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Patient access to medicines in two countries with similar health systems and differing medicines policies: Implications from a comprehensive literature review

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Background: Countries with similar health systems but different medicines policies might result in substantial medicines usage differences and resultant outcomes. The literature is sparse in this area. Objective: To review… Click to show full abstract

Background: Countries with similar health systems but different medicines policies might result in substantial medicines usage differences and resultant outcomes. The literature is sparse in this area. Objective: To review pharmaceutical policy research in New Zealand and Australia and discuss differences between the two countries and the impact these differences may have on subsequent medicine access. Methods: A review of the literature (2008–2016) was performed to identify relevant, peer‐reviewed articles. Systematic searches were conducted across the six databases MEDLINE, PubMed, Science Direct, Springer Links, Scopus and Google Scholar. A further search of journals of high relevance was also conducted. Using content analysis, a narrative synthesis of pharmaceutical policy research influencing access to medicines in Australia and New Zealand was conducted. The results were critically assessed in the context of policy material available via grey literature from the respective countries. Results: Key elements regarding pharmaceutical policy were identified from the 35 research papers identified for this review. Through a content analysis, three broad categories of pharmaceutical policy were found, which potentially could influence patient access to medicines in each country; the national health system, pricing and reimbursement. Within these three categories, 9 subcategories were identified: national health policy, pharmacy system, marketing authorization and regulation, prescription to non‐prescription medicine switch, orphan drug policies, generic medicine substitution, national pharmaceutical schedule and health technology assessment, patient co‐payment and managed entry agreements. Conclusions: This review systematically evaluated the current literature and identified key areas of difference in policy between Australia and NZ. Australia appears to cover and reimburse a greater number of medicines, while New Zealand achieves much lower prices for medicines than their Australian counterparts and has been more successful in controlling national pharmaceutical expenditure. Delays in patient access to new therapies in New Zealand have considerable implications for overall patient access to medicines; however, higher patient co‐payments and relative pharmaceutical expenditure in Australia and its effect upon patient access to medicines must also be considered. HighlightsThis review has identified key areas of difference in medicines policy between Australia and NZ which could influence patient access to medicines.Both countries differ in terms regulation with parallel processing available in Australia, enhanced medicine switch in New Zealand and a lack of orphan drug legislation in New Zealand.New Zealand achieved much lower prices for medicines and has been more successful in controlling medicine expenditure while Australia appeared to fund a greater number of medicines.Delays in patient access to new therapies in New Zealand have considerable implications for access to medicines.This critical anaysis could potentially better inform policy decision‐makers when considering access to medicines.

Keywords: medicine; policy; new zealand; patient access; access medicines; access

Journal Title: Research in Social and Administrative Pharmacy
Year Published: 2019

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