Kanavos, Panos 
ORCID: 0000-0001-9518-3089 and Wouters, Olivier J. ORCID: 0000-0002-2514-476X
(2014)
Pharmaceutical policies in Cyprus: a review of the current system and future options.
.
World Health Organization, Copenhagen, Denmark.
Abstract
The pharmaceutical market in Cyprus is characterised by several country- and system specific peculiarities and challenges, including: • Small market size; • The system of external price referencing (ERP) does not enable the country to capitalise on transaction prices in reference countries; • The absence of a health insurance scheme and the resulting absence of a suitable reimbursement system does not allow the country to exercise any form of market power; this may lead to inequities in access and expose citizens to undue financial and health risks; • There are no mechanisms in place to monitor and control the prescribing behaviour of physicians; coupled with brand awareness, this likely encourages the over-prescribing of expensive, on-patent products; • There do not appear to be any limits on promotional activities by manufacturers and distributors or any self-regulating practices (such as a code of practice), potentially incentivising providers to induce demand; • The pharmacy remuneration structure and the absence of generic substitution favour the dispensing of expensive products; • For patients, there is little cost-sharing in the public sector, whereas drug costs are borne out-of-pocket in the private sector. A World Health Organization (WHO) mission to study the current system of pharmaceutical pricing and coverage decisions resulted in a series of recommendations. Chronologically, these have been divided into three categories: first, interventions for the short-term to refine the way the current system works, aiming to increase its efficiency and economise on resources; second, interventions aiming to address gaps in the organisation and delivery of health and pharmaceutical services in anticipation of the introduction of a general health insurance scheme (GeSY); and, third, interventions aiming to ensure the sustainability of health and pharmaceutical care provision following GeSY implementation.
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