Publication:
A Generic Drug Policy as Cornerstone to Essential Medicines in China

Loading...
Thumbnail Image
Files in English
English PDF (1.33 MB)
432 downloads
English Text (125.06 KB)
37 downloads
Date
2010-06
ISSN
Published
2010-06
Author(s)
Editor(s)
Abstract
Compared with developed economies, health expenditure in China is not particularly high on a per capita basis or as a share of Gross Domestic Product (GDP). Similarly, pharmaceutical expenditure in comparative perspective is not particularly high on a per capita basis or as a percentage of GDP. China's exceptionally high rate of pharmaceutical expenditure has important implications for the future of a health care system that not only serves a rapidly aging population, but encourages overuse of drugs in ways that are both financially and medically inefficient. Pharmaceutical reform is therefore a high priority for China's health policymakers. Several factors are discussed for reforming this system based on lessons from recent reforms. The section following this introduction briefly reviews the expansion of basic medical insurance coverage in the 2000s and several structural features of the pharmaceutical sector in China. The related concepts of an essential medicines policy, an essential drug list, and a generic drug policy are briefly described in first section. The second section of the paper looks at several hurdles that are built into the path of essential medicines reform. The third section considers some lessons for pharmaceutical reform based on China's recent learning from regional experimentation and piloting initiatives. The fourth section considers several relevant lessons derived from reform experiences in other countries. The fifth section looks at the path forward-success factors for implementing an essential medicines program based on low-cost generic drugs.
Link to Data Set
Citation
World Bank. 2010. A Generic Drug Policy as Cornerstone to Essential Medicines in China. China Health Policy Notes;No. 4. © World Bank. http://hdl.handle.net/10986/27722 License: CC BY 3.0 IGO.
Associated URLs
Associated content
Report Series
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections

Related items

Showing items related by metadata.

