Innovation, prioritization and sustainability: contemporary dilemmas of Pharmaceutical Services.

Over the last five years, articles addressing pharmaceutical services have increasingly focused on issues such as technology incorporation, funding, inequalities in access to medicines and regulatory challenges. This essay discusses the implications of focusing on innovation to the detriment of essential medicine prioritization, particularly the effects of this approach on the sustainability of the health system. First-in-class innovations do not always meet health priorities or established criteria for prioritizing medicines. From a health system perspective, innovations that genuinely address unmet health needs may be prioritized, provided their use is supported by robust evidence. However, the system needs to have the necessary structural and financial conditions and technical and workforce capacity and capability to effectively implement the technology. Ways to overcome these challenges include increasing the use of budget impact analyses and improving the regulatory framework for incorporation. To organize, or rather reorganize PS, there is an urgent need to address the dilemmas outlined in this paper.