on medicines is rising up to 6% per year driven by increasing prevalence of non-communicable diseases (NCDs) and new premium priced medicines for cancer, orphan diseases and other complex areas. This is difficult to sustain without reforms. Methods: Extensive narrative review of published papers and contextualizing the findings to provide future guidance. Results: New models are being introduced to improve the managed entry of new medicines including managed entry agreements, fair pricing approaches and monitoring prescribing against agreed guidance. Multiple measures have also successfully been introduced to improve the prescribing of established medicines. This includes encouraging greater prescribing of generics and biosimilars versus originators and patented medicines in a class to conserve resources without compromising care. In addition, reducing inappropriate antibiotic utilization. Typically, multiple measures are the most effective. Conclusion: Multiple measures will be needed to attain and retain universal healthcare.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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