Powers, engagements and resultant influences over the design and implementation of medicine pricing policies in Ghana

Dados Bibliográficos

ID21880366
AutoresAugustina Koduah (0000-0001-9915-5333, University of Ghana, autor correspondente), Leonard Baatiema (0000-0003-3286-6565, University of Ghana), Irene Akwo Kretchy (0000-0001-6811-5937, University of Ghana), Irene Akua Agyepong (0000-0002-0193-5882, Dodowa Health Research Centre), Anthony Danso‐Appiah (0000-0003-1747-0060, University of Ghana), Anthony Danso-Appiah (Epidemiology and Disease Control, University of Ghana School of Public Health, Legon, Accra, Ghana), Anna Cronin De Chavez (0000-0002-4050-4276, London School of Hygiene & Tropical Medicine), Tim Ensor (0000-0003-0279-9576, University of Leeds), Tolib Mirzoev (0000-0003-2959-9187, London School of Hygiene & Tropical Medicine)
Ano2022
Volume7
Fascículo5
Páginase008225
Data de publicação2022-05-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoBMJ Global Health (JOURNAL)
Identificadores do periódicoISSN: 2059-7908 • E-ISSN: 2059-7908
EditoraBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2021-008225
PMID35589156
OpenAlexW4280583214
IdiomaEN
Citações recebidas1
Referências citadas48

INTRODUCTION: Universal availability and affordability of essential medicines are determined by effective design and implementation of relevant policies, typically involving multiple stakeholders. This paper examined stakeholder engagements, powers and resultant influences over design and implementation of four medicines pricing policies in Ghana: Health Commodity Supply Chain Master Plan, framework contracting for high demand medicines, Value Added Tax (VAT) exemptions for selected essential medicines, and ring-fencing medicines for local manufacturing. METHODS: Data were collected using reviews of policy documentation (n=16), consultative meetings with key policy actors (n=5) and in-depth interviews (n=29) with purposefully identified national-level policymakers, public and private health professionals including members of the National Medicine Pricing Committee, pharmaceutical wholesalers and importers. Data were analysed using thematic framework. RESULTS: A total of 46 stakeholders were identified, including representatives from the Ministry of Health, other government agencies, development partners, pharmaceutical industry and professional bodies. The Ministry of Health coordinated policy processes, utilising its bureaucratic mandate and exerted high influences over each policy. Most stakeholders were highly engaged in policy processes. Whereas some led or coproduced the policies in the design stage and participated in policy implementation, others were consulted for their inputs, views and opinions. Stakeholder powers reflected their expertise, bureaucratic mandates and through participation in national level consultation meetings, influences policy contents and implementation. A wider range of stakeholders were involved in the VAT exemption policies, reflecting their multisectoral nature. A minority of stakeholders, such as service providers were not engaged despite their interest in medicines pricing, and consequently did not influence policies. CONCLUSIONS: Stakeholder powers were central to their engagements in, and resultant influences over medicine pricing policy processes. Effective leadership is important for inclusive and participatory policymaking, and one should be cognisant of the nature of policy issues and approaches to policy design and implementation

Bureaucracy · Business · Economic growth · Economics · Essential medicines · Health care · Mandate · Pharmaceutical policy · Political science · Politics · Public relations · Stakeholder · Health Systems, Economic Evaluations, Quality of Life · Pharmaceutical Economics and Policy · Pharmaceutical Quality and Counterfeiting · Public Administration · Health Policy