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Category: Health Financing

  • An Impact Evaluation of Medical Insurance for Poor in Georgia: Preliminary Results and Policy Implications

    An International peer reviewed journal Health Policy and Planning has published an article An impact evaluation of medical insurance for poor in Georgia: preliminary results and policy implications, authored by Curatio International Foundation experts.

    The authors evaluated the impact of Medical Insurance for Poor in Georgia (MIP), the Government program that delivered state-subsidized health benefits to the poorest groups of the Georgian population through contracts with private insurance companies.

    This study documented that after 3 years of the MIP implementation the program successfully managed to reduce financial access barriers for the MIP covered individuals by delivering greater financial benefits to the poorest. Although the MIP did not facilitate growth in health care utilization for all beneficiaries, positive trends were observed among capital city residents.

    The equity impact of the MIP and improved financial protection, especially for the poor, are benefits to be considered by the government for the Universal Health Coverage.

    Visit ResearchGate to read and download the article.

  • Georgian Healthcare System Barometer: Experts' Evaluations of Changes Taking Place in the Healthcare

    Curatio International Foundation published results of the survey, representing expert evaluations of processes and changes taking place in the Georgian healthcare field.

    “Georgian Healthcare System Barometer” is based on evaluations of 98 experts and covers 6-month period – May-October, 2013.

    The survey was focused on expected results of the Universal Insurance; possible influence of steps made by the Government on private investments in healthcare; population health; quality of the medical service and medical education; a policy of healthcare financing.

    Curatio International Foundation first published Barometer in April 2013. In the second survey, some assessments have become more optimistic, although issues with increased pessimistic expectations have emerged as well.

    Major findings of the survey:

    • Experts believe that initiatives introduced by the Government in the healthcare sector for the past 6 months have generally been efficient – during this period, the number of skeptics significantly dropped from 52.4% to 33%;
    • This time, more respondents consider that steps made by the Government are efficient but  funding of this sector is evaluated as “less adequate”;
    • Despite the significant increase in State funding, experts’ expectations that healthcare would become more affordable and/or prices would go down, have become more pessimistic in the second wave;
    • In the second wave, optimistic expectations that prices on medications would go down have decreased from 38.8% to 25.5%. This is probably caused by the fact that 47.3% of experts believe that, in terms of pharmaceutical market management and regulation, no  important steps have been made for the past 6 months;
    • According to experts, just as in the first wave, the quality of medical service, as well as medical education system, remain problematic;
    • The majority of experts thinks that the medical personnel training system still does not meet current requirements and 69.8% of experts indicates that effective steps have not been made in this direction for the past 6 months either;
    • It is well known that for the development of the sector, it is necessary to improve the investment climate. The majority of experts are skeptical that the policy pursued for the last 6 months will promote private investments in the insurance industry (70.3%) or in medical facilities (61.6%);
    • Experts believe that the policy conducted in this sector will increase the Government’s role in insurance companies (54.9%) and clinical facilities (76.9%).

    Positive perception of results and tendencies by experts is probably caused by a clear formulation of concrete priorities by the State and communication through programmatic and/or State documents as well as through media. The negative results are probably caused by either an absence of declared priorities by the State of insufficient detalization of them.

    Researchers conclude that clear and transparent formulation of priorities and adequate communication can have a positive influence on the future of the health sector and consequently on the public opinion.

    Experts participating in the survey represent ministries and government bodies, medical facilities, international organizations, professional associations, insurance companies and research groups.

    Curatio International Foundation will conduct such survey every six months in order to observe in dynamics processes taking place in this sector and experts’ attitude towards these changes.

  • Assessing the Health Insurance for the Poor in Georgia

    During the last two decades Government of Georgia initiated series of reforms introducing major changes in health financing policy and restructuring the health system to reverse the negative trends observed in equity, affordability and quality of essential health service for significant part of the country population and particularly for the poor.

    Addressing problems in equity and financial protection against health care costs through re attainment of universal coverage for essential health care services for the entire population was one of the longstanding and explicitly stated national health policy goals.

    Affordability of health care services is one of the most critical issues for Georgia’s health sector. The matter is among top five most important national issues for a large part of the Georgian population. Medical Insurance for the Poor (MIP), a public program initiated in 2007, provides private insurance coverage to one fifth of the Georgian population and is aimed to protect its beneficiaries from financial hardship and impoverishment that may be caused by health care expenditures.

    The study implemented by the Curatio International Foundation with the support from the Alliance for Health Policy and Systems Research/World Health Organization assesses the impact of Medical Health Insurance (MIP) for the Poor on equity in access to essential health care services and financial protection against health care costs for the poor and general population.

