Sir,
The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) is preparing pharmacoeconomics guidelines for India. The health-care delivery in each country is influenced by local and global politics.[1]
India has a strong price control mechanism through the National Pharmaceutical Pricing Authority. A mix of social, voluntary, private and community-based health insurance plans are available in India. Although the government pays only for approximately 20% of drugs used in India,[1] private out-of-pocket expenditure in India on health-care is one of the highest in the world. Increased public funding combined with flexibility of financial transfers from center to state can greatly improve the performance of state-operated public systems. Just by increasing public health-care funding would not help the quality of health-care delivery unless there are strictly implemented robust pharmacoeconomics guidelines in place.[2] In New Delhi, Mumbai, and Trivandrum, state authorities have invited the National Institute for Health and Clinical Excellence to help in the development of clinical guidelines.[3]
Preparing pharmacoeconomics guidelines will be an important step in order to establish health technology assessment (HTA) in India. Areas in which HTA could be applied in the Indian context include, drug pricing, development of clinical practice guidelines and prioritizing interventions that represent the greatest value with in a limited budget.[4]
India is planning to be part of universal health coverage scheme by 2022. It is a big capacity building challenge for central and state governments to provide high quality health-care without financial hardship on the health-care seekers. It is important to focus on preventive and public health strategies aimed at reducing the most important health problems in India. Recent advancements in high quality primary health-care including maternal and child health services by the State Tamil Nadu is encouraging.[5]
Challenges in developing and implementing pharmaco-economics guideline could be managed by involvement of all stakeholders. Some suggestions are as follows:
Constituting pharmacoeconomics advisory groups for central and state drug regulators
Implement HTA using pharmacoeconomics guidelines.
Concentrate on both direct and indirect services to decrease the burden of ailments such as improving nutrition, decrease poverty, develop infrastructure for health-care and living healthy and prevent transmission of diseases by treating patients and immunizing public
Improve access to life-saving medicines and afford ability of essential medicines
Implementing public, public-private partnership medical insurance systems linked with Aadhar card
Collect health-care tax and increase spending on health budgets
Creating awareness in public and professionals for better resource utilization
Consider health-care as a basic necessity, individual right and responsibility
Include pharmacoeconomics principles in medical, pharmacy, nursing, public health and other health-care professional education.
REFERENCES
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