Health Insurance Systems and Access to Medicines - Case Studies from: Argentina, Chile, Colombia, Costa Rica, Guatemala and the United States of America: CHAPTER 4: Conclusions and Recommendations: 3- Demand

Health Insurance Systems and Access to Medicines - Case Studies from: Argentina, Chile, Colombia, Costa Rica, Guatemala and the United States of America
(2002; 96 pages) [Spanish]

Table des matières

PREFACE
INTRODUCTION
CHAPTER 1: Economics and Medicines Policy
	1- Health Care from an Economic and Political Perspective
	2- General Overview of Drug Markets and Policies
	3- Characteristics of the Pharmaceutical Market and its Regulation
CHAPTER 2: Typology of Health Insurance Systems
	1- Health Systems and Health Insurance
		1.1. Ideal Types of Health Systems
		1.2. Selected Cases and Ideal Types of Systems
	2- Health Insurance Components
		2.1. Management Model
		2.2. Financing Model
		2.3. Care Model
		2.4. System Components in the Cases Selected
CHAPTER 3: Health Insurance and Medicines
	Institution and Country
	1- Social Assistance Schemes
	2- Decentralized Social Security Scheme
	3- Centralized Social Insurance
	4- Universal Social Security Scheme
	5- Private Insurance
CHAPTER 4: Conclusions and Recommendations
	1 - National Drug Policy³⁹
	2- Regulation
	3- Demand
	4- Importance of Guaranteed Quality
	5- Use
BIBLIOGRAPHY

3- Demand

3.1. BULK PURCHASING

Bulk purchasing experiences of health insurance systems in the survey countries demonstrate that it is possible to rationalize drug demand and obtain large scale economies when compared to buying by individual units. Schemes can vary, in contract provision types by insurers, or formation of cooperatives of hospitals specialised in consolidated purchasing.

3.2. PROFIT MARGIN NEGOTIATIONS

Another scheme to rationalize demand and procurement costs may be characterised as negotiation with manufacturers of a profit margin based on production costs. This requires the very strong negotiating power of a legitimate regulatory agency.