    The first phase of the study was published in May 2011. The document briefly describes identified accomplishments and shortcomings of the public private partnership in realization of medical insurance for the poor and discusses emerging policy options and policy recommendations on the future of MIP.

    The second part of the study aimed to assess the overall impact of medical insurance for the poor. The resulting document also reviews steps undertaken by the government in the design and implementation of the insurance program: the way the benefit package was designed, institutional and purchasing arrangements. It also describes the role of high level actors in MIP formulation and implementation, their influence, nature of interest and perceived position on possible future MIP expansion.

    View full documents:

    Policy Brief-Medical Insurance for the Poor: impact on access and affordability of health services in Georgia

    Policy Brief- Health Insurance for the Poor in Georgia, Content, Process and Actors

    Full Study Report- Health Insurance for Poor: Georgia’s Path to Universal Coverage

     

  • Health Insurance for Poor: Georgia's Path to Universal Coverage

    The study assesses the impact of Medical Health Insurance (MIP) for the Poor on equity in access to essential health care services and financial protection against health care costs for the poor and general population. The document briefly describes identified accomplishments and shortcomings of the public private partnership in realization of MIP and discusses emerging policy options and policy recommendations on the future of MIP.

    The study was financially and technically supported by the Alliance for Health Policy and Systems Research/World Health Organization and carried out by Curatio International Foundation.

    View the Policy Brief-Medical Insurance for the Poor: impact on access and affordability of health services in Georgia

    View the Policy Brief- Health Insurance for the Poor in Georgia, Content, Process and Actors

    Read the Full Study Report- Health Insurance for Poor: Georgia’s Path to Universal Coverage

     

  • Health care in Georgia is currently available for very rich and very poor

    As the lead key informant to the policy brief on Medical Insurance for the Poor: impact on access and affordability of health services in Georgia says, the “health care in Georgia is currently affordable for very reach and very poor”. This conclusion grounds on the findings of the study that explored one of the most critical issues- affordability of health care services in Georgia. The matter is among top five most important national issues for a large part of the Georgian population. Medical Insurance for the Poor (MIP), a public program initiated in 2007, provides private insurance coverage to one fifth of the Georgian population and is aimed to protect its beneficiaries from financial hardship and impoverishment that may be caused by health care expenditures.

    The study assessed the impact of Medical Health Insurance (MIP) for the Poor on equity in access to essential health care services and financial protection against health care costs for the poor and general population. The document briefly describes identified accomplishments and shortcoming of the public private partnership in realization of MIP and discusses emerging policy options and policy recommendations on the future of MIP.

    The study was financially and technically supported by the Alliance for Health Policy and Systems Research/World Health Organization and carried out by Curatio International Foundation.

    Read the full version of the Policy Brief here to find out more on key findings, achievements and policy recommendations.

    Read the full study report.

  • Price, availability and affordability of medicines in Georgia-2009-2011

    The present report unveils the findings of the study “Price, availability and affordability of medicines in Georgia” implemented over the course of three years- 2009-2011 in the capital Tbilisi and regional cities. The study was supported by the World Bank and the Open Society Institute.

    The survey looked at availability and price of Innovative Brands and their equivalent low price generics, analyzed collected data by type of medicine, regional differences as well as by type of pharmacy. The survey also looks at medicine mark-ups and compares with mark-ups in European countries, measures affordability of standard treatments as percent of average subsistence monthly allowance and provides comparison of the standard treatments by innovative brands and equivalent low price generics.

    The present report “Price, availability and affordability of medicines in Georgia” attempted to obtain reliable data on these aspects and documents tendencies of change over the course of three years. Over the course of three years the study covered almost all licensed pharmacies and 52 types of medications in the capital Tbilisi and regional cities.

    The power point presentation document and brief study report can be viewed here (yet avaialble only in Georgian).

  • Findings of the pharmaceutical market study in 2009-2011 years

    The key aim of the study is to improve affordability and availability of medicines for the population.

    Based on a three-year observation of pharmacies and different medicines in Georgia, Curatio International Foundation studied the practice in the pharmaceutical sector and came up with recommendations based on research findings. The recommendations will be presented to the broad audience of the health sector – the Health Care Committee of Parliament, the Ministry of Health, the insurance sector and other interested parties.

    Giorgi Gotsadze, the Curatio International Foundation Director: “Through the study we provide strong evidence to decision and policy makers on the current condition of the pharmaceutical market. We hope that this study will foster debates between the interested parties”.

    The study was conducted using the methodology of the World Health Organization (WHO). The survey looked at prices and mark-ups of 52 medicines (brand-name medicines and their cheap generic equivalents) over the period of three years in licensed pharmacies nationwide.

