High cost drugs in Latin America: access and barriers

ABSTRACT

Introduction

Latin America comprises a large set of culturally diverse middle-income countries sharing an inequality gap and a rapidly aging population. A better informed growing middle class adds to the pressure on fragmented health systems that strive to attain universal coverage. Cost containment becomes crucial for sustainability.

Areas covered

Using ‘high cost’ as free term, together with individual country names, a search was performed in Pubmed and Scopus databases for relevant documents centered on pharmaceutical products. References of selected articles were also reviewed.

Expert opinion

In the region as elsewhere improving health information systems has been the starting point. Official health technology assessment agencies have been established in several countries, supporting decisions on best available evidence. A few centralized procurement and price regulation schemes using international reference pricing have been successful. Fast-track approval of generics and biosimilars, or establishing a separate funding source for high cost technologies are other options that, with varying degrees of success, have been. Since Latin America is characterized by its social, geographical and political diversity, each health system needs to recognize its individual priorities, learn from successful experiences elsewhere, and adapt possible alternative interventions to the different local contexts.

KEYWORDS:

• Biosimilar pharmaceuticals
• economics
• health care costs
• Latin america
• pharmaceutical preparations
• technology, high-cost

Article highlights

• Growing costs are a global problem, in Latin America a rapidly aging population adds additional pressure to healthcare systems

• Improving information systems and creating or strengthening HTA agencies have been considered widespread short-term solutions.

• The high cost of certain medications has been addressed through price regulation and a few examples of centralized procurement.

• Some flexibility is needed for the entry on generics and biosimilars

Declaration of interest

D Rosselli declares having received honoraria for lecturing on health economics topics on 19 Latin American countries mainly from the pharmaceutical industry (including Amgen, Pfizer, Roche and Sandoz, manufacturers of biologics and Biosimilars), but also by universities, government agencies or private consultancies. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.