Document Type : Original Article
Authors
1 Department of Health Service Management, Shiraz University of Medical Sciences, Shiraz, Iran
2 Department of Pharmaceutical Sciences, Tehran University of Medical Sciences, Tehran, Iran
3 Department of Health Information Technology, Lorestan University of Medical Sciences, Khorramabad, Iran
Abstract
Objective: Pharmaceutical access for the poor is an essential factor in developing
countries that can be improved through strategic purchasing. This study was conducted
to identify the elements affecting price in order to enable insurance organizations to
put strategic purchasing into practice.
Methods: This was a qualitative study conducted through content analysis with an
inductive approach applying a five‑stage framework analysis (familiarization, identifying
a thematic framework, indexing, mapping, and interpretation). Data analysis was started
right after transcribing each interview applying ATLAS.ti. Data were saturated after 32
semi‑structured interviews by experts. These key informants were selected purposefully
and through snowball sampling.
Findings: Findings showed that there are four main themes as Pharmaceutical Strategic
Purchasing Requirements in Iran as follows essential and structural factors, international
factors, economical factors, and legal factors. Moreover, totally 14 related sub‑themes
were extracted in this area as the main effective variables.
Conclusion: It seems that paying adequate attention to the four present themes and
14 sub‑themes affecting price can enable health system policy‑makers of developing
countries like Iran to make the best decisions through strategic purchasing of drugs by
the main insurers in order to improve access and health in the country.
Keywords
- Mehralian G, Bastani P. Pharmaceutical strategic purchasing:
A key to improve access to medicines. Iran J Pharm Res
2015;14:345‑6.
2. WHO. The World Health Report 2000. Health Systems: Improving
Performance. Geneva: World Health Organization; 2000.
3. Steinle C, Schiele H. Limits to global sourcing? Strategic
consequences of dependency on international suppliers:
Cluster theory, resource based view and case studies. J Purch
Supply Manage 2008;14:3‑14.
4. Tangcharoensathien V, Limwattananon L, PatcharanarumolW,
Thammatacharee J, Jongudomsuk P, Sirilak S. Achieving
universal health coverage goals in Thailand: The vital role of
strategic purchasing. Health Policy Plan Adv 2014;5:1‑10.
5. Deber R, Lewis S. Thoughts on the day: Strategic purchasing
and equity. Healthc Pap 2007;8:114‑23.
6. Preker AS, Langenbrunner JC, Belli PC. Public Ends Private
Means Strategic Purchasing of Health Services. Washington,
DC: The World Bank; 2007.
7. Bastani P, Mehralian G, Dinarvand R. Resource allocation
and purchasing arrangements to improve accessibility of
medicines: Evidence from Iran. J Res Pharm Pract 2015;4:9‑17.
8. PrekerAS, LangenbrunnerJC. Spending Wisely. Buying Health
Services for the Poor. Washington, DC: The International Bank
for Reconstruction and Development/The World Bank; 2005.
9. Govindaraj R, Reich MR, Cohen JC. World Bank
Pharmaceuticals, HNP Discussion Paper. Washington, DC:
World Bank; 2000. - 10. Arney L, Yadav P, Miller R, Wilkerson T. Strategic contracting
practices to improve procurement of health commodities. Glob
Health Sci Pract 2014;2:295‑306.
11. Abachizade K, Bastani P, Abolhalaj M. A comprehensive
analysis of drug system money map in Islamic Republic of
Iran. J Econ Sustain Dev 2013;4:158‑64.
12. Langenbrunner JC, Orosz E, Kutzin J, Wiley MM. Textbook
Purchasing and Paying Provider. Ch. 11. Washington, DC:
World Bank; 2005.
13. Anonymous, Accomplishments, Challenges and Horizons in
Front of Islamic Republic of Iran Health Care System, Ministry
of Health and Medical Education publisher, vol. 1; 2010.
14. Saravi N, Nia FK. Strategic Purchasing in Armed Forces
Medical Services Insurance Organization. The 2nd Seminar
in Health Economics. Tehran, Iran: Armed Forces Medical
Services Insurance Organization; 2012.
15. Nasiripour AA, Raeissi P, Tabibi SJ, Karimi KH. Variables
affecting the price of strategic purchasing in the indirect health
section of Iranian social security organization. Am J Sci Res
2011;(20,21):47‑53.
16. Jafari M, Bastani P, Ibrahimipour H, Dehnavieh R. Attitude
of health information system managers and officials of the
hospitals regarding the role of information technology in
reengineering the business procedures: A qualitative study.
Health Med 2012;6:208‑15.
17. Rashidian A, Eccles MP, Russell I. Falling on stony ground?
A qualitative study of implementation of clinical guidelines’
prescribing recommendations in primary care. Health Policy
2008;85:148‑61.
18. Bastani P, Abolhasani N, Shaarbafchizadeh N. Electronic
Health in Perspective of Healthcare Managers: A Qualitative
Study in South of Iran. Iran J Public Health 2014;43:809‑20.
19. Kebriaeezadeh A, Koopaei NN, Abdollahiasl A, Nikfar S,
Mohamadi N. Trend analysis of the pharmaceutical market in
Iran; 1997‑2010; policy implications for developing countries.
Daru 2013;21:52.
20. Shabaninejad H, Mehralian G, RashidianA, BaratimarnaniA,
Rasekh HR. Identifying and prioritizing industry‑level
competitiveness factors: Evidence from pharmaceutical
market. Daru 2014;22:35.
21. Clarke PM, Fitzgerald EM. Expiry of patent protection on
statins: Effects on pharmaceutical expenditure in Australia.
Med J Aust 2010;192:633‑6.
22. CheraghaliAM. Impacts of international sanctions on Iranian
pharmaceutical market. Daru 2013;21:64.
23. Pazirandeh A. Sourcing in global health supply chains for
developing countries. Literature review and a decision
making framework. Int J Phys Distrib Logist Manage
2011;41:364‑84.
24. Yip W, Hanson K. Purchasing health care in China:
Experiences, opportunities and challenges. Adv Health Econ
Health Serv Res 2009;21:197‑218.
)