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Regulatory Intervention: Regulatory


Any intervention that aims to change health services delivery by regulation or law.


Two high quality reviews (Aaserud, Green) were identified. From the Aaserud review, a mix of immediate effects were observed on the total use of drugs in the reference group. The inception of reference pricing led to immediate increases in the use of reference drugs, decreases in the use of cost share drugs, and decreased but long-standing effects for both at short-term follow-ups. Relatively few studies were identified for other cost containment comparisons, and mixed results were observed for the effect of reference pricing on appropriate care outcomes. Insufficient evidence was found to determine the effect of index pricing on cost containment. In the Green review, the authors reported that changes to reimbursement policy likely had an effect on drug use outcomes, however we were unable to reliably determine the specific impact on prescribing behaviour as defined in this project as the outcomes were difficult to interpret as described in the review.

Summary of Overall Findings from Reviews

2 reviews evaluated the effectiveness of regulatory interventions were identified and both were assessed as being of high quality.

Summary of Findings Related to Prescribing

No high quality or key reviews with a sufficient number of studies to draw conclusions about prescribing outcomes were identified.

Reviews listed as "Summary Pending" will be analyzed, summarized and reported at a later date.

The findings will then be incorporated in the overall evidence summaries of the interventions they address.

Reviews Addressing This Intervention Quality Assessment Tool:
AMSTAR Score (of 11 points)
Aaserud M, Dahlgren AT, Kosters JP, Oxman AD, Ramsay C, Sturm H. Pharmaceutical policies: effects of reference pricing, other pricing, and purchasing policies. Cochrane Database of Systematic Reviews 2006 2:CD005979. 10 (High)
Green C, Maclure M, Fortin P, Ramsay C, Aaserud M, Bardal S. Pharmaceutical policies: effects of restrictions on reimbursement. Cochrane Database of Systematic Reviews 2010 8:CD008654. 9 (High)
Viswanathan M, Golin CE, Jones CD, Ashok M, Blalock SJ, Wines RC, Coker-Schwimmer EJ, Rosen DL, Sista P, Lohr KN. Interventions to improve adherence to self-administered medications for chronic diseases in the United States: a systematic review. Annals of Internal Medicine 2012 157 (11):785-795. 8
Summary Pending