From: Quality use of medicines within universal health coverage: challenges and opportunities
Domain and question | Sample indicator | Possible data source |
---|---|---|
Availability of quality generic and innovative products | ||
Does local industry produce a reliable supply of needed high-quality, low-cost generics? | Volume and percent of locally-produced generics that meet quality and price standards | Industry data |
Quality test records | ||
Do risk-sharing strategies between pharmaceutical companies and payers to provide access to selected high-cost medicines for selected patients achieve intended outcomes, and what are unintended ones? | Percent patients with a target conditions who receive an innovative product that results in expected health benefits | Industry risk sharing program data |
Equitable access | ||
Do people receive the medicines they need? | Percentage of people with a diagnosed chronic illness who currently have an appropriate medicine available to treat their condition | Household surveys |
How does access to appropriate medicines differ between groups of patients? | Percentage of patients with a given diagnosis who receive a recommended first-line drug in different subgroups (categorized by insurance scheme, geographic location, age group, gender, race and ethnicity, socioeconomic status) | Prescriptions or dispensing records at health facilities |
Insurance claims records | ||
Appropriate use | ||
Are we overusing medicines? | Percentage of primary care patients who receive an antibiotic | Prescriptions or dispensing records at health facilities |
Insurance claims records | ||
Are we underusing medicines? | Percentage of patients with a chronic condition (e.g., diabetes, hypertension) who receive at least one of the recommended treatments | Prescriptions or dispensing records at health facilities |
Insurance claims records | ||
Affordable costs | ||
How much does the insurance scheme/health system spend on medicines? | Medicines expenditures per member per month (overall, by member category, by specific diagnoses, by specific therapeutic categories) | Insurance reimbursement records |
What is the financial burden associated with medicines spending in households? | Proportion of patients who indicate that they forego medicines treatment or spend less on other basic needs due to medicines costs | Household surveys |