How to Develop and Implement a National Drug Policy (Second Edition)
(2001; 96 pages) [French] [Spanish] View the PDF document
Table of Contents
View the documentContributors
View the documentAbbreviations and acronyms
View the documentPreface
Open this folder and view contentsPart I: How to develop and implement a national drug policy
Close this folderPart II: Key components of a national drug policy
Open this folder and view contents4. Selection of essential drugs
Open this folder and view contents5. Affordability
Open this folder and view contents6. Drug financing
Open this folder and view contents7. Supply systems
Open this folder and view contents8. Drug regulation
Close this folder9. Rational use of drugs
View the document9.1 Why is it important to promote rational use?
View the document9.2 Challenges
View the document9.3 Planning for activities to promote rational use of drugs
View the document9.4 Core strategies to improve drug use
View the document9.5 Educational strategies
View the document9.6 Managerial strategies to promote rational drug use
View the document9.7 Regulatory strategies to promote rational drug use
View the document9.8 Promoting rational drug use in the private sector
Open this folder and view contents10. Research
Open this folder and view contents11. Human resources development
Open this folder and view contents12. Monitoring and evaluation
View the documentReferences
View the documentSelected WHO publications and documents of related interest
View the documentBack cover

9.8 Promoting rational drug use in the private sector

Most of the interventions described above apply to the private sector as well. For example, basic training of health workers, drug registration, pricing policies, regulation of pharmaceutical promotion, positive reimbursement lists and public education affect the private sector just as much as the public sector. There are a few interventions that specifically aim at the private sector, and these are briefly described below.

Continuing education

In many countries, unfortunately, most continuing education activities are heavily dependent on the support of pharmaceutical companies, as public funds are usually insufficient. Governments should support efforts by university departments and national professional associations to provide independent continuing education, for example based on the national clinical guidelines. This support could be a financial incentive, or simply making sufficient copies of the national clinical guidelines or other materials available.

Regulatory measures and law enforcement

The government could consider regulatory measures to separate prescribing and dispensing functions, in order to remove a perverse incentive. For example, both dispensing doctors and prescribing pharmacists have a tendency to overprescribe. Generic policies, pricing policies and the dispensing fee structure could be used to encourage the use of essential drugs and promote generic prescribing and substitution. Regulations on the sale of prescription drugs could often be better enforced. In view of the many vested interests, a stepwise approach is recommended.

Health insurance

Drug benefits within health insurance schemes can also have a positive effect on rational prescribing in the private sector. For example, when reimbursement of drug costs is restricted to a positive list and to published clinical guidelines, the patient has a financial incentive to put pressure on the prescriber to stay within the limits of these standards.

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