Pricing and Reimbursement of the Healthcare System in India - Low Levels of Drug Reimbursement Lead to a High Out-Of-Pocket Expenditure - GBI Research Reports

Pricing and Reimbursement of the Healthcare System in India - Low Levels of Drug Reimbursement Lead to a High Out-Of-Pocket Expenditure

Pricing and Reimbursement of the Healthcare System in India - Low Levels of Drug Reimbursement Lead to a High Out-Of-Pocket Expenditure - GBI Research Reports
Pricing and Reimbursement of the Healthcare System in India - Low Levels of Drug Reimbursement Lead to a High Out-Of-Pocket Expenditure
Published Mar 23, 2012
57 pages — Published Mar 23, 2012
Price US$ 3,500.00  |  Buy this Report Now

About This Report

  
Abstract:

Summary

GBI Research, the leading business intelligence provider, has released its latest research Pricing and Reimbursement of the Healthcare System in India - Low Levels of Drug Reimbursement Lead to a High Out-Of-Pocket Expenditure. It provides a comprehensive overview of the healthcare system, and pricing and reimbursement process in India with a detailed analysis of the different regulatory mechanisms used in India. The report closely scrutinizes the major changes in pharmaceuticals related pricing and reimbursement in the recent past, and the impact these changes will have in the future. The health insurance is responsible for facilitating demand by making high-cost prescription drugs more affordable. Although the per capita income is rising in India, the modest income of most of the population keeps the high cost drugs and medicines out of reach of the majority of the population. Drugs would become more expensive with the enforcement of product patents and so the sales of the expensive drugs depend on the growth and the maturity of the health insurance sector. If the health insurance industry does not mature, the market for patented drugs would experience adverse effects. The next three to five years will see a significant growth and change in the Indian health insurance industry as new insurance players and insurance products respond to the increased demand.

India has a dual system of care: a private fee-for-service based sector where the money is paid Out-Of-Pocket (OOP) by individual households and a tax-based public sector where the providers are salaried. The utilization of insurance under both these systems is partly restricted by the affordability of the individual household and availability of the budget. On the other hand, insurance, as a means of financing, is a far more sophisticated mechanism, requiring a comprehensive understanding of the failures that characterize health insurance markets. Despite the improving health status of the Indian population, healthcare infrastructure in India is far from achieving 100% quality, technology and superior healthcare delivery systems. While the Central Government is limited to family welfare and disease control programs, the state governments are responsible for primary and secondary medical care, with a limited role in specialty care. Looking at the healthcare indicators and the growing prevalence of non-communicable lifestyle related diseases, both the government and private sector realize the need to meet this basic demand. Today, the private sector provides 80 percent of the healthcare service.

Scope

- Detailed study of the healthcare systems and roles of the key insurance players in the drug reimbursement process
- Analysis of the major pricing and reimbursement mechanisms in India.
- Key trends that follow from the recent changes brought about in the pricing and reimbursement mechanism.
- Build an understanding of the possible major challenges brought about by the enactment of changes in the pricing and reimbursement scene in India.

Reasons to buy

- Build understanding of the pharmaceuticals related key pricing and reimbursement mechanisms in India and also specifically in some states of India.
- Optimize your investment through the identification and understanding of the changes in the pharmaceuticals regulatory mechanism in the Indian economy.
- Develop effective business strategies related to new drug launches through the analytical insight gained from key trends in the pricing and reimbursement scene of India.
- Improve negotiations with the government agencies to maximize reimbursement on the drugs by understanding the mechanism.

