Policies and institutional arrangements for rationalizing drug selection and consumption patterns in African healthcare systems

Keeping pharmaceutical expenditures affordable and within national budgets and household incomes (while maintaining or maximizing expected therapeutic effects and health outcomes) requires influencing prices and "volumes", the latter being related to rational selection and use of medicines. Additional benefits of rationalizing drug consumption relate to correcting deadweight losses of treatment resistance and failures, iatrogenic illnesses, drug dependence, and negative healthcare-seeking behavior. This article presents a model-mix approach for rationalizing drug consumption in African nations that recognizes the dichotomy between professionally determined and consumer-driven consumption. The model-mix policy relies on financial and nonfinancial interventions, including those aimed at correcting information asymmetries and failures, for modifying "volumes" of consumption. These interventions will be operated and coordinated by dedicated medicines management agencies in African nations.