Pharmaceutical Reform : A Guide to Improving Performance and Equity

This publication, which is based on the unique methodology and tools developed for the World Bank Institute/Harvard School of Public Health Flagship Course on Health System Reform and Sustainable Financing, provides a powerful set of resources to help policy makers better navigate the complicated process of reforming pharmaceutical systems. Its problem solving approach complements technical resources and training curricula available on the discrete elements of a pharmaceutical sector. The application of the flagship approach to the pharmaceutical sector is both useful and timely. Ensuring the availability of medicines and the effective management of their procurement and distribution is central to the drive to achieve coverage and access to basic health care that is both universal and financially sustainable. Together, the methodology and case materials contained in this publication provide a rich resource from which policy makers in developing countries may draw to guide their efforts to meet these challenges. This book is designed to help participants gain a better understanding of all that goes on in the pharmaceutical sector. As noted above, it uses the flagship framework that we helped develop over the past decade. The essence of that approach is not to try to tell policy makers in detail what they should do. Rather it comprises a set of analytical tools that are combined into an overall, structured methodology for developing, adopting, and implementing reform proposals. The flagship framework also includes a comprehensive review of reform alternatives and a systematic review of their strengths and weaknesses in various situations. Throughout this book the authors have used the flagship framework to structure our analysis of pharmaceutical reform, continuously and explicitly applying its methods and concepts to the pharmaceutical sector. With a few minor exceptions, all the examples and all of the reform options come directly from pharmaceutical reform efforts around the world. The authors have also given specific attention to issues in pharmaceutical policy related to reproductive health.