OBJECTIVES

The current pricing system has some challenges. Affordable and accessible pharmaceutical care is essential to the sustainable health system. External reference pricing (ERP), a common pharmaceutical policy worldwide, suffers today from indigenous weaknesses that may cause market barriers to care, burdening mostly the weak economies, and hence, raising political worrying.The MoH decided to introduce methods of differential pricing within a country, to evaluate their applicability for Kazakhstan by taking into account the ERP framework, and to provide recommendations for fair pricing of pharmaceuticals in Kazakhstan. introduce some reform actions to address these problems, aiming to achieve fair pricing policy, using the differential pricing concept.

METHODS

The focus group of policy makers, decision makers and industry experts was established to discuss the possible pricing options within the healthcare system of Kazakhstan context and develop core assumptions before preparing a draft report. The recommendations were developed by using the Delphi method. Content analysis was used for analyzing the qualitative data, and descriptive analysis for the quantitative data.

RESULTS

Small sets of reference countries are preferred to large baskets, as they produce similar results, while presenting better qualities by increasing the flexibility of the reimbursement system and the transparency of the market. Innovative pricing models, like differential pricing with confidential agreements, are expected to shift the financial burden of pharmaceuticals’ price to the more affluent consumers and distribute the cost of innovation across the patients according to their socio-economic status, and reduce negative externalities related to the ERP system.

CONCLUSIONS

Differential pricing with confidential agreements would achieve a win-win situation, where MoH achieves equity principles by enhancing access to medicine among the patients. Pharmaceutical pricing models that fit prices to income and affordability are better in all aspects, as they produce fairer results, while resulting in low external costs for the ERP system as a whole.