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Use of medicine pricing and reimbursement policies for universal health coverage in Indonesia

Author

Listed:
  • Riswandy Wasir
  • Sylvi Irawati
  • Amr Makady
  • Maarten Postma
  • Wim Goettsch
  • Erik Buskens
  • Talitha Feenstra

Abstract

Objectives: This study aimed to define the problems of the current use of the e-Catalogue and the national formulary (NF)—two elements of medicine pricing and reimbursement policies in Indonesia for achieving universal health coverage (UHC)—by examining the knowledge and attitudes of stakeholders. Specifically, to investigate (1) the perceived challenges involved in the further implementation of the e-Catalogue and the NF, (2) reasons of prescribing medicines not listed in the NF, and (3) possible improvements in the acceptance and use of the e-Catalogue and the NF. Methods: Semi-structured interviews were conducted with stakeholders (policymakers, healthcare providers, a pharmaceutical industry representative, and experienced patients) to collect the qualitative data. The data was analysed using directed content analysis, following the guidelines of the COnsolidated criteria for REporting Qualitative studies (COREQ) in reporting the findings. Results: Interestingly, 20 of 45 participants decided to withdraw from the interview due to their lack of knowledge of the e-Catalogue and the NF. All 25 stakeholders who fully participated in this research were in favor of the e-Catalogue and the NF. However, interviewees identified a range of challenges. A major challenge was the lack of harmonization between the lists of medicines in the e-Catalogue and the NF. Several system and personal reasons for prescribing medicines not listed in the NF were identified. Important reasons were a lack of incentives for physicians as well as a lack of transparent and evidence-based methods of selection for the medicines to be listed in the NF. Conclusions: The e-Catalogue and the NF have not been fully utilized for achieving UHC in Indonesia. Some possible improvements suggested were harmonization of medicines listed in the e-Catalogue and the NF, restructuring incentive programs for prescribing NF medicines, and increasing the transparency and evidence-based approach for selection of medicines listed in the e-Catalogue and the NF.

Suggested Citation

  • Riswandy Wasir & Sylvi Irawati & Amr Makady & Maarten Postma & Wim Goettsch & Erik Buskens & Talitha Feenstra, 2019. "Use of medicine pricing and reimbursement policies for universal health coverage in Indonesia," PLOS ONE, Public Library of Science, vol. 14(2), pages 1-19, February.
    • Handle: RePEc:plo:pone00:0212328
    DOI: 10.1371/journal.pone.0212328
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    References listed on IDEAS

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    1. Aris Angelis & Ansgar Lange & Panos Kanavos, 2018. "Using health technology assessment to assess the value of new medicines: results of a systematic review and expert consultation across eight European countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(1), pages 123-152, January.
    2. Björn Wettermark & Brian Godman & Bengt Jacobsson & Flora Haaijer-Ruskamp, 2009. "Soft regulations in pharmaceutical policy making," Applied Health Economics and Health Policy, Springer, vol. 7(3), pages 137-147, September.
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    1. Riswandy Wasir & Sylvi Irawati & Amr Makady & Maarten Postma & Wim Goettsch & Talitha Feenstra & Erik Buskens, 2019. "The implementation of HTA in medicine pricing and reimbursement policies in Indonesia: Insights from multiple stakeholders," PLOS ONE, Public Library of Science, vol. 14(11), pages 1-14, November.

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