Regulation of mark-ups within the pharmaceutical supply and distribution chain could be instrumental in controlling medicine prices and facilitating broader access to medicines. This is suggested by the systematic review aimed at determining the effectiveness of policies on mark-up regulations in managing pharmaceutical product prices.
The review involved a thorough search for studies published between January 1, 2004, and October 10, 2019. These studies compared policies on regulating mark-ups against other interventions or counterfactuals. Various study designs were eligible for the review, including randomized trials, non-randomized or quasi-experimental studies such as interrupted time series (ITS), repeated measures (RM), and controlled before-after studies.
Inclusion in the review was based on whether the studies 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 evaluated using the GRADE methodology.
Out of a total of 32,011 records, seven were deemed eligible for inclusion in the review. The limited evidence available cautiously suggests that policies regulating mark-ups could be effective in reducing medicine prices and pharmaceutical expenditures. However, the design of mark-up regulations was identified as a critical factor for their potential success.
Further research is necessary to confirm the effects of these policies on the availability, affordability, or usage patterns of medicines, particularly in low- and middle-income countries. Future studies will provide additional insights into the potential benefits and pitfalls of these policies.
Original Article DOI: 10.1016/j.healthpol.2023.104919
Original title: A systematic review of policies regulating or removing mark-ups in the pharmaceutical supply and distribution chain
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