Health Care : Current Reviews

It is possible to stop the dizzing growth in drugs expenditures: Experience proven in real life data for 16 years

Joint Event on 39^th European Ophthalmology Congress 11^th World Congress on Health Economics, Health Policy and Healthcare Management

March 18, 2025 Webinar

Yossi Lomncky

Israeli Health Care Organization, Israel

Scientific Tracks Abstracts: Health Care Curr Re

Abstract:

Background: Drug expenditure has been growing at an accelerated rate in Western countries with a recent annual change of 2-10%. Maccabi Healthcare Services (MHS), a large health maintenance organization in Israel has implemented a “smart policy” which includes 21 measures aimed at reducing non-essential drug costs while maintaining a maximum health services quality. We evaluated the impact of the measures implemented at MHS to contain medication expenditures between 2007 and 2023. Methods: A retrospective analysis of MHS’s database. The annual drug expenditures and the average drug expenditure per patient were determined. The results were standardized to the 2023 Israel Health Value Index" of 2023. The global impact of all measures and the impact of effect of specific cost-containment measures on drug expenditures were evaluated. Results: Between 2007 and 2023, the 21 measures taken by MHS have led to cost containment of spending on medications, which resulted in an annual "growth in drug expenditure of "-0.2% - lower than that observed for most countries. Among the measures taken, the most meaningful move was the aggressive implementation of generic medications. Additional measures that contributed to cost reduction were the establishment of a pre-authorization center for medications and limiting the period during which approved medications could be obtained. Conclusions: Measures taken by MHS have resulted in only a modest increase in drug expenditure. This successful cost control has enabled MHS to offer its members many medications that are not included in the national health basket, while also preventing a significant financial shortfall. This “smart comprehensive costcontaining policy” successfully controls the expenditures of healthcare services that operate their own drug formularies. Keywords: cost containment; drug expenditures; health maintenance organization; health policy

Biography :

Yossi Lomncky is completed his PhD at Hebrew University, Jerusalem, Israel. (School of Pharmacy).