Journal
HEALTH POLICY
Volume 138, Issue -, Pages -Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.healthpol.2023.104919
Keywords
Mark-ups; Supply chain; Systematic review; Pricing policy; Medicine prices
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Regulating mark-ups throughout the pharmaceutical supply and distribution chain can be an effective approach to control medicine prices and improve access to medicines. However, the design of these regulations plays a crucial role in their success. Further research is needed to determine the impact of these policies on medicine availability, affordability, and usage patterns in low- and middle-income countries.
The regulation of mark-ups throughout the pharmaceutical supply and distribution chain may be a valuable approach to control prices of medicines and to achieve broader access to medicines. As part of a wider review, we aimed to systematically determine whether policies regulating mark-ups are effective in managing the prices of pharmaceutical products. We searched for studies published between January 1, 2004 and October 10, 2019, comparing policies on regulating mark-ups against other interventions or a counterfactual. Eligible study designs included randomized trials, and non-randomized or quasi-experimental studies such as interrupted time-series (ITS), repeated measures (RM), and controlled before-after studies. Studies were eligible if they included at least one of the following outcomes: price (or expenditure as a proxy for price and volume), volume, availability or affordability of pharmaceutical products. The quality of the evidence was assessed using the GRADE methodology. A total of 32,011 records were retrieved, seven of which were eligible for inclusion for this review. The limited body of evidence cautiously suggests that policies regulating mark-ups may be effective in reducing medicine prices and pharmaceutical expenditures. However, the design of mark-up regulations is a critical factor for their potential success. Additional research is required to confirm the effects of these policies on the availability, affordability or usage patterns of medicines and in low- and middle-income countries.
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