THE EFFECT OF PRICING POLICIES AND COST-CONTAINMENT MEASURES IN ALBANIAN HEALTH INSURANCE SCHEME

Enkelejda Avdi ()
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Enkelejda Avdi: Faculty of Economy, Tirana University

Romanian Economic Business Review, 2013, vol. 8, issue 3, 61-78

Abstract: This paper presents and analyses the evolution of pharmaceutical expenditure, to see the effect of policy measures targeting pharmaceutical expenditure in Health Insurance Scheme in Albania.Quantitative analysis of time series data, comparing and controlled before-after measures are undertaken. In order to answer the research question concerning Albanian pharmaceutical expenditures on HIS are used official data from Health Insurance Institute and other institutions’ statistics. Based on this analysis, the appropriate model of regulation in Albanian health scheme, may involve a combination of positive list, restriction on prescribing and reimbursement systems, price control, reference pricing, expenditures drugs control, mark-up scheme and generic substitution. The controlling of health care costs requires a more effective and efficient health care system. The high level of expenditures on pharmaceuticals is likely due to the lack of rules and regulations to control this sector and the lack of a significant policy for using generic drugs as substitutes for expensive products with the same active substances. In the economic and social conditions of Albania, it is important the continual expansion of the list of generic reimbursable drugs, as well as the strengthening the control and monitoring of the financial impact. Is necessary an increasing of accountability of policy makers at all levels of the management health scheme and to strengthen the role of the HII as the sole purchaser of health services in Albania.

Keywords: expenditure; pharmaceuticles; reimbursement; reference pricing; quantitative analysis. (search for similar items in EconPapers)
Date: 2013
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