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A systematic review of policies regulating or removing mark-ups in the pharmaceutical supply and distribution chain

Author

Listed:
  • Joosse, Iris R.
  • Tordrup, David
  • Glanville, Julie
  • Mantel-Teeuwisse, Aukje K.
  • van den Ham, Hendrika A.

Abstract

The regulation of mark-ups throughout the pharmaceutical supply and distribution chain may be a valuable approach to control prices of medicines and to achieve broader access to medicines. As part of a wider review, we aimed to systematically determine whether policies regulating mark-ups are effective in managing the prices of pharmaceutical products. We searched for studies published between January 1, 2004 and October 10, 2019, comparing policies on regulating mark-ups against other interventions or a counterfactual. Eligible study designs included randomized trials, and non-randomized or quasi-experimental studies such as interrupted time-series (ITS), repeated measures (RM), and controlled before-after studies. Studies were eligible if they included at least one of the following outcomes: price (or expenditure as a proxy for price and volume), volume, availability or affordability of pharmaceutical products. The quality of the evidence was assessed using the GRADE methodology. A total of 32,011 records were retrieved, seven of which were eligible for inclusion for this review. The limited body of evidence cautiously suggests that policies regulating mark-ups may be effective in reducing medicine prices and pharmaceutical expenditures. However, the design of mark-up regulations is a critical factor for their potential success. Additional research is required to confirm the effects of these policies on the availability, affordability or usage patterns of medicines and in low- and middle-income countries.

Suggested Citation

  • Joosse, Iris R. & Tordrup, David & Glanville, Julie & Mantel-Teeuwisse, Aukje K. & van den Ham, Hendrika A., 2023. "A systematic review of policies regulating or removing mark-ups in the pharmaceutical supply and distribution chain," Health Policy, Elsevier, vol. 138(C).
  • Handle: RePEc:eee:hepoli:v:138:y:2023:i:c:s016885102300204x
    DOI: 10.1016/j.healthpol.2023.104919
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    References listed on IDEAS

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