Cohen, Jillian ClareCercone, James A.Macaya, Roman2014-10-142014-10-142002-10https://hdl.handle.net/10986/20426This study presents a diagnostic framework and methodology to evaluate a pharmaceutical system s vulnerability to corruption and to determine which corrupt practices can have a major impact on the system s ultimate efficiency. We thus provide: (a) a systematic and quantifiable assessment of the extent to which a country s pharmaceutical system is vulnerable to corrupt practices; and (b) the identification of potential actions to increase the system s resistance to corruption, and ultimately, improve access of the population to good quality, essential medicines. The diagnostic framework and methodology permit users to identify key decision points in the pharmaceutical supply and distribution system (registration, selection, procurement, distribution, service delivery and use); assess the extent to which a country s current policies and practices at each of these key decision points make the system vulnerable to corruption; and understand the range of options that could reduce this vulnerability. This diagnostic tool has been designed for use by World Bank health specialists involved in health lending operations that include pharmaceutical components, and their national counterparts to help them identify points of vulnerability in the pharmaceutical system, address these points, and thus help ensure that pharmaceutical expenditures are maximized. While developed in the context of the health systems of Latin America and the Caribbean (and implemented in a pilot study in Costa Rica), the methodology can be modified with ease so that it is applicable to other regions.en-USCC BY 3.0 IGOABUSESACCESS TO PHARMACEUTICALSACCOUNTABILITYACTIVE INGREDIENTSADJUDICATIONALLOCATION OF RESOURCESANALGESICSANTIBIOTICSANTICORRUPTIONANTICORRUPTION POLICIESAUDITORAUDITSBASIC SERVICESBEST PRACTICESBRIBEBRIBESBUSINESS TRANSACTIONSCASH FLOWCERTIFICATIONCITIZENSCIVIL SERVANTCLINICSCOLLUSIONCOMPETITIVE BIDDINGCONFIDENCECORRUPTCORRUPT PRACTICESCORRUPTIONCOUNTERFEIT DRUGSCRIMECULTURAL PRACTICESDECISION MAKINGDEVELOPING COUNTRIESDISCLOSUREDISCRETIONDISTRIBUTION OF PHARMACEUTICALSDISTRIBUTION SYSTEMSDOCTORSDOSAGE FORMSDRUG CONSUMPTIONDRUG PRESCRIBINGDRUG PRICESDRUG SELECTIONDRUG STORAGEDRUG TESTINGDRUG UTILIZATIONDRUGSECONOMIC GROWTHECONOMIC POLICYEMPLOYMENTENFORCEMENT OF LAWSEPIDEMICEPIDEMIOLOGICAL SURVEILLANCEEQUILIBRIUMESSENTIAL DRUGSESSENTIAL MEDICINESEXPENDITURESFEASIBILITYFINANCIAL MANAGEMENTFOCUS GROUP DISCUSSIONSFOREIGN CORRUPT PRACTICESFOREIGN CORRUPT PRACTICES ACTFOREIGN DIRECT INVESTMENTGLOBAL POPULATIONGOOD GOVERNANCEGOVERNMENT OFFICIALSGROUP DISCUSSIONSHEALTH CAREHEALTH CARE PROFESSIONALSHEALTH CARE PROVIDERHEALTH CARE PROVIDERSHEALTH CARE PROVISIONHEALTH CARE SYSTEMHEALTH CARE SYSTEMSHEALTH COSTSHEALTH FACILITIESHEALTH INITIATIVESHEALTH INSURANCEHEALTH OFFICIALSHEALTH ORGANIZATIONHEALTH POLICYHEALTH PROBLEMSHEALTH PROFESSIONALSHEALTH RESEARCHHEALTH SECTORHEALTH SECTOR REFORMHEALTH SERVICESHEALTH SYSTEMHEALTH SYSTEMSHIDDEN COSTSHIV/AIDSHOSPITALHOSPITAL MANAGEMENTHOSPITAL RECORDSHOSPITALSHOUSEHOLD INCOMEHUMAN DEVELOPMENTILLNESSESINCOMEINDIVIDUAL HEALTHINDUCED DEMANDINFECTIOUS DISEASESINFORMATION SYSTEMINFORMATION SYSTEMSINTEGRITYINVENTORY CONTROLINVENTORY MANAGEMENTLAWSLEADERSHIPLIMITED RESOURCESMARKETINGMEDIAMEDICAL CAREMEDICAL SPECIALTIESMEDICAL STORESMEDICAL SUPPLIESMEDICINEMEDICINESMINISTERMINISTRY OF HEALTHMONOPOLIESMONOPOLYMORAL HAZARDMORBIDITYMULTINATIONALNATIONAL DRUGNATIONAL HEALTH INSURANCENATIONAL HEALTH SYSTEMNDPNURSESNUTRITIONOPERATING COSTSPACKAGINGPATIENTPATIENT CAREPATIENT COMPLIANCEPATIENTSPENALTYPERCEPTION OF CORRUPTIONPHARMACEUTICALPHARMACEUTICAL COMPANIESPHARMACEUTICAL DISTRIBUTIONPHARMACEUTICAL INDUSTRYPHARMACEUTICAL LEGISLATIONPHARMACEUTICAL POLICIESPHARMACEUTICAL PRICINGPHARMACEUTICAL PROCUREMENTPHARMACEUTICAL PRODUCTSPHARMACEUTICAL RESEARCHPHARMACEUTICAL SECTORPHARMACEUTICAL SUPPLIESPHARMACEUTICAL SUPPLYPHARMACEUTICAL SYSTEMSPHARMACEUTICALSPHARMACISTSPHARMACYPHYSICIANPHYSICIANSPOLICY DECISIONSPOLICY DEVELOPMENTPOLICY MAKERSPOLITICAL APPOINTEESPOLLUTIONPRESCRIPTIONSPRIMARY CAREPRIVATE PHARMACIESPROBABILITYPROCUREMENTPROCUREMENT OFFICESPROCUREMENTSPSYCHOTROPIC DRUGSPUBLIC FUNDSPUBLIC HEALTHPUBLIC HEALTH CAREPUBLIC HEALTH CARE SERVICESPUBLIC HEALTH EXPENDITURESPUBLIC HOSPITALSPUBLIC INFORMATIONPUBLIC OFFICIALPUBLIC OFFICIALSPUBLIC PHARMACIESPUBLIC POLICIESPUBLIC POLICYPUBLIC SERVICESPURCHASINGQUALITY ASSURANCEQUALITY CONTROLQUANTITATIVE DATARESOURCE ALLOCATIONSAFETY STOCKSANCTIONSSANITATIONSERVICE DELIVERYSOCIAL SECURITYSPECIFIC INCENTIVESSUPPLY CHAINSSUPPLY SYSTEMSSUSTAINABLE DEVELOPMENTTECHNICAL SKILLSTENDERINGTHEFTTHERAPEUTICSTRANSPARENCYTRANSPORTATIONTREATMENT GUIDELINESUSER FEESVACCINATIONVULNERABILITYWASTEWORKERSWORKING CONDITIONSWORLD HEALTH ORGANIZATION10.1596/20426