Medicines in Health Systems Working Toward Universal Health Coverage
Overall goals of the course
The goal of the Medicines in Health Systems course is to strengthen the capacity of practitioners working toward universal health coverage in low- and middle-income country health systems to design, implement, and monitor evidence-informed pharmaceutical policy and management strategies.
Many countries are reforming their health systems working toward universal health coverage (UHC). These reforms can be harnessed to increase equity in medicines access, affordability, and appropriate use of medicines. However, they also have the potential to decrease the effectiveness of prescribing and dispensing, increase unnecessary use of medicines, and derail systems from a path toward sustainable universal coverage.
To guide health system development with respect to pharmaceuticals, decision makers need to have a conceptual understanding of medicines in health systems; operational staff need detailed, in-depth understanding of key medicines issues and of the policy and management options to address them; system planners and managers need access to data and tools to assess medicines situations and to monitor impacts of changes. Because different actors in the pharmaceutical sector may have competing objectives, all actors must understand the perspectives of others to work toward effective policies that facilitate achieving the goals of universal coverage: equitable and improved population health, financial risk protection of households, and citizen satisfaction with sustainable health systems.
The goal of the Medicines in Health Systems course is to strengthen the capacity of practitioners working toward universal health coverage in low- and middle-income country health systems to design, implement, and monitor evidence-informed pharmaceutical policy and management strategies. Specifically, after completing the course, participants will be able to:
- Explain the different roles medicines play in health systems, and the roles and responsibilities of different system actors with respect to medicines in systems.
- Illustrate the competing objectives that system stakeholders face when striving toward greater availability of and more equitable access to high quality medicines, at affordable costs for households and the system, and with appropriate use to achieve target health outcomes.
- Assess the potential of different medicines policy and management approaches to balance these competing objectives, and identify the facilitators of and barriers to success of specific strategies, in a given context
- Lay out strategies for monitoring desired and potential unintended outcomes of specific medicines policy and management strategies in a given setting.
This is currently a self-paced online course, consisting of 10 modules with activities and quizzes. (At times, the course will be offered with facilitation by experts in the field and the facilitated version will include participant discussion fora; the course has also been taught face-to-face in different settings, in collaboration with faculty in different countries and focused on local system environments.) Course DescriptionFollowing is a brief description of the course modules.
Section 1: Medicines in Health Systems: Why, and how, should we explicitly focus on medicines in health systems? Medicines contribute to, and hinder, achieving the overarching goals of health systems working toward universal health coverage: sustainable high value health care that contributes to optimal, equitable population health. Module 1: Roles of medicines in health systemsModule 2: Frameworks for medicines management in health systems
Section 2: Medicines Policies and Management Tools: Which medicines policy options and management tools can systems consider? When designed, implemented, and updated appropriately, medicines policy approaches and management tools can help balance inherently competing objectives: availability of quality generic and innovative medicines; equitable access; appropriate use; and costs that are affordable to individuals and society.Module 3: Medicines policy optionsModule 4: Core medicines management tools
Section 3: Priority Setting for Medicines in Health Systems: How can systems make and implement challenging decisions on the medicines coverage they provide? Decision makers face challenging tasks in setting and continuously adjusting priorities for spending on medicines and must strive toward fair processes in doing so. Well-designed medicines benefit packages help making priority setting explicit and transparent. Module 5: Values underlying medicines decisions Module 6: Medicines benefits
Section 4: Data for Decision Making: How can systems know about the value of their investments in medicines? Evidence needs to inform medicines policy decisions. Data and systems exit, and must continuously be improved, to generate information for medicines decision-making. Module 7: Data on medicines in health systems. Module 8: Medicines policy objectives and indicators
Section 5: Addressing the Challenges of Specialty Medicines and Monitoring Medicines Use and Spending: How do policy makers and managers know in which ways to adapt systems to rapidly changing environments?High-cost specialty medicines present an enormous, increasing challenge for decision makers who need to balance individual and population health priorities. Health care and financing systems must routinely monitor the extent to which medicines spending purchases health value and is equitable, and whether spending is affordable for households and sustainable for the system. Module 9: Specialty medicines. Module 10: Monitoring medicines in health systems