Confidentiality agreements: a challenge in market regulation
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFMG |
Texto Completo: | https://doi.org/10.1186/s12939-019-0916-3 http://hdl.handle.net/1843/61202 |
Resumo: | Background: Sustainability and the ability to maintain the right to health, with the guarantee of access to quality medicines and health services, have been a great challenge for countries with universal health systems. The great technological advances bring with it an expressive increase in the expenditures of the health systems, especially those directed towards the acquisition of high-cost drugs, which are still under patent protection, have a high cost and, in some cases, present uncertainties about their effectiveness and safety. As a way of maintaining the proper functioning of the systems and guaranteeing access to these medicines, some countries started to negotiate discounts with manufacturing companies. Pricing agreements have been adopted by developed countries with the objective of reducing their spending on high-cost medicines and, although they represent an opportunity for better negotiation with the industries, they violate the principle of transparency that regulates the world market. However, the existence of confidentiality agreements has meant that the declared prices are not the actual prices, unfairly harming the countries that use these price lists as beacons in their systems. Methods: Representatives of health, judicial, legislative, patient organizations and academics from eight countries in Latin America and South Korea participated in a meeting in September 2017 in Chile to discuss price confidentiality agreements and the impact on public health policies. During the meeting, participants were presented with a hypothetical case to subsidize the discussion on the topic. Divided into groups, participants should propose recommendations for the problem by pointing out the pros and cons if each proposed recommendation was adopted. The groups were then confronted by a simulated jury and finally issued a single and final recommendation for the problem. Results: The topic was widely discussed and recommendations were raised by the participants. Among them, it is worth noting the elaboration of norms that regulate the negotiations of prices between the countries bringing transparency and harmony in the adopted conducts. In addition, the possible consequences and potential impacts of confidentiality on drug prices and inputs, such as information asymmetry and inequity of access between countries, were pointed out. Conclusion: Despite there are efforts to make price negotiations more transparent, there is still no well-established standardization that promotes a well-functioning market. Confidentiality agreements hamper the fairness of access to essential health products. |
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2023-11-21T19:37:52Z2023-11-21T19:37:52Z2019-06-031816https://doi.org/10.1186/s12939-019-0916-31475-9276http://hdl.handle.net/1843/61202Background: Sustainability and the ability to maintain the right to health, with the guarantee of access to quality medicines and health services, have been a great challenge for countries with universal health systems. The great technological advances bring with it an expressive increase in the expenditures of the health systems, especially those directed towards the acquisition of high-cost drugs, which are still under patent protection, have a high cost and, in some cases, present uncertainties about their effectiveness and safety. As a way of maintaining the proper functioning of the systems and guaranteeing access to these medicines, some countries started to negotiate discounts with manufacturing companies. Pricing agreements have been adopted by developed countries with the objective of reducing their spending on high-cost medicines and, although they represent an opportunity for better negotiation with the industries, they violate the principle of transparency that regulates the world market. However, the existence of confidentiality agreements has meant that the declared prices are not the actual prices, unfairly harming the countries that use these price lists as beacons in their systems. Methods: Representatives of health, judicial, legislative, patient organizations and academics from eight countries in Latin America and South Korea participated in a meeting in September 2017 in Chile to discuss price confidentiality agreements and the impact on public health policies. During the meeting, participants were presented with a hypothetical case to subsidize the discussion on the topic. Divided into groups, participants should propose recommendations for the problem by pointing out the pros and cons if each proposed recommendation was adopted. The groups were then confronted by a simulated jury and finally issued a single and final recommendation for the problem. Results: The topic was widely