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改善短缺药品可及性的政策:伊朗食品药品监督管理局的经验。

Policies to improve access to pharmaceutical products in shortage: the experience of Iran food and drug administration.

机构信息

Department of Pharmacoeconomics and Pharma Management, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Daru. 2019 Jun;27(1):169-177. doi: 10.1007/s40199-019-00259-2. Epub 2019 Mar 23.

Abstract

BACKGROUND

In the past decades, economic sanctions imposed on Iran for its nuclear program. The embargo made difficulty in foreign trade and led to lack of timely access to medicines. As the internationally-led sanctions caused to the shortage of medicine there, healthcare systems need to applied the new policies for maintaining health service quality especially in pharmaceutical sector.

OBJECTIVES

This paper is about policies applied in Iran health system during the crisis reached its peak in 2012 as a good experience for guarantying access to pharmaceutical products.

METHODS

Through interviewing experts and managers in pharmaceutical regulatory system, the implemented policies in targeted historical period were extracted, then quantitative data were analyzed to show the impact of the policies on the access and affordability of medicines before and after their implementation in Iran food and drug administration (IFDA). This paper tries to show strategies employed by to tackle the crisis caused by sanctions and to offer practical policies to make medicines more accessible at the time of crisis.

RESULTS

In order to reduce the harmful effects of this crisis, IFDA proposed some changes at different levels ranging from organizational procedures to parliament legislations. The main achievements of IFDA were making drugs easily available are as follows, significantly reducing prices, decreasing the share of market regarding the imported medicines, facilitating the manufacture of domestic medicines, encouraging foreign investment in manufacturing drugs domestically, controlling the shortage of drugs, and finally giving financial support to all patients in general and to those patients who had problem paying for drugs in particular.

CONCLUSION

These experiences which made the Iran pharmaceutical sector survive during the international sanctions, can be considered as a good example of resilience strategies in similar situations. Graphical abstract IFDA policies to improve access to pharmaceutical products in sanction.

摘要

背景

在过去的几十年里,伊朗因其核计划而遭受经济制裁。禁运使对外贸易陷入困境,导致药品无法及时获得。由于国际主导的制裁导致该国出现药品短缺,医疗保健系统需要应用新政策来维持医疗服务质量,特别是在制药部门。

目的

本文旨在探讨伊朗卫生系统在 2012 年危机达到顶峰时所采取的政策,这些政策为保障药品可及性提供了宝贵经验。

方法

通过采访药品监管系统的专家和管理人员,提取目标历史时期实施的政策,然后对定量数据进行分析,以显示政策在伊朗食品和药物管理局(IFDA)实施前后对药品可及性和可负担性的影响。本文旨在展示应对制裁危机所采用的策略,并为危机时期提供更易获得药品的实用政策。

结果

为了减轻这场危机的不利影响,IFDA 在不同层面提出了一些变革,从组织程序到议会立法。IFDA 的主要成就是使药品更容易获得,具体表现在以下几个方面:大幅降低价格、减少进口药品的市场份额、便利国内药品生产、鼓励外国投资于国内药品制造、控制药品短缺,最终为所有患者,特别是那些无力支付药品费用的患者提供财政支持。

结论

这些经验使伊朗制药部门在国际制裁期间得以生存,可以被视为在类似情况下采取弹性策略的良好范例。

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