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Table 3 Definitions of secondary outcomes

From: Systematic reviews of ten pharmaceutical pricing policies – a research protocol

TermOperational definitionMeasurement unit
TransparencySee price transparency in Table 1.Qualitative description, as presented in literature
EfficiencyAHRQ’s definition: Avoiding waste, including waste of equipment, supplies, ideas, and energy.
Allocative efficiency: Allocating resources in such a way as to provide the optimal mix of goods and services to maximise the benefits to society
Technical efficiency: Using the least amount of resources or the right combination of inputs to produce a given mix of goods and services
As measured and presented in literature or qualitative description, as presented in literature
Qualitative measures of process efficiency, e.g. timeliness, resource-intensiveness
ShortageEMA’s definition: a shortage of a medicinal product occurs when there are changes to either demand or supply of the medicine, so that clinical need can no longer be met. A medicine shortage causes temporary unavailability. The total stock across all levels of the national supply chain, across all geographical regions, cannot meet demand during a medicine shortageAs measured and presented in literature or qualitative description, as presented in literature
Quality of pharmaceutical productsWhether products are substandard or falsified (SF)
WHO’s definitions:
Substandard: Also called “out of specification”, these are authorized medical products that fail to meet either internationally accepted quality standards or specifications, or both.
Falsified: Medical products that deliberately/fraudulently misrepresent their identity, composition or source.
Occurrence of SF products
SafetyIOM’s definition: the prevention of harm to patientsAs measured and presented in literature
Unethical conductBusiness or professional conduct that contravenes social norms or social responsibilitiesQualitative description, as presented in literature
Illegal conductBusiness or professional conduct that contravenes the lawQualitative description, as presented in literature
EquityDifferences in [access or] health that are avoidable and also considered unfair or unjustQualitative assessment, including assessing differences in the relative effect size of the intervention; assessing indirectness of evidence to disadvantaged populations and/or settings.
  1. AHRQ: Agency for Healthcare Research and Quality, EMA: European Medicines Agency, IOM: Institute of Medicine, WHO: World Health Organization