discussed and recommendations were raised by the participants. Among them, it is worth noting the elaboration of norms that regulate the negotiations of prices between the countries bringing transparency and harmony in the adopted conducts. In addition, the possible consequences and potential impacts of confidentiality on drug prices and inputs, such as information asymmetry and inequity of access between countries, were pointed out. Conclusion: Despite there are efforts to make price negotiations more transparent, there is still no well-established standardization that promotes a well-functioning market. Confidentiality agreements hamper the fairness of access to essential health products.Antecedentes: A sustentabilidade e a capacidade de manter o direito à saúde, com a garantia de acesso a medicamentos e serviços de saúde de qualidade, têm sido um grande desafio para os países com sistemas de saúde universais. Os grandes avanços tecnológicos trazem consigo um aumento expressivo nos gastos dos sistemas de saúde, especialmente aqueles direcionados à aquisição de medicamentos de alto custo, que ainda estão protegidos por patentes, têm custo elevado e, em alguns casos, apresentam incertezas sobre sua eficácia e segurança. Como forma de manter o bom funcionamento dos sistemas e garantir o acesso a estes medicamentos, alguns países passaram a negociar descontos com empresas fabricantes. Acordos de preços têm sido adotados pelos países desenvolvidos com o objetivo de reduzir seus gastos com medicamentos de alto custo e, embora representem uma oportunidade para melhor negociação com as indústrias, violam o princípio da transparência que regula o mercado mundial. No entanto, a existência de acordos de confidencialidade fez com que os preços declarados não fossem os preços reais, prejudicando injustamente os países que utilizam estas listas de preços como faróis nos seus sistemas. Métodos: Representantes de organizações de saúde, judiciais, legislativas, de pacientes e acadêmicos de oito países da América Latina e da Coreia do Sul participaram de uma reunião em setembro de 2017 no Chile para discutir acordos de confidencialidade de preços e o impacto nas políticas de saúde pública. Durante o encontro, foi apresentado aos participantes um caso hipotético para subsidiar a discussão sobre o tema. Divididos em grupos, os participantes deveriam propor recomendações para o problema, apontando os prós e os contras caso cada recomendação proposta fosse adotada. Os grupos foram então confrontados por um júri simulado e finalmente emitiram uma recomendação única e final para o problema. Resultados: O tema foi amplamente discutido e recomendações foram levantadas pelos participantes. Dentre elas, vale destacar a elaboração de normas que regulam as negociações de preços entre os países trazendo transparência e harmonia nas condutas adotadas. Além disso, foram apontadas as possíveis consequências e potenciais impactos da confidencialidade sobre os preços e insumos de medicamentos, como a assimetria de informação e a desigualdade de acesso entre os países. Conclusão: Apesar de haver esforços para tornar as negociações de preços mais transparentes, ainda não existe uma padronização bem estabelecida que promova um mercado que funcione bem. Acordos de confidencialidade dificultam a equidade no acesso a produtos de saúde essenciais.engUniversidade Federal de Minas GeraisUFMGBrasilFAR - DEPARTAMENTO DE FARMÁCIA SOCIALInternational Journal for Equity in HealthDireito à saúdeEquidadeCobertura universal de saúdeEquityConfidentiality agreementsMarket regulationConfidentiality agreements: a challenge in market regulationinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleRoberto Fontes IunesManuela Villar UribeJanet Bonilla TorresMarina Morgado GarciaCarolina Zampirolli DiasJuliana Alvares TeodoroFrancisco de Assis AcurcioAugusto Afonso Guerra Júniorapplication/pdfinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSELicense.txtLicense.txttext/plain; charset=utf-82042https://repositorio.ufmg.br/bitstream/1843/61202/1/License.txtfa505098d172de0bc8864fc1287ffe22MD51ORIGINALConfidentiality agreements a challenge in market regulation.pdfConfidentiality agreements a challenge in market regulation.pdfapplication/pdf612373https://repositorio.ufmg.br/bitstream/1843/61202/2/Confidentiality%20agreements%20a%20challenge%20in%20market%20regulation.pdf14ac3624c8c3406a18bc1f0f49bbc3f2MD521843/612022023-11-21 17:53:53.274oai:repositorio.ufmg.br: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Repositório de PublicaçõesPUBhttps://repositorio.ufmg.br/oaiopendoar:2023-11-21T20:53:53Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false |
dc.title.pt_BR.fl_str_mv |
Confidentiality agreements: a challenge in market regulation |
title |
Confidentiality agreements: a challenge in market regulation |
spellingShingle |
Confidentiality agreements: a challenge in market regulation Roberto Fontes Iunes Equity Confidentiality agreements Market regulation Direito à saúde Equidade Cobertura universal de saúde |
