Introduction: This study highlights the importance of access to treatment services and medicines. Research has shown that a significant portion of direct expenses for individuals who are not covered by health insurance is allocated to treatment, diagnostics, and medication costs, indicating issues with the accessibility and quality of health services.
According to the World Health Organization recommendations, if out-of-pocket health expenses exceed 25% of total health financing, it heightens the risk of deepening poverty and creates inequalities related to income.
Although policies and programs aimed at increasing access to subsidized medicines are being implemented, the expected outcomes and actual implementation of these initiatives have not fully met the health needs of the entire population.
Therefore, addressing these issues is essential. For instance, improving the regulation of medicine prices, ensuring adequate supply, and enhancing the subsidy system may be necessary steps moving forward. Methods: This study was conducted using a cross sectional design, employing methods such as document analysis, comparative study, and synthesis.
The list of discounted medicines provided by the health insurance fund includes 650 items from 161 manufacturers across 40 countries. Among these medicines, 7% have expired registration, 9% have been removed from registration, 11% are out of stock, and 73% are supplied normally. Of the medicines listed, 7% are domestic, and 93% are imported, with 39% coming from Asian countries and 54% from European countries, indicating a high reliance on imports for medicine supply and accessibility. A study of the medicines supplied by the pharmaceutical supply organizations shows that 16.5% of the prices are above the maximum price set by the health insurance fund, indicating the need for establishing medicine prices based on research and evidence. Conclusion Out of the 650 types of medicines registered in the list of subsidized medicines, 27% are in a status of expired, removed, or out of stock. The price from the pharmaceutical supply organizations exceeds the upper limit of the subsidized medicine prices set by the insurance fund, covering 83.5% of the total group of medicines.
Therefore, it is necessary to update the list of subsidized medicines from the health insurance fund based on research and evidence.