“Budget Impact Analyses”: a practical policy making tool for drug reimbursement decisions

Increasing accessibility and affordability of healthcare services has been considered as an important policy objective since the beginning of 1980s in Iran. However, current 60- 70% health care out-of-pocket payments create a barrier to an equal access to quality health services, especially in terms of new medicines which affects equity issues and "health" in Iran. Currently, health insurance organizations, which are considered the main budget holders or purchasers of medicine and healthcare services, do not consider comprehensive economic evaluations (cost-effectiveness plus budget impact analyses) for their reimbursement decisions. The present study was conducted to introduce a standard Budget Impact Analysis (BIA) model for the first time in Iran. The main purpose was to provide healthcare budget decision makers with a practical tool for improving resource allocation as well as accelerating and facilitating the process of pharmaceutical reimbursement decision making to address the problem of considerable out-of-pocket payments in Iran.International standard guidelines and empirical studies on BIAs conducted over the last decade were reviewed to provide a comprehensive standard model for conducting a satisfying BIA. Furthermore, practical additional examples and recommendations were included in the model to make it as much implementable in developing countries as possible. The final model consisted of general and detailed recommendations which were extracted mainly from ISPOR standard guideline (as a backbone) and other reputable guidelines (e.g. Canadian and Polish guidelines) for BIAs.