All South Asian countries have some type of regulation of pharmaceuticals, although the resources and level of regulation vary extensively. While a country like India could undertake reforms on its own, and some Indian states have already done so, the situation is more difficult for smaller countries that do not have adequate regulatory infrastructure.
Regional support to evaluate options according to the needs of each country could make it possible to establish common systems that may include quality control,purchasing support, and monitoring drug availability. WHO has already developed a methodology for putting in place regulations and monitoring the availability and prices of drugs, but it needs to be carried
out by countries (Cameron et al. 2009; Niens and Brouwer 2009).
Thus, the rationale for increasing access and affordability of essential medications is that the negotiating power of procurement units would increase (especially in smaller countries), and bulk purchasing would reduce costs and help assure adequate supplies. This approach would be most feasible for neighboring countries with similar health systems and good cross-border collaboration. However, the transaction costs may be significant,29 and would need to be weighed against the benefits.
Establish a Regional Health Technology Assessment Institution to Improve the Comparative Effectiveness of Interventions for NCDs and other Conditions
Although accurate data are scant, Chapter 2 showed that significant resources are spent on NCDs in South Asia. Thus, assuring that these resources have the best chance of achieving the desired outcomes is a high priority. The fast-growing global knowledge base for NCDs is an important asset to help countries channel resources where they will have the largest impact but is not currently be used much by countries. However, there are major challenges in tapping this base.
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