International Experience in the Management of Pharmaceutical Expenditure: A Narrative Literature Review.

Abstract

This narrative review examines global efforts to manage pharmaceutical expenditures across diverse economic settings, with the goal of identifying strategies that balance cost containment with equitable access to medications. The review highlights the impact of various policy measures on pharmaceutical pricing and spending trends in high-, middle-, and low-income countries. We conducted a comprehensive narrative literature review using PubMed, Scopus, and EconLit databases, applying no chronological or geographical restrictions. Articles were selected based on their relevance to pharmaceutical cost-containment strategies and their impact on medication access. Data extraction was performed independently by two independent reviewers, with a conflict-resolution protocol to ensure accuracy and minimize bias. The review identifies a range of policy interventions, including price regulation, reference pricing, and the promotion of generic drugs. While high-income countries have implemented sophisticated regulatory frameworks, lower-income countries often face challenges in aligning cost containment with healthcare access needs. The effectiveness of these strategies varies widely, underscoring the need for policies tailored to local healthcare and economic conditions. Effective management of pharmaceutical expenditures requires adaptable policy frameworks that consider local contexts and economic capacities. International collaboration and continuous policy evaluation are essential to developing sustainable strategies that enhance both cost efficiency and access to essential medicines.