Administrative process and criteria ranking for drug entering health insurance list in Iran-TOPSIS-based consensus model

The purposes of our study were to identify a drug entry process, collect, and prioritize criteria for selecting drugs for the list of basic health insurance commitments to prepare an "evidence based reimbursement eligibility plan" in Iran. The 128 noticeable criteria were found when studying the health insurance systems of developed countries. Four parts [involving criteria] formed the first questionnaire: evaluation of evidences quality, clinical evaluation, economic evaluation, and managerial appraisal. The 85 experts [purposed sampling] were asked to mark the importance of each criterion from 1 to 100 as 1 representing the least and 100 the most important criterion and 45 out of them replied completely. Then, in the next questionnaire, we evaluated the 48 remainder criteria by the same45 participants under four sub-criteria [Cost calculation simplicity, Interpretability, Precision, and Updating capability of a criterion]. After collecting the replies, the remainder criteria were ranked by TOPSIS method. Softwares "SPSS" 17 and Excel 2007 were used. The ranks of the five most important criteria which were found for drug approval based on TOPSIS are as follows: 1-domestic production [0.556], 2-duration of using [0.399], 3-independence of the assessment group [0.363] 4-impact budgeting [0.362] 5-decisions of other countries about the same drug [0.358]. The numbers in parenthesis are relative closeness alternatives in relation to the ideal solution. This model gave a scientific model for judging fairly on the acceptance of novelty medicines

Costs of treatment after renal transplantation: is it worth to pay more?

The present study aimed to provide an estimation of the current financial burden of renal transplantation therapy for insurance organisations. An Excel-based model was developed to determine the treatment costs of current clinical practice in renal transplantation therapy [RTT]. Inputs were derived from Ministry of Health and insurance organizations' database, hospital and pharmacy records, clinical trials and available literature. A one-way sensitivity analysis and Monte-Carlo simulation were performed to illustrate total cost changes made by cost components and to test the reliability of model probabilities respectively. According to the model, 2200 patients received RTT in the study year which resulted in the first year total treatment cost of almost $14,000,000. These costs corresponded to annual total cost per patient of almost $6500 for the payers. According to the results of the study, treatment cost per patient in RTT is almost $6500 for the payers in Iran. Although RTT is almost fully reimbursed by government in Iran, an improvement in insurance decision making especially regarding new effective immunosuppressive drugs is quite necessary for controlling growing trends of OOP expenditures in these patients. The present study aimed to improve efficiency in budget allocation by providing insurance decision makers with an estimation of financial impact of current clinical practice in RTT, making it possible for them to compare current financial burden of the disease with the future cost burden of including newly submitted drugs to their formulary in RTT and also provided practical policy making recommendations in the end

Developing a suitable model for supplier selection based on supply chain risks: an empirical study from Iranian pharmaceutical companies

The supply chain represents the critical link between the development of new product and the market in pharmaceutical industry. Over the years, improvements made in supply chain operations have focused largely on ways to reduce cost and gain efficiencies in scale. In addition, powerful regulatory and market forces have provided new incentives for pharmaceutical firms to basically rethink the way they produce and distribute products, and also to re-imagine the role of the supply chain in driving strategic growth, brand differentiation and economic value in the health continuum. The purpose of this paper is to formulate basic factors involved in risk analysis of pharmaceutical industry, and also determine the effective factors involved in suppliers selection and their priorities. This paper is based on the results of literature review, experts' opinion acquisition, statistical analysis and also using MADM models on data gathered from distributed questionnaires. The model consists of the following steps and components: first factors involved in to supply chain risks are determined. Based on them a framework is considered. According the result of statistical analysis and MADM models the risk factors are formulated. The paper determines the main components and influenceial factors involving in the supply chain risks. Results showed that delivery risk can make an important contribution to mitigate the risk of pharmaceutical industry