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  "Purchasing Pharmaceuticals" in Spending Wisely: Buying Health Services for the Poor

  Ulrika Enemark, Anita Alban, Enrique Seoane-Vazquez, and Andreas Seiter

  "Pharmaceuticals are a critical input to the proper functioning of the health services. Most curative and many preventive health services depend on pharmaceuticals. Patients perceive availability of pharmaceuticals in a facility as an indicator of the quality of health services, and drug availability helps explain overall utilization of health services. Despite significant progress in increasing the number of people with access to essential medicine over the past decades, a substantial share of the world’s population (more than a third worldwide and more than half in the poorest parts of Africa and Asia) still lack access to reliable supplies of essential medicines (World Health Organization [WHO] 2000). Many factors influence whether poor people can obtain affordable essential drugs of standard quality. Increased access to drugs depends on an efficient resource allocation and purchasing (RAP) system including rational selection and use of medicines, adequate and sustainable financing, affordable prices, and reliable health care and drug supply systems. This chapter is based on literature found by systematic search of published literature, particularly in Africa and Asia. Search criteria included pharmaceuticals/ drugs and developing countries combined with key parameters regarding RAP (Enemark, Alban, and Seoane-Vazquez 2004)."

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  Protein Kinase Inhibitors in Drug Discovery

  Keykavous Parang and Gongqin Sun

  This chapter explores the ways in which protein kinase inhibitors perform.

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  Purchasing Pharmaceuticals (Health, Nutrition and Population (HNP) Discussion Paper)

  Ulrika Enemark, Anita Alban, and Enrique Seoane-Vazquez

  This paper discusses the purchasing of pharmaceuticals as a key component of costeffective and equitable healthcare delivery. Pharmaceuticals account for a high, sometimes the dominant share of health expenditures in developing countries, but the desired health outcomes can only be achieved if the adequate medicines reach the right people and are used in the correct way. This requires purchasing arrangements that take into account the information asymmetry between patients and providers, ensure selection of effective, safe and affordable medicines and set economic incentives in a way that encourages rational drug use. The organizational and institutional frameworks define the roles of the various public and private stakeholders and establish the rules and regulations for registration, import, prescription and distribution of pharmaceuticals within which active purchasing can take place. While there is a trend towards more active purchasing arrangements for pharmaceuticals, the move from passive to active purchasing, using up-to-date information systems to link inputs and outcomes, and pooled purchasing arrangements to optimize the use of limited resources, has been slow.