Pharmaceutical policies: effects on rational drug use, an overview of reviews


Large amounts of health care money are spent on drugs, and these amounts are increasing. Spending more on drugs could mean less money for hospitals, doctors or even other non-health care services. There is therefore a pressure to control the costs of drugs, without decreasing health benefits. A number of pharmaceutical policies are used in different health care systems but the relative benefits and harms are unknown. This study has undertaken a suite of systematic reviews using Cochrane systematic review methods to address this uncertainty.

Four reviews have been completed (reference pricing, restriction on reimbursements, prescribing policies and co-payments). Based on the evidence from the reference pricing review, reference drug pricing can reduce third party drug expenditures by inducing a shift in drug use towards less expensive drugs.  There was no evidence of adverse effects on health and no clear evidence of increased health care utilisation.


Craig Ramsay;




Green, C. J., MacLure, M, Fortin, P. M., and Ramsay, C. R. Pharmaceutical policies: effects of restrictions on reimbursement.   The Cochrane Database of Systematic Reviews 2010, 8 DOI: 10.1002/14651858.CD008654.

Sturm, H, Austvoll-Dahlgren, A, Aaserud, M, Oxman, A. D., Ramsay, C., Vernby, A, and Kosters, J. P. Pharmaceutical policies: effects of financial incentives for prescribers.  Cochrance Database of Systematic Reviews 2007, 3 Art. No.: CD006731. DOI: 10.1002/14651858.CD006731.

Aaserud, M, Dahlgren, A, Kosters, J. P, Oxman, A. D., Ramsay, C., and Sturm, H. Pharmaceutical policies: effects of reference pricing, other pricing, and purchasing policies.  The Cochrane Database of Systematic Reviews 2006, Issue 2 Art. No.: CD005979. DOI: 10.1002/14651858.CD005979.