The effect evaluation on catastrophic disease medical assistance policy in China: A case study of Qindao City / 中国卫生政策研究

Objective: In order to evaluate the effect of catastrophic disease medical assistance policy in Qingdao and provide suggestions for Qingdao policy reform.Methods: This paper selects NSCLC and liver cancer as the typical deceases to analyze the effects of the policy on patients and medical insurance institutions and finally evaluate the effect of the policy.Results: results shows that after the implementation of special medicines and special medical equipment assistance, the rate of co-paying patients decreased 40.57%, and the pressure on medical insurance institutions' expenditure was significantly reduced;while after the implementation of large cost assistance, but rate of co-paying patients only decreased 7.13%, and the pressure on medical insurance institutions' expenditure was not effectively alleviated.Conclusions: Therefore, the policy not only protects patients with catastrophic disease by greatly reducing their medical burdens, but it also achieves the fine management of medical insurance fund and increases the efficiency of the fund.

Federalism, the Economic-Industrial Health Care Complex and High-Cost Pharmaceutical Assistance in Brazil / Federalismo, complexo econômico-industrial da saúde e assistência farmacêutica de alto custo no Brasil

Brazil has a relevant, although relatively unknown, special medicines programme that distributes high-cost products, such as drugs needed for cancer treatments. In 2009, the purchase of these medicines became the responsibility of the Brazilian Federal Government. Until then, there were no clear norms regarding the responsibilities, in terms of the management/financing of these medicines, of the Brazilian Federal Government and of the states themselves. This qualitative study analyses the policy process needed to transfer this programme to the central government. The study examines the reports of the Tripartite Commission between 2000 and 2012, and in-depth interviews with eleven key informants were conducted. The study demonstrates that throughout the last decade, institutional changes have been made in regard to the federal management of these programmes (such as recentralisation of the purchasing of medicines). It concludes that these changes can be explained because of the efficiency of the coordinating mechanisms of the Federal Government. These findings reinforce the idea that the Ministry of Health is the main driver of public health policies, and it has opted for the recentralisation of activities as a result of the development project implicit in the agenda of the Industrial and Economic Heal.

O Brasil possui um relevante, porém pouco conhecido, programa de medicamentos especializado, com distribuição de produtos de alto custo, como no caso do tratamento do câncer. Em 2009, a compra destes medicamentos passou a ser de responsabilidade federal. Até então, não existiam normas claras sobre as responsabilidades da União e estados na gestão e financiamento deste programa. O presente estudo qualitativo analisa a evolução do processo de transição deste programa para a esfera do governo federal. Através de uma consulta às atas da Comissão Intergestora Tripartite, de 2000 e 2012, e entrevistas com onze informantes, o estudo demonstrou que ao longo da última década foram realizadas alterações institucionais relevantes na gestão federativa destes programas, como a recentralização da compra destes medicamentos e a elaboração de critérios para a introdução de novos medicamentos neste programa, o que é explicável pela eficácia dos mecanismos de coordenação do governo federal. Esses achados reforçam a ideia de que o Ministério da Saúde, além de constituir o principal indutor de políticas públicas de saúde, tem optado pela recentralização de atividades, por força do projeto desenvolvimentista implícito na agenda do Complexo Econômico e Industrial da Saúde.