Table 2.

Overview of strategies used to promote cost-effective use of medicines in the four medicines benefit programs

Type of strategies	Strategies Medicines	NCMS (China)	National Health Insurance (Ghana)	Jamkesmas (Indonesia)	Seguro Popular (Mexico)
Selection	Formulary	✓	✓	✓	✓
	Cost sharing for medicines included in the formulary	✓	✗	✗	✗
	Generic substitution	✗	✓	✗	✗
Procurement	Medicines prices negotiation or rebates	✓	✗c	✓	(✓)
	Bulk procurement	✓	✓ a	✓	✓
	Generic reference pricing	✗	✓	✗a	✓
Contracting	Fee for service for prescribers	✓
	Fixed salary for prescribersa		✓	✓a	✓
	Fixed reimbursement rates for medicines	✓	✓	✗	✗
	Preferred provider network (accreditation)	✗	✓	✓	✓
Utilization	Standard treatment guidelines	(✓)	✓	✓	✓
	Payment for performance	(✓)	✗	✗	✗
	Separation of prescribing and dispensing	✓	✓	✓	✓
	Disease management programs	✓	No info	✓	✓
Monitoring and evaluation	User satisfaction monitoring	✗	✗	✗	✓
	Medicines purchasing monitoring	✓b		✓	✓
	Prescription monitoring	✗	✗	✗	✗

^a = in the public sector; () = Limited use; ^b = information not publically available; ^c = healthcare facilities do their own negotiation with suppliers; italics = strategies common to all the four insurance programs