Pharmacoeconomics and Pharma Management, Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
Pharmacoeconomics and Pharma Management, Health Management and Economics Research Centre, Iran University of Medical Sciences, Tehran, Iran.
BMC Health Serv Res. 2020 Jul 8;20(1):626. doi: 10.1186/s12913-020-05477-y.
The present study aimed to develop an Analytic Network Process (ANP) model to assist policymakers in identifying and prioritizing allocation indicators, which are being used or should be used to distribute drugs in short supply among different provinces.
The model encompasses the interactions between various indicators and efficiency, equity, and effectiveness paradigms. Accordingly, a set of clusters and elements, which were associated with the allocation of drugs in short supply in Iran's pharmaceutical system, were detected to develop the model and were then compared in pairs in terms of a specified factor to show the priorities.
Equity had the highest priority (0.459) following by Efficiency (0.37), and Effectiveness (0.171). The 4 most important allocation indicator were "number of prescriptions" (0.26) and "total bed occupancy rate" (0.19) related to equity, "total population" (0.21) in efficiency and "the burden of rare and incurable disease" (0.07) in effectiveness paradigm.
The capability to overcome inefficient resource allocation patterns caused by both oversupply and undersupply derived from historic resource allocation may be highly limited in the absence of the need indicators. The quality of the decision is related to a careful balancing act of the three paradigms which represents roughly the triple aim of public healthcare systems: clinical improvement (effectiveness), population health improvement (equity and access), and reducing cost (economic aspects -efficiency).
本研究旨在开发一个分析网络过程（ANP）模型，以帮助政策制定者识别和优先考虑分配指标，这些指标正在或应该用于在不同省份之间分配短缺药物。
该模型涵盖了各种指标之间的相互作用以及效率、公平和效果范式。因此，确定了一组与伊朗制药系统中短缺药物分配相关的集群和要素，以开发该模型，然后根据特定因素对其进行配对比较，以显示优先级。
公平性的优先级最高（0.459），其次是效率（0.37）和效果（0.171）。4 个最重要的分配指标是与公平性相关的“处方数量”（0.26）和“总床位占用率”（0.19），与效率相关的“总人口”（0.21），以及与效果范式相关的“罕见和不治之症负担”（0.07）。
如果没有需求指标，从历史资源分配中克服由供过于求和供不应求引起的低效资源分配模式的能力可能非常有限。决策的质量与三个范式的谨慎平衡有关，这大致代表了公共医疗保健系统的三重目标：临床改善（效果）、人口健康改善（公平和获得）以及降低成本（经济方面 - 效率）。
