Health Affairs
May 2016; Volume 35, Issue 5
http://content.healthaffairs.org/content/current
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Prescription Drugs, Global Health & More
From The Editor-in-Chief
Prescription Drugs, Global Health, And Population Health
Alan R. Weil
This month’s issue of Health Affairs covers a broad range of topics. We begin with prescription drugs, noting the recent report from IMS Health that drug spending increased by 8.5 percent in 2015.
Prescription Drugs
Unit prices for cancer drugs are higher in the United States than other developed countries. Sebastian Salas-Vega and Elias Mossialos compare the value in lives saved for cancer drug spending in nine countries, including the United States. Assigning a standard value for extended life-years, the authors calculate a $32.6 billion net positive return from cancer drug care in 2014 in the United States—a lower return per dollar spent than in all other countries analyzed. Japan achieved almost seven times the US rate of return.
Anomalies in the US drug market often yield price increases over time after a drug has been released. Caroline Bennette and colleagues set out to understand why. Analyzing data for twenty-four cancer drugs over six …
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Global Health
Improving Health Care Coverage, Equity, And Financial Protection Through A Hybrid System: Malaysia’s Experience
Ravindra P. Rannan-Eliya, Chamara Anuranga, Adilius Manual, Sondi Sararaks, Anis S. Jailani,
Abdul J. Hamid, Izzanie M. Razif, Ee H. Tan, and Ara Darzi
Author Affiliations
1Ravindra P. Rannan-Eliya (raviofficelk@gmail.com) is executive director of the Institute for Health Policy, in Colombo, Sri Lanka.
2Chamara Anuranga is a research associate at the Institute for Health Policy.
3Adilius Manual is a research officer at the Institute for Health Systems Research, National Institutes of Health (NIH), in Selangor, Malaysia.
4Sondi Sararaks is a senior medical officer at the Institute for Health Systems Research, NIH, Malaysia.
5Anis S. Jailani is a research officer at the Institute for Health Systems Research, NIH, Malaysia.
6Abdul J. Hamid is a research officer at the Institute for Health Systems Research, NIH, Malaysia.
7Izzanie M. Razif is a research officer in the National Health Financing Unit of the Ministry of Health, in Putrajaya, Malaysia.
8Ee H. Tan is senior principal assistant director of the Oral Health Division of the Ministry of Health, in Putrajaya.
9Ara Darzi is executive chair of the World Innovation Summit for Health, Qatar Foundation, and director of the Institute of Global Health Innovation, Imperial College London, in the United Kingdom.
Abstract
Malaysia has made substantial progress in providing access to health care for its citizens and has been more successful than many other countries that are better known as models of universal health coverage. Malaysia’s health care coverage and outcomes are now approaching levels achieved by member nations of the Organization for Economic Cooperation and Development. Malaysia’s results are achieved through a mix of public services (funded by general revenues) and parallel private services (predominantly financed by out-of-pocket spending). We examined the distributional aspects of health financing and delivery and assessed financial protection in Malaysia’s hybrid system. We found that this system has been effective for many decades in equalizing health care use and providing protection from financial risk, despite modest government spending. Our results also indicate that a high out-of-pocket share of total financing is not a consistent proxy for financial protection; greater attention is needed to the absolute level of out-of-pocket spending. Malaysia’s hybrid health system presents continuing unresolved policy challenges, but the country’s experience nonetheless provides lessons for other emerging economies that want to expand access to health care despite limited fiscal resources.