The Pharmaceutical Sector of the Western Balkan Countries
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World Bank, Washington, DC
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There is a strong political will in the
Western Balkan states to align the region's
pharmaceutical legislation and practice with that of the
European Union. Accordingly, recent policy changes were
aimed at harmonization of policies with other European
countries. Several national drug laws were updated or
completely re-written in the last several years. More
specifically, provisions were made for the simplification of
drug registration requirements, licensing of professionals
and businesses in the sector, implementation of ethics
standards, price controls and reimbursement of drugs through
national health insurance systems. Countries in the region
have introduced various measures for cost containment,
mostly through positive lists with various co-payment levels
or expenditure caps for prescribing physicians. Some
institutional buyers are using pooled procurement with open
tenders to ensure lower prices. Nevertheless, there are
still a number of challenges such as lack of enforcement of
rules and standards, limited access to drugs for low income
populations, inefficiencies in resource allocation and in
the distribution chain, lack of control over physicians
prescribing behavior and occasional conflicts between public
health and industrial policy objectives. For the foreseeable
future, there will be a need for further capacity building
in the pharmaceutical sector, with a focus on increased
oversight and higher professional standards, more efficient
use of limited public resources, equity of access and
rational use of medicines. Nevertheless, drug expenditure is
set to grow in this region as it did in other countries in
Eastern Europe, typically at a rate of about twice GDP
growth, due to inevitable factors such as innovation, aging
populations, increasing incomes and better access to healthcare.
Palabras clave
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