    The survey measures the quality of access to medicines in both pharmacy chains and independent pharmacies. In 2011, Pharmadepo and Parmacenter added to the pharmacy chains involved in the survey (PSP, Aversi, GPC) in 2009-2010.
    The survey looks at the access to medicines by years as well. It analysis the impact of amendments made in 2009 to the Law on Drugs on the access to medicines and medicine prices in Georgia. The survey analysis how the changes influence the patients’ treatment costs in patients with different diagnosis.

    The survey has found that:

    • The market has witnesses a tougher rivalry since 2009, which has likely led to the reduction of markups of brand-name products. Markups decreased most in 2001;
    • The year 2011 witnessed an increase in access to both brand-name products and their cheap generic equivalents;
    • Despite improved affordability the market is experiencing a lack of generic products;
    • Access to medicines varies by regions. Access, especially the access to generic medicines, in some regions is still low;
    • The level of access is highest in the Pharmadepo/Pharmacenter pharmacy chain and lowest in independent pharmacies, which is likely to be the result of unequal competition among pharmacies;
    • Even though there is a decreasing trend in medicine markups, the markups in Georgia are higher than in European states, which means that Georgian importers add more funds to medicine prices than European ones (which should respectively lead to higher profits). Consequently, the share of pharmaceutical costs in the national healthcare spending in Georgia is much higher compared to European states.
    Impact on Standard Treatment Costs:
    • There has been a decreasing trend in the standard treatment price for the past three years;
    • In 2011 standard treatment costs decreased more in case of treatment by brand-name medicines compared to treatment by generic products, however the treatment by generic medicines requires less spending because of low retail price of such medicines.
    The survey of prices and availability of medicines was divided into three phases and conducted in Georgia in 2009-2011. The first and third stags were financed by the World Bank, while the second one – by the Open Society Institute.CIF presents the results of the study exploring “Price, availability and affordability of medicines in Georgia”.

    Study presentation and small study report (available in Georgian).

  • Main findings of Catastrophic Health Expenditure Analysis in Georgia

    The researcher of the Curatio International Foundation Natia Rukhadze presented the findings of Catastrophic Health Expenditure Analysis in Georgia at the “Seminar on Health Financing Reforms in Georgia” held in MoLHSA on October 26, 2011.

    The study was funded by the World Health Organization (WHO) and uses the data from nationally representative Integrated Household Survey (HIS) conducted by National Statistical Office (GEOSTAT) on an annual basis; Study looked at trends in household catastrophic health spending during 2006-2010 among different population groups. The purpose of the study was to look at population level impact of the Government’s health financing reforms initiated in 2006/07 and aimed at providing state subsidized health insurance to extremely poor.

    See the full report of the study.

  • Catastrophic Health Expenditure Analysis in Georgia

    On October 26, 2011 the researcher of the Curatio International Foundation Natia Rukhadze presented the findings of Catastrophic Health Expenditure Analysis in Georgia at the “Seminar on Health Financing Reforms in Georgia” held in MoLHSA.

    The study was funded by the World Health Organization (WHO) and uses the data from nationally representative Integrated Household Survey (HIS) conducted by National Statistical Office (GEOSTAT) on an annual basis; Study looked at trends in household catastrophic health spending during 2006-2010 among different population groups. The purpose of the study was to look at population level impact of the Government’s health financing reforms initiated in 2006/07 and aimed at providing state subsidized health insurance to extremely poor.

    See the full report of the study.

  • Prices, Availability and Affordability of Medicines in Georgia-the New Study Report Endorsed

    In December 2010 CIF wrapped up the second stage of the study exploring “Price, availability and affordability of medicines in Georgia”.

    The study aimed at increasing awareness of civil society and improved access to medicines for the population through strengthening respective evidence. Field works during the first stage of the study were conducted in December 2009, while the second phase in July 2010. During the second phase the research covered four Georgian regions involving 146 pharmacies.

    The present report “Price, availability and affordability of medicines in Georgia” attempted to obtain reliable data on these aspects and documents tendencies of change over the course of 6 months in 2010. The survey looked at availability and price of Innovative Brands and their equivalent low price generics, analyzed collected data by type of medicine, regional differences as well as by type of pharmacy. The survey also looks at medicine mark-ups and compares with mark-ups in European countries, measures affordability of standard treatments as percent of average subsistence monthly allowance and provides comparison of the standard treatments by innovative brands and equivalent low price generics. Though the study has not covered all therapeutic categories, these do not detract from the importance of the above results as basis for action and as baseline for future studies.