Designing, implementing and evaluating the economic impact of the new distribution policy of medicines for hemophilia patients covered by the General Health Insurance Department of Tehran Province

As a strategic commodity, medicine has a fundamental role in the economy and health of the family and society. This study was conducted with an action research approach in order to design and implement a comprehensive method to prevent possible abuses and improve the distribution cycle of medicines for hemophilia patients in the Iran Health Insurance Organization of Tehran Province, Iran.

The current research is a qualitative study based on the action research approach. The participation of 12 experts was used to diagnose and explain the problem, choose a solution/create change and analyze the results. The research population included all patients with hemophilia type A and B covered by the Iran Health Insurance Organization of Tehran Province, Iran. Sampling was done by census (n=553). The required data were extracted from the system of hemophilia patients covered by the General Directorate of Health Insurance of Tehran province in 2018 and 2019. The data collection tool was a checklist made by the researcher. The findings were analyzed using Excel software.

The amount of consumption (drug dose) of Factor 7 decreased by 36.4%, Factor 8 by 35.9%, Factor 9 by 52.3%, VONWILLEBRAND by 20.8% and FEIBA by 43.6%. The paid share of Factor 7 organization is 36.4%, Factor 8 is equivalent to 31.3%, Factor 9 is equivalent to 51.1%, VONWILLEBRAND is equivalent to 20.3% and FEIBA is equivalent to 43.4%. The comparison of the costs in two stages before and after the implementation of the program shows the changes of 33.5% - the total costs of the patients Iran Health Insurance Organization of Tehran Province. The most changes (-51.1%) are related to factor 9 and the least related to VONWILLEBRAND (with -20.3%). The expenses of the General Administration show a total decrease of 157,223,071,000 Rials.

Conducting targeted interventions with an action research approach, in addition to helping to correct and improve the management of the drug distribution cycle, will lead to optimal management of resources, improvement of insurance coverage and satisfaction of the insured.