National Institute of Public Health, Avenida Universidad 655, Colonia Santa María, 62100 Cuernavaca, Morelos, Mexico.
Bull World Health Organ. 2012 Oct 1;90(10):788-92. doi: 10.2471/BLT.12.106633. Epub 2012 Aug 22.
As countries expand health insurance coverage, their expenditures on medicines increase. To address this problem, WHO has recommended that every country draw up a list of essential medicines. Although most medicines on the list are generics, in many countries patented medicines represent a substantial portion of pharmaceutical expenditure.
To help control expenditure on patented medicines, in 2008 the Mexican Government created the Coordinating Commission for Negotiating the Price of Medicines and other Health Inputs (CCPNM), whose role, as the name suggests, is to enter into price negotiations with drug manufacturers for patented drugs on Mexico's list of essential medicines.
Mexico's public expenditure on pharmaceuticals has increased substantially in the past decade owing to government efforts to achieve universal health-care coverage through Seguro Popular, an insurance programme introduced in 2004 that guarantees access to a comprehensive package of health services and medicines.
Since 2008, the CCPNM has improved procurement practices in Mexico's public health institutions and has achieved significant price reductions resulting in substantial savings in public pharmaceutical expenditure.
The CCPNM has successfully changed the landscape of price negotiation for patented medicines in Mexico. However, it is also facing challenges, including a lack of explicit indicators to assess CCPNM performance; a shortage of permanent staff with sufficient technical expertise; poor coordination among institutions in preparing background materials for the annual negotiation process in a timely manner; insufficient communication among committees and institutions; and a lack of political support to ensure the sustainability of the CCPNM.
随着各国扩大医疗保险覆盖范围，其药品支出也在增加。为了解决这个问题，世界卫生组织建议每个国家制定一份基本药物清单。尽管清单上的大多数药物都是仿制药，但在许多国家，专利药物在药品支出中占很大比例。
为了帮助控制专利药物的支出，2008 年墨西哥政府成立了药品和其他卫生投入价格谈判协调委员会（CCPNM），顾名思义，其作用是与制药商就墨西哥基本药物清单上的专利药物进行价格谈判。
由于政府通过 2004 年推出的全民医疗保险计划（Seguro Popular）努力实现全民医疗保健覆盖，在过去十年中，墨西哥的公共药品支出大幅增加，该保险计划保证了全面的医疗服务和药品的获取。
自 2008 年以来，CCPNM 改善了墨西哥公共卫生机构的采购做法，并实现了大幅降价，从而为公共药品支出节省了大量资金。
CCPNM 已成功改变了墨西哥专利药品价格谈判的格局。然而，它也面临着挑战，包括缺乏评估 CCPNM 绩效的明确指标；缺乏具有足够技术专长的常设工作人员；在及时为年度谈判过程准备背景材料方面，各机构之间协调不力；委员会和机构之间沟通不足；以及缺乏政治支持，无法确保 CCPNM 的可持续性。
