Table 2 Overview of strategies used to promote cost-effective use of medicines in the four medicines benefit programs
Type of strategies | Strategies Medicines | NCMS (China) | National Health Insurance (Ghana) | Jamkesmas (Indonesia) | Seguro Popular (Mexico) |
|---|---|---|---|---|---|
Selection | Formulary | ✓ | ✓ | ✓ | ✓ |
Cost sharing for medicines included in the formulary | ✓ | ✗ | ✗ | ✗ | |
Generic substitution | ✗ | ✓ | ✗ | ✗ | |
Procurement | Medicines prices negotiation or rebates | ✓ | ✗c | ✓ | (✓) |
Bulk procurement | ✓ | ✓ a | ✓ | ✓ | |
Generic reference pricing | ✗ | ✓ | ✗a | ✓ | |
Contracting | Fee for service for prescribers | ✓ | |||
Fixed salary for prescribersa | ✓ | ✓a | ✓ | ||
Fixed reimbursement rates for medicines | ✓ | ✓ | ✗ | ✗ | |
Preferred provider network (accreditation) | ✗ | ✓ | ✓ | ✓ | |
Utilization | Standard treatment guidelines | (✓) | ✓ | ✓ | ✓ |
Payment for performance | (✓) | ✗ | ✗ | ✗ | |
Separation of prescribing and dispensing | ✓ | ✓ | ✓ | ✓ | |
Disease management programs | ✓ | No info | ✓ | ✓ | |
Monitoring and evaluation | User satisfaction monitoring | ✗ | ✗ | ✗ | ✓ |
Medicines purchasing monitoring | ✓b | ✓ | ✓ | ||
Prescription monitoring | ✗ | ✗ | ✗ | ✗ |