Case Studies

Development of a Reference Pricing System and Pharmaceutical Reimbursement Scheme for Primary Healthcare

The government decided to reform the existing procurement, logistics and dispensation systems for pharmaceuticals due to the relatively high costs of medications and a number of inefficiencies and bottlenecks in the supply chain.

In order to assist the government in this transformation, we worked closely with both public and private stakeholders via workshops, focus group studies and interviews. We developed a tailor-made and adaptive reference pricing strategy for primary healthcare medications, and used it to conduct costing for 170 pharmaceuticals in the positive list. We also developed a reimbursement scheme and its roadmap by covering operational, contractual, and financial relations with the manufacturers, warehouses and pharmacies. Finally, we conducted projections on the impact of the designed reforms on the national health expenditures.

Country

Kingdom of Saudi Arabia

Client

National Unified Procurement Company (NUPCO)

Date

2018

Impact of the Project

The reference pricing approach developed in this project provided a tool to the government for calculating justified prices of pharmaceuticals that would ensure cost control without  compromising the interests of the private sector. The new reimbursement scheme, reference pricing strategy and identified costs were successfully communicated to pharmaceutical manufacturers and enabled the government to start a transformation to achieve significant benefits of cost reduction and efficiency gains simultaneously.

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