  • Publication
    Turkey
    (Ankara, World Bank, 2008) Celik, Yusuf; Seiter, Andreas
    Pharmaceuticals are essential to achieve health outcomes, but are at the same time a major cost factor in every health system. From a patient perspective, access to pharmaceuticals is a proxy for the functioning of the health system. With increasing economic strength, patients become more demanding with regard to access to modern, sophisticated drugs and providers become more aggressive in marketing those drugs. This paper reflects the situation in the pharmaceutical sector in Turkey, identifies critical issues, and discusses policy options based on current trends and the overall policy objectives of the Turkish government. This paper is structured as follows: chapter one gives introduction; chapter two gives overall policy objectives in the pharmaceutical sector in Turkey; chapter three presents institutional and regulatory framework; chapter four presents reimbursement rules; chapter five focuses on governance issues in the pharmaceutical sector; chapter six gives market overview; chapter seven gives payment for pharmaceuticals in Turkey; chapter eight presents prescribing practices - rational use of medicines; and chapter nine gives conclusions and way forward.
  • Publication
    The Pharmaceutical Sector in Ghana
    (World Bank, Washington, DC, 2009-11) Gyansa-Lutterodt, Martha; Seiter, Andreas
    Main pharmaceutical policy goals in Ghana are access to essential medicines for everybody, quality assurance for all drugs on the market, a functioning and efficient supply chain as well as rational use of medicines by professionals and patients. There is also a commitment to strengthen the domestic pharmaceutical industry, outlined under health industry in the national health policy. The National Health Insurance System (NHIS) has significantly improved access to medicines for insured patients, measured in increased utilization of facilities and rapidly growing turnover of revolving drug funds. The risk is now that non-rational prescribing and fraud lead to a growing medicine bill that threatens financial sustainability of NHIS. On the other hand, National Health Insurance Authority (NHIA) has the resources and purchasing power to influence provider behavior as well as the market in terms of quality and price. The purpose of this policy note is to provide a compact overview of the situation, trends and opportunities in the pharmaceutical sector in Ghana as relevant to the strategic objectives in the five year program of work. It summarizes data from a number of recent studies and reports that were done by a range of partners inside and outside the country as well as discussions with key stakeholders in the sector. The intent is to give decision makers up-to-date background information and provide some suggestions for specific policy initiatives designed to achieve the work program objectives, with a particular focus on the role health insurance can play to stabilize and improve service delivery, increase access to quality medicines and promote rational use. The overall legal framework for the pharmaceutical sector is set by the Food and Drugs Law from 1992, amended by Act 523 in 1996. It defines the role of the food and drugs board as separate entity under control of the Ministry of Health (MOH), responsible for regulating the sector. The Food and Drugs Board (FDB) also runs the official drug quality control laboratory that is in charge of testing quality samples obtained from manufacturers, importers, distributors or other sources. The FDB is also working on an improvement of its public website in an effort to strengthen communication with the general public to increase transparency and improve governance.
  • Publication
    Pharmaceutical Reform : A Guide to Improving Performance and Equity
    (World Bank, 2011-09-21) Roberts, Marc J.; Reich, Michael R.
    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.
  • Publication
    A Practical Approach to Pharmaceutical Policy
    (World Bank, 2010) Seiter, Andreas
    This book discusses the wide range of challenges faced by policy makers in the pharmaceutical sector, presents the current know-how in terms of policy measures, and provides specific examples of policy packages that can be used in defined circumstances, even if one assumes a certain degree of political resistance and capacity limits on the side of the implementing agency. This book focuses on developing countries and tries to address the issues faced by both low- and middle-income countries. The book does not cover the vaccines market and its respective policies because too many differences exist between the markets for vaccines and pharmaceuticals to cover both subsectors in one publication of this type. The book ends with an outlook on how things might evolve in the longer term. It assumes that some form of convergence will take place toward "models that work," thus reducing the fragmentation of policies and enhancing regulatory and economic efficiencies over time-one hopes to the benefit of all stakeholders in the sector and, in particular, those who, as patients, currently do not have reliable access to effective and safe medicines.
  • Publication
    Bulgaria Health Sector Diagnosis : Policy Note
    (Washington, DC, 2012) World Bank
    The health system in Bulgaria has undergone significant transformations since the transition and it continues to evolve. This policy note updates a similar document prepared in 2009. It highlights some positive developments, particularly in the area of public health, but continues to find gaps that recent reforms have been unable to reverse. In particular: i) health status in Bulgaria is improving at a slower pace than in other European Union (EU) countries, and the burden of non-communicable diseases is particularly high; ii) coverage of preventive services is low and Bulgarians are much more frequently hospitalized than other Europeans, a sign that the system may not be producing the right mix of services; iii) Bulgarians are among the least satisfied Europeans when it comes to their health system; and iv) total health expenditure is comparable to that of countries with similar income, but the out-of pocket share is disproportionately large and has grown over time, and the financial protection provided by the system is incomplete. Whilst more public expenditure on health will be needed in the medium to long-term, any increases should be accompanied by improvements in efficiency and effectiveness in order to make the best use of resources and ensure the delivery of better health outcomes. This policy note thus primarily focuses on three areas where decisive and prompt action could rapidly bring results and improve the experience of Bulgarian citizens: hospitals, outpatient care, and drug policies. These issues are closely interlinked and tackling them is a key to the modernization of service delivery in all European countries. Indeed, in order to face the challenges brought about by ageing and non-communicable diseases and to meet the population's needs and expectations, new models of health and social care need to emerge that enable patients to stay out of hospital. This is possible through technological change, but can only happen if the outpatient sector delivers more and patients can manage diseases and risk factors through access to appropriate services and medicines.

