Table 3.

Pharmaceutical Purchasing challenges of Iranian Insurance Companies

Themes	Sub Themes
Basic Benefit Package Challenges	Narrow pharmaceutical packages
	Different pharmaceutical packages among various insurers
Reimbursement Challenges	Incorrect cycle of funds in pharmaceutical section by theinsurers
	Incorrect and long process of pharmaceuticalreimbursement
	Difference in payment ceilings for the same pharmaceuticals
	Difference in payment levels and payment mechanisms of pharmaceutical by various insurers
Decision making Challenges	Existence of adverse selection and moral hazard in pharmaceutical sector
	Lack of attention to cost effectiveness implications in pharmaceutical purchasing
Technology Challenges	Force on applying new technologies and expensive pharmaceuticals
	Devoting great costs to pharmaceutical sector and high technologies
Contract Challenges	Lack of existence fair contracts for pharmaceutical purchasing
	Lack of purchasing grand use pharmaceuticals through mass purchase
	Lack of ranking the pharmaceutical providers by policy makers