Table 3 Pharmaceutical Purchasing challenges of Iranian Insurance Companies

Basic Benefit Package Challenges

Narrow pharmaceutical packages

Different pharmaceutical packages among various insurers

Reimbursement Challenges

Incorrect cycle of funds in pharmaceutical section by theinsurers

Incorrect and long process of pharmaceuticalreimbursement

Difference in payment ceilings for the same pharmaceuticals

Difference in payment levels and payment mechanisms of pharmaceutical by various insurers

Decision making Challenges

Existence of adverse selection and moral hazard in pharmaceutical sector

Lack of attention to cost effectiveness implications in pharmaceutical purchasing

Technology Challenges

Force on applying new technologies and expensive pharmaceuticals

Devoting great costs to pharmaceutical sector and high technologies

Contract Challenges

Lack of existence fair contracts for pharmaceutical purchasing

Lack of purchasing grand use pharmaceuticals through mass purchase

Lack of ranking the pharmaceutical providers by policy makers