Users also downloaded

Showing related downloaded files

  • Publication
    The Journey Ahead
    (Washington, DC: World Bank, 2024-10-31) Bossavie, Laurent; Garrote Sánchez, Daniel; Makovec, Mattia
    The Journey Ahead: Supporting Successful Migration in Europe and Central Asia provides an in-depth analysis of international migration in Europe and Central Asia (ECA) and the implications for policy making. By identifying challenges and opportunities associated with migration in the region, it aims to inform a more nuanced, evidencebased debate on the costs and benefits of cross-border mobility. Using data-driven insights and new analysis, the report shows that migration has been an engine of prosperity and has helped address some of ECA’s demographic and socioeconomic disparities. Yet, migration’s full economic potential remains untapped. The report identifies multiple barriers keeping migration from achieving its full potential. Crucially, it argues that policies in both origin and destination countries can help maximize the development impacts of migration and effectively manage the economic, social, and political costs. Drawing from a wide range of literature, country experiences, and novel analysis, The Journey Ahead presents actionable policy options to enhance the benefits of migration for destination and origin countries and migrants themselves. Some measures can be taken unilaterally by countries, whereas others require close bilateral or regional coordination. The recommendations are tailored to different types of migration— forced displacement as well as high-skilled and low-skilled economic migration—and from the perspectives of both sending and receiving countries. This report serves as a comprehensive resource for governments, development partners, and other stakeholders throughout Europe and Central Asia, where the richness and diversity of migration experiences provide valuable insights for policy makers in other regions of the world.
  • Publication
    Remarks at the United Nations Biodiversity Conference
    (World Bank, Washington, DC, 2021-10-12) Malpass, David
    World Bank Group President David Malpass discussed biodiversity and climate change being closely interlinked, with terrestrial and marine ecosystems serving as critically important carbon sinks. At the same time climate change acts as a direct driver of biodiversity and ecosystem services loss. The World Bank has financed biodiversity conservation around the world, including over 116 million hectares of Marine and Coastal Protected Areas, 10 million hectares of Terrestrial Protected Areas, and over 300 protected habitats, biological buffer zones and reserves. The COVID pandemic, biodiversity loss, climate change are all reminders of how connected we are. The recovery from this pandemic is an opportunity to put in place more effective policies, institutions, and resources to address biodiversity loss.
  • Publication
    Economic Recovery
    (World Bank, Washington, DC, 2021-04-06) Malpass, David; Georgieva, Kristalina; Yellen, Janet
    World Bank Group President David Malpass spoke about the world facing major challenges, including COVID, climate change, rising poverty and inequality and growing fragility and violence in many countries. He highlighted vaccines, working closely with Gavi, WHO, and UNICEF, the World Bank has conducted over one hundred capacity assessments, many even more before vaccines were available. The World Bank Group worked to achieve a debt service suspension initiative and increased transparency in debt contracts at developing countries. The World Bank Group is finalizing a new climate change action plan, which includes a big step up in financing, building on their record climate financing over the past two years. He noted big challenges to bring all together to achieve GRID: green, resilient, and inclusive development. Janet Yellen, U.S. Secretary of the Treasury, mentioned focusing on vulnerable people during the pandemic. Kristalina Georgieva, Managing Director of the International Monetary Fund, focused on giving everyone a fair shot during a sustainable recovery. All three commented on the importance of tackling climate change.
  • Publication
    South Asia Development Update, April 2024: Jobs for Resilience
    (Washington, DC: World Bank, 2024-04-02) World Bank
    South Asia is expected to continue to be the fastest-growing emerging market and developing economy (EMDE) region over the next two years. This is largely thanks to robust growth in India, but growth is also expected to pick up in most other South Asian economies. However, growth in the near-term is more reliant on the public sector than elsewhere, whereas private investment, in particular, continues to be weak. Efforts to rein in elevated debt, borrowing costs, and fiscal deficits may eventually weigh on growth and limit governments' ability to respond to increasingly frequent climate shocks. Yet, the provision of public goods is among the most effective strategies for climate adaptation. This is especially the case for households and farms, which tend to rely on shifting their efforts to non-agricultural jobs. These strategies are less effective forms of climate adaptation, in part because opportunities to move out of agriculture are limited by the region’s below-average employment ratios in the non-agricultural sector and for women. Because employment growth is falling short of working-age population growth, the region fails to fully capitalize on its demographic dividend. Vibrant, competitive firms are key to unlocking the demographic dividend, robust private investment, and workers’ ability to move out of agriculture. A range of policies could spur firm growth, including improved business climates and institutions, the removal of financial sector restrictions, and greater openness to trade and capital flows.
  • Publication
    Media and Messages for Nutrition and Health
    (World Bank, Washington, DC, 2020-06) Calleja, Ramon V., Jr.; Mbuya, Nkosinathi V.N.; Morimoto, Tomo; Thitsy, Sophavanh
    The Lao People’s Democratic Republic (Lao PDR) has experienced rapid and significant economic growth over the past decade. However, poor nutritional outcomes remain a concern. Rates of childhood undernutrition are particularly high in remote, rural, and upland areas. Media have the potential to play an important role in shaping health and nutrition–related behaviors and practices as well as in promoting sociocultural and economic development that might contribute to improved nutritional outcomes. This report presents the results of a media audit (MA) that was conducted to inform the development and production of mass media advocacy and communication strategies and materials with a focus on maternal and child health and nutrition that would reach the most people from the poorest communities in northern Lao PDR. Making more people aware of useful information, essential services and products and influencing them to use these effectively is the ultimate goal of mass media campaigns, and the MA measures the potential effectiveness of media efforts to reach this goal. The effectiveness of communication channels to deliver health and nutrition messages to target beneficiaries to ensure maximum reach and uptake can be viewed in terms of preferences, satisfaction, and trust. Overall, the four most accessed media channels for receiving information among communities in the study areas were village announcements, mobile phones, television, and out-of-home (OOH) media. Of the accessed media channels, the top three most preferred channels were village announcements (40 percent), television (26 percent), and mobile phones (19 percent). In terms of trust, village announcements were the most trusted source of information (64 percent), followed by mobile phones (14 percent) and television (11 percent). Hence of all the media channels, village announcements are the most preferred, have the most satisfied users, and are the most trusted source of information in study communities from four provinces in Lao PDR with some of the highest burden of childhood undernutrition.