Overview

Medicines account for 20–60% of health spending in low- and middle-income countries, compared with 18% in countries of the Organisation for Economic Co-operation and Development. Up to 90% of the population in developing countries purchase medicines through out-of-pocket payments, making medicines the largest family expenditure item after food. As a result, medicines, particularly those with higher costs, may be unaffordable for large sections of the global population and are a major burden on government budgets.

Contents

• Acknowledgements
• Overall coordination
• Funding and declarations of interest
• Executive summary
• 1. Introduction
• 2. Target audience
• 3. Scope of the guideline
• 4. How this guideline was developed
• 5. Recommendations
  • 5.1 Regulation of mark-ups in the pharmaceutical supply and distribution chain
  • 5.2 Tax exemptions/reductions for pharmaceutical products
  • 5.3 Application of cost-plus pricing formulae for pharmaceutical price setting
  • 5.4 Use of external reference pricing
  • 5.5 Promotion of the use of generic medicines
  • 5.6 Use of health technology assessment
• 6. Guideline use and adaptation – key principles and general considerations
  • 6.1 Key principles for policy planning and implementation
  • 6.2 Overarching considerations for policy selection
  • 6.3 Health system and pharmaceutical sector considerations for policy implementation
• 7. Research priorities and guideline update
• 8. References
• 9. Annexes
  • 9.1 Annex A Abbreviations and acronyms
  • 9.2 Annex B Lists of meeting participants and external experts/organizations
  • 9.3 Annex C Summary of declared interests
  • 9.4 Annex D Guideline scope and development process
  • 9.5 Annex E Evidence summary 1 – Regulation of mark-ups in the pharmaceutical supply chain
  • 9.6 Annex F Evidence summary 2: Tax exemptions/reductions for pharmaceutical products
  • 9.7 Annex G Evidence summary 3 – Application of cost-plus pricing formulae for pharmaceutical products
  • 9.8 Annex H Evidence summary 4 – Use of external reference pricing
  • 9.9 Annex I Evidence summary 5 – Promotion of the use of generic medicines
  • 9.10 Annex J Evidence summary 6 – Use of health technology assessment
  • 9.11 Annex K References

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