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Welfare Reform on the Web (July 2011): Healthcare - overseas

Democratizing health: consumer groups in the policy process

H. Lofgren, E. de Leeuw and M. Leahy(editors)

Cheltenham: Elgar, 2011

This book examines the important role of consumer activism in health policy in different national contexts. In an age of shifting boundaries between state and civil society, consumer groups are potentially drivers of democratisation in the health domain. The expert contributors explore how their activities bring new dynamics to relations between service providers, the medical profession, government agencies, and other policy actors. This book is unique in comprehensively analysing the opportunities and dilemmas of this type of activism, including ambiguous partnerships between consumer groups and stakeholders such as the pharmaceutical industry. These themes are explored within an internationally comparative framework, with case studies from various countries.

Drugs firms cut vaccine cure prices for Third world

S. Lister

The Times, June 6th 2011, p. 1, 3

'Cheaper medicines for millions of at-risk children' Andrew Witty, the chief executive of GlaxoSmithKline, said that drugs companies must behave 'in step with society' and put people before profits. He said that too often the industry has acted 'as though it is detached from society' causing corrosion of public trust. He set out a new pricing structure for a vaccine against diarrhea, the second biggest killer of children under the age of 5 in developing countries, which will allow it to be sold to the poorest nations for 1.50 a dose 5 per cent of its 30 Western market price. Mr. Witty called for the rest of the pharmaceuticals industry to follow suit by building commercial goals around long-term business models that address the world's most urgent health needs, giving people the medicines they need at affordable prices.

The Emergency Medical Recovery Act (EMRA): Ireland's bold healthcare initiative for the next decade?

C.A. Jones and E.S. Sills

Journal of Pharmaceutical Health Services Research, vol. 2, 2011, p. 17-20

Ireland faces a longstanding shortage of both hospital doctors and general practitioners, especially in rural and inner city areas. This article proposes addressing the problem by making eligible physicians' first 250,000 of income tax free to attract and retain world class medical talent.

Estimating the demand for health services in four poor districts of Cape Town, South Africa

J. Skordis-Worrall, K. Hanson and A. Mills

International Health, vol.3, 2011, p.44-49

In a highly unequal setting such as South Africa, differences in people's demand for healthcare may perpetuate inequities in disease incidence, morbidity and survival. The country has undergone a period of health systems reorganisation aimed at decentralising delivery, improving gate-keeping to tertiary care and removing systemic inequities. This has had significant implications for demand and recent qualitative studies describe patient confusion over the new structure and a growing disillusionment with the quality of public primary care. In view of these changes, this paper aims to estimate demand for healthcare among residents of the poorest communities in Cape Town. By focusing on care-seeking amongst the poorest urban population, this analysis aims to inform strategies to improve the equity of health service access in the province.

Incidence of transaction costs in Brazilian Health Ministry programmes: a case study of pluriannual evaluative reports

P. Calmon and M. Moraes Pedroso

Public Management Review, vol. 4, 2011,p. 575-593

The objective of this article was to provide an alternative framework for the assessment of social programmes in developing countries that takes into account the incidence of transaction costs. Fifteen different sources of transaction costs are identified. These can be aggregated into three larger categories: 'ex-ante', 'process' and 'ex-post' transaction costs. The study then attempts to monitor the presence of these costs in the ten largest health programmes in Brazil. The analyses show the importance of two particular types of transaction costs associated with programme implementation. The first concerns the difficulties inherent in identifying, training, hiring and retaining staff needed for the operation of Health Ministry programmes. The other is related to the planning and management of the financial resources necessary for the programmes to operate properly. Both problems generate considerable management uncertainty and strongly affect the efficiency and effectiveness of Health Ministry programmes.

Patients' experiences with generic substitution: a Swedish pharmacy survey

P. Frisk and others

Journal of Pharmaceutical Health Services Research, vol. 2, 2011, p. 9-15

For reasons of cost containment, generic substitution has been implemented in numerous countries. However, concerns have been expressed that generic substitutions may compromise patient safety. In Sweden, generic substitution for reimbursed drugs was introduced on October 1st 2002. This study aimed to evaluate how Swedish drug consumers experience generic substitution. Interviews with 1551 respondents showed that a sizeable minority experience difficulties, partly resulting in medication errors.

Pharmaceutical policy and market in Iran: past experiences and future challenges

M. Davari, T. Walley and A. Haycox

Journal of Pharmaceutical Health Services Research, vol.2, 2011, p.49-52

In response to drug shortages in Iran following the Islamic Revolution and Iraq War, the 'Generic Scheme' was launched in 1980. The scheme comprised government support for generic drug manufacture, a national list of essential drugs, a commitment to promote equity of access to good quality drugs at a reasonable and regulated price, and the manufacture and prescribing of all drugs under generic names. This scheme worked well in the 1980s but new problems in the 1990s led to privatisation, a freer competitive market with brand name prescribing and looser pricing. This has created new challenges in the Iranian pharmaceuticals market, arising from increasing drug utilisation, rising pharmaceutical expenditure and the lack of a clear policy.


Reproductive Health Matters, vol.19, no.37, 2011, p. 4-116

Most of the papers in this themed section on privatisation in health systems come from Asia and sub-Saharan Africa with some contributions from the Netherlands and Poland. They address the role of the public vs the private sector in dealing with maternal morbidity and mortality, antenatal care and delivery, family planning, unsafe abortion, reproductive tract infections and gynaecological diseases. They reveal how little is known about standards of care in the private sector in low- and middle-income countries and just how much women and young people have to depend on the informal sector to get any treatment at all. They reveal that not enough is being invested in public health services or in the education and training of a new generation of health professionals, and that the private sector is not making up for what the public sector is not providing and cannot afford to provide, especially for poor and rural populations.

Spending 814m on vaccines is value for money, taxpayers told

S. Lister and C. Smyth

The Times, June 14th 2011, p. 1 7

Britain was the largest single contributor at the London conference , more than doubling its commitment to fund vaccines for the world's poorest children. The money should save one child's life every two seconds until 2015 by vaccinating more than 80 million children and saving 1.4 million lives. It therefore represents 'absolutely brilliant value for money'.

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