Pharmaceutical Reform: A Guide to Improving Performance and Equity is a practical guide for developing effective policies that will improve the performance of the pharmaceutical sector in low- and middle income countries. This book is designed to provide policy makers with the skills and the information they need to develop policy initiatives that will produce real results in their own national settings. This volume responds to an important need within the general area of health sector reform and strengthening of health systems. Particularly in low- and middle-income countries, pharmaceutical policy has a significant impact on population health, public satisfaction with the health sector, and—because of widespread reliance on out-of-pocket payments—the financial burden the health sector places on citizens. The public pharmaceutical sector suffers from unreliable supplies, while private sellers charge high prices and may off er products of unreliable quality. Inappropriate usage of medicines by patients only serves to further undermine overall cost-effectiveness.

Using the “Flagship Framework” for health sector reform, developed by a team from the World Bank Institute and Harvard University, this book insists that reform start with a clear definition of the problem and a diagnosis of the causes of poor performance, which involve both ethical and political perspectives. The framework describes how to apply five “control knobs” — financing, payment, organization, regulation, and persuasion—to improve pharmaceutical system performance. Ten case studies help readers develop an appreciation for the detailed issues in policy design, and are useful tools for skill development.

Pharmaceutical Reform: A Guide to Improving Performance and Equity is a reference, practical guide, and teaching tool that should be of great interest to a variety of stakeholders in health care and pharmaceutical reform, both governmental and nongovernmental, as well as to all those interested in improving their understanding of these important issues.