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Benin National Supply Chain Assessment

In an effort to improve the health status of the Beninese population, a priority activity included in the 2015 convention between the US Government, represented by USAID, and the Benin Government, represented by the Ministry of Health (MOH), was to conduct a comprehensive assessment of the public health supply chain, focused on essential medicines that are associated with the package of low-cost, high-impact interventions. SIAPS undertook this assessment in close collaboration with and under the leadership of the MOH, represented by the National Health Products Supply Chain. This report presents information on the capability, maturity, and operational performance of Benin’s health supply system, along with a strategic plan of interventions to address identified weaknesses that will allow reliable supply and use of medicines in the health system.

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Identifying Indicators for Tracking Pharmaceutical Expenditure in Low- and Middle-Income Countries

SIAPS endeavored to help low- and middle-income countries track Pharmaceutical expenditures (PE) systematically to inform decisions related to the mobilization and allocation of domestic resources and to formulate necessary pharmaceutical finance policies as a key strategy for achieving UHC. Working with its partner, Results for Development (R4D), in 2014, SIAPS reviewed existing approaches that track health and/or PEs. One of the key recommendations from that review was to explore the feasibility of adopting the System of Health Accounts (SHA) methodology to capture PEs. This paper presents the SHA/NHA methodology as a potential platform for capturing PEs and discusses some of the challenges encountered in collecting such expenditure data. It identifies key policy questions that underpin the need for LMICs to comprehensively monitor PEs and discusses a set of proposed indicators they would need to formulate and monitor effective financing policies, particularly toward achieving UHC. It also provides information that enables LMICs and their development partners to realize the challenges in applying the SHA methodology to PE tracking and/or to data collection so that they can take them into consideration during the next phase of piloting these indicators.

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High Cost of Medicines in Ukraine: Factors and Price Components

Medicine prices are a contentious issue, with many products arguably unaffordable, even in developed countries, where, on average, approximately 10% of the health budget is spent on medicines. But in low- and middle-income countries, that figure is usually substantially higher, reflecting both limited resources and generally inefficient public health systems. Given that a sizable proportion of the population usually pays for medicines out of pocket, high medicine costs disproportionally affect the economically disadvantaged and are more likely to impair patient access to effective treatments in poorer communities.

The final price for the paying customer—whether the patient, the public health service, or an insurance company— is compounded by all activities involved in the development, production, procurement, and distribution of the medicine. This report will focus on only those activities that are under the control of the Government of Ukraine, that is, procurement and distribution. However, it is worth mentioning that development and production costs—activities that are undertaken by private companies and that are often used to justify high prices—are currently under international scrutiny, with recent studies showing that pharmaceutical companies spend more on marketing than on research and development.

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