Evaluation of Effect of Insurance Coverage on Sale Volume and Price of Entered Drugs in Insurance List in 2012 in Iran

Background: Drug industry is considered as the second profitable industry in the world and plays an important role in global economy. The sharp annual growth in drug expenditures imposes heavy loads on the health insurance organizations as a major part of these costs are covered by these companies. Covering a drug by health insurance companies not only reduces the out of pocket costs of patients, but also increases probability of prescribing the covered drug by physicians. Consequently this generally ends to an increase in pharmaceutical sales volume. This enables the health insurance companies to negotiate a lower price with pharmaceutical companies.

Methods: In this study, the effect of insurance coverage of a list of drugs in Iran on increase of their sale volume as well as the reduction in their price has been evaluated. The SPSS software used to assess the trend of numerical, monetary sales and price of the insured drugs compared to non-insured medicines in a cross-sectional study. Paired tests (Student t test and Wilcoxon test) with a significance level of 0.05<P were used to analyze data in the current study.

Results: The achieved results showed that although the sale volume of the insured drugs were increased during the investigated period, this was the same for non-insured drugs as well, However, the prices of investigated insured drugs were reduced following covering by insurance companies while this was not the case for non-insured drugs.

Conclusion: The results of this research can be used by policy-makers to have a better understanding of drug policies in Iran and by insurance organizations in order to evaluate consequences of adding drugs to their coverage list.