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Table 1 Examples of indicators to monitor medicines policies in UHC systems

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