title_short |
Confidentiality agreements: a challenge in market regulation |
title_full |
Confidentiality agreements: a challenge in market regulation |
title_fullStr |
Confidentiality agreements: a challenge in market regulation |
title_full_unstemmed |
Confidentiality agreements: a challenge in market regulation |
title_sort |
Confidentiality agreements: a challenge in market regulation |
author |
Roberto Fontes Iunes |
author_facet |
Roberto Fontes Iunes Manuela Villar Uribe Janet Bonilla Torres Marina Morgado Garcia Carolina Zampirolli Dias Juliana Alvares Teodoro Francisco de Assis Acurcio Augusto Afonso Guerra Júnior |
author_role |
author |
author2 |
Manuela Villar Uribe Janet Bonilla Torres Marina Morgado Garcia Carolina Zampirolli Dias Juliana Alvares Teodoro Francisco de Assis Acurcio Augusto Afonso Guerra Júnior |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Roberto Fontes Iunes Manuela Villar Uribe Janet Bonilla Torres Marina Morgado Garcia Carolina Zampirolli Dias Juliana Alvares Teodoro Francisco de Assis Acurcio Augusto Afonso Guerra Júnior |
dc.subject.por.fl_str_mv |
Equity Confidentiality agreements Market regulation |
topic |
Equity Confidentiality agreements Market regulation Direito à saúde Equidade Cobertura universal de saúde |
dc.subject.other.pt_BR.fl_str_mv |
Direito à saúde Equidade Cobertura universal de saúde |
description |
Background: Sustainability and the ability to maintain the right to health, with the guarantee of access to quality medicines and health services, have been a great challenge for countries with universal health systems. The great technological advances bring with it an expressive increase in the expenditures of the health systems, especially those directed towards the acquisition of high-cost drugs, which are still under patent protection, have a high cost and, in some cases, present uncertainties about their effectiveness and safety. As a way of maintaining the proper functioning of the systems and guaranteeing access to these medicines, some countries started to negotiate discounts with manufacturing companies. Pricing agreements have been adopted by developed countries with the objective of reducing their spending on high-cost medicines and, although they represent an opportunity for better negotiation with the industries, they violate the principle of transparency that regulates the world market. However, the existence of confidentiality agreements has meant that the declared prices are not the actual prices, unfairly harming the countries that use these price lists as beacons in their systems. Methods: Representatives of health, judicial, legislative, patient organizations and academics from eight countries in Latin America and South Korea participated in a meeting in September 2017 in Chile to discuss price confidentiality agreements and the impact on public health policies. During the meeting, participants were presented with a hypothetical case to subsidize the discussion on the topic. Divided into groups, participants should propose recommendations for the problem by pointing out the pros and cons if each proposed recommendation was adopted. The groups were then confronted by a simulated jury and finally issued a single and final recommendation for the problem. Results: The topic was widely discussed and recommendations were raised by the participants. Among them, it is worth noting the elaboration of norms that regulate the negotiations of prices between the countries bringing transparency and harmony in the adopted conducts. In addition, the possible consequences and potential impacts of confidentiality on drug prices and inputs, such as information asymmetry and inequity of access between countries, were pointed out. Conclusion: Despite there are efforts to make price negotiations more transparent, there is still no well-established standardization that promotes a well-functioning market. Confidentiality agreements hamper the fairness of access to essential health products. |
publishDate |
2019 |
dc.date.issued.fl_str_mv |
2019-06-03 |
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2023-11-21T19:37:52Z |
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2023-11-21T19:37:52Z |
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http://hdl.handle.net/1843/61202 |
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https://doi.org/10.1186/s12939-019-0916-3 |
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1475-9276 |
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International Journal for Equity in Health |
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Universidade Federal de Minas Gerais |
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FAR - DEPARTAMENTO DE FARMÁCIA SOCIAL |
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Universidade Federal de Minas Gerais |
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