  
Source:
Document ID
GBIHC196MR
Country
Industry
Format:
PDF Adobe Acrobat
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Sections

TitleStarting PageNumber of Pages
Table of Contents33
  List of Tables51
  List of Figures51
Pricing and Reimbursement in India - Introduction61
  GBI Research Report Guidance61
Pricing and Reimbursement in India - Overview77
  Introduction to Healthcare System in India71
    Healthcare Expenditure Highly Correlated with GDP72
    Estimated Public Health Spending as a Percentage of GDP91
    Health Expenditure per Capita91
    Out-of-Pocket Health Expenditure as a Percentage of Private Expenditure on Health101
    Demographics by Age101
  Public Healthcare System111
    Drug Distribution in the Public Sector121
  Private Healthcare System121
  Rationale for Drug Use in the Healthcare Facilities131
Pricing and Reimbursement in India- Overview of Pharmaceutical Regulations in India143
  PEST Analysis of the Pharmaceutical Industry in India141
  Regulatory Bodies in the Indian Pharmaceutical Sector151
    National Pharmaceutical Pricing Authority (NPPA)151
    Drug Prices Control Order (DPCO)161
    The Pharmaceutical Policy, 2002161
Pricing and Reimbursement in India- Pricing of Drugs1720
  Introduction171
    Price Registration Process in India181
    International Price Comparison191
      Value-Based Pricing191
      Reference Pricing201
  Price Setting Procedures211
    Essential Drugs List (EDL) Pricing213
    Pricing Methodology for the Essential Drugs241
    Factors Determining the Pricing of the Drugs251
    Criteria for Selection of Drugs for Price Control261
  Pricing of Formulations271
  Annual Price Adjustments281
  Distribution of the Price Reduction Under National Pharmaceuticals Pricing Policy 2011291
  Branded Generics Share301
    India-Specific Pricing311
    Pricing Approach to Patented Drugs321
      Selection of the Comparator Countries331
      Important Considerations while Fixing the Prices of the Patented Drugs331
    Pricing of the Orphan Drugs341
      Global Approach for Orphan Drug Development351
      Introduction of the Sales Ceiling and Flexible Market Exclusivity351
    Introduction of the Jan Aushadhi Shops361
Pricing and Reimbursement in India - Reimbursement Scenario in India3716
  Introduction371
  Health Insurance381
    Central Government Health Scheme391
    Employees State Insurance Scheme391
  Medical Reimbursement in India401
    Reimbursement Plans of Major Insurance Players401
      Oriental Insurance Company Limited401
      National Insurance Company Limited411
      New India Assurance Company Limited421
      Birla Sun Life Insurance431
    Private and Public Sector Insurance Companies in India431
  Reimbursement Policies in Other Countries441
  Out-of-Pocket (OOP) Expenditures451
    Co-Payment461
    Out-of-Pocket Expenditures in India471
    Comparison of OOP Expenditures481
    Irrational Drug Usage481
  Universal Health Care492
  Trends in Drug Reimbursement Policies511
    Health insurance Scenario in India521
    Challenges in Health Insurance521
Pricing and Reimbursement in India - Conclusion531
Pricing and Reimbursement in India - Appendix544
  Market Definitions541
  Abbreviations541
  Research Methodology543
    Coverage541
    Secondary Research551
    Primary Research551
      Overview551
      Overview of Pharmaceutical Regulations in India561
      Pricing of Drugs561
      Reimbursement Scenario in India561
    Expert Panels561
  Contact Us561
  Disclaimer561
  Sources571

Table Of Contents

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Cite this Report

  
MLA:
GBI Research Reports. "Pricing and Reimbursement of the Healthcare System in India - Low Levels of Drug Reimbursement Lead to a High Out-Of-Pocket Expenditure" Mar 23, 2012. Alacra Store. May 11, 2025. <http://www.alacrastore.com/storecontent/GBI-Research-Reports/Pricing-and-Reimbursement-of-the-Healthcare-System-in-India-Low-Levels-of-Drug-Reimbursement-Lead-to-a-High-Out-Of-Pocket-Expenditure-2115-384>
  
APA:
GBI Research Reports. (2012). Pricing and Reimbursement of the Healthcare System in India - Low Levels of Drug Reimbursement Lead to a High Out-Of-Pocket Expenditure Mar 23, 2012. New York, NY: Alacra Store. Retrieved May 11, 2025 from <http://www.alacrastore.com/storecontent/GBI-Research-Reports/Pricing-and-Reimbursement-of-the-Healthcare-System-in-India-Low-Levels-of-Drug-Reimbursement-Lead-to-a-High-Out-Of-Pocket-Expenditure-2115-384>
  
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