Innovation in regulation of rapidly changing health markets.
Innovation in regulation of rapidly changing health markets.
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DOI：
10.1186/1744-8603-10-53
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发表时间：
2014-06-24
影响因子：
10.8
通讯作者：
Peters DH
中科院分区：
文献类型：
--
作者：
Bloom G;Henson S;Peters DH
卫生市场在低收入和中等收入国家的迅速发展和扩大，大大增加了世界各地与卫生有关的商品和服务的供应。监管这些市场所需的支持机构一直落后，监管体系薄弱，资源不足。本文探讨了与监管低收入中等收入国家卫生市场相关的关键问题，以及监管的不同目标，即医疗质量和安全、性价比、公平获取和融资的社会协议以及问责。许可证、价格控制和其他监管保健品和服务市场的传统方法发挥了重要作用，但它们在确保LMICs使用者的安全性和有效性方面的有效性令人怀疑。本文提出了一个健康市场系统的概念框架，利用健康商品和服务的生产、分销和零售的价值链，来考察低收入国家背景下的健康市场的监管。最后，我们将探索未来不断变化的背景，阐述对未来健康市场监管的影响。我们认为，对低收入国家保健品和服务市场采取新的监管方法的理由是令人信服的。尽管传统的“命令和控制”方法将在监管机构的工具包中占有一席之地，但需要一套更广泛的方法，以适应特定中小岛屿发展中国家的国家和市场层面的背景。这意味着不可能将标准或单一的干预措施应用于所有国家，因为在一种情况下被证明行之有效的方法不一定在其他地方也能奏效。
The rapid evolution and spread of health markets across low and middle-income countries (LMICs) has contributed to a significant increase in the availability of health-related goods and services around the world. The support institutions needed to regulate these markets have lagged behind, with regulatory systems that are weak and under-resourced. This paper explores the key issues associated with regulation of health markets in LMICs, and the different goals of regulation, namely quality and safety of care, value for money, social agreement over fair access and financing, and accountability. Licensing, price controls, and other traditional approaches to the regulation of markets for health products and services have played an important role, but they have been of questionable effectiveness in ensuring safety and efficacy at the point of the user in LMICs. The paper proposes a health market systems conceptual framework, using the value chain for the production, distribution and retail of health goods and services, to examine regulation of health markets in the LMIC context. We conclude by exploring the changing context going forwards, laying out implications for future heath market regulation. We argue that the case for new approaches to the regulation of markets for health products and services in LMICs is compelling. Although traditional "command and control" approaches will have a place in the toolkit of regulators, a broader bundle of approaches is needed that is adapted to the national and market-level context of particular LMICs. The implication is that it is not possible to apply standard or single interventions across countries, as approaches proven to work well in one context will not necessarily work well elsewhere.
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影响因子：
5.4
作者：
Bloom, Gerald;Standing, Hilary;Lloyd, Robert
通讯作者：
Lloyd, Robert
影响因子：
--
作者：
Peters, DH
通讯作者：
Peters, DH
影响因子：
5.4
作者：
Goudge, J;Gilson, L
通讯作者：
Gilson, L
影响因子：
2.9
作者：
Henson, Spencer;Humphrey, John
通讯作者：
Humphrey, John
影响因子：
5.4
作者：
Peters, David H.;Muraleedharan, V. R.
通讯作者：
Muraleedharan, V. R.