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Table 2 Limitations and problems of the HIBP policy process

From: Health insurance benefit package in Iran: a qualitative policy process analysis

Limitations and issues that can be investigated
• Lack of clear criteria to include services into the HIBP
• Not considering the epidemiological transitions to increase the effectiveness of included services.
• Scientific evidences were not adequately used
• Health Technology Assessment (HTA) studies were not used
• Bargaining power had an important role in the ISCHI decisions
• The extensive HIBP list regardless of the priorities and costs
• Policies on HIBP and the strategic purchasing were not implemented
• Cultural, social and economic issues were not considered
• Passive performance of health insurance organizations to include new proposed services within the HIBP
• Lack of revision and evaluation systems
• OTC drugs are included in the HIBP
• Unproportioned percentage of the health expenditures are created by a small percentage of patients
• Development and implementation of programs and policies are not permanent
• Inadequate resources