Welcome to our library! Here you will find IDB publications on Health Technology Assessment (HTA), Health Benefit Plans (HBP), pharmaceutical policy, drugs and medical devices regulation, catastrophic funds, and horizon scanning, among others. We classify our publications into three categories: books, policy documents, and technical notes. 

The collection presented here contains all our English publications. If you would like to access our full collection of publications, please visit the Spanish version of our website by changing the language in the upper right corner of this site.

Two pager: How to improve the impact and sustainability of health projects for the population
According to estimates from the Inter-American Development Bank (IADB), the public health network of Latin American and the Caribbean has an investment deficit of over $150 billion. This deficit corresponds to the uncovered financial needs to guarantee the adequate functioning of infrastructure assets and medical equipment.
How much could Chilean households save by switching to generic medications?
In Latin America and the Caribbean, pharmaceutical expenditure ranges from 8.5% (Costa Rica) to 22.1% (Mexico) of total health expenditure[1]. Governments cover part of this expenditure, but in many countries households foot a considerable part of the cost.
¿Cuánto podrían ahorrar y qué ganarían los hogares chilenos usando medicamentos genéricos en vez de sus equivalentes de marca?
Notas técnicas
En Chile, el gasto en salud pagado directamente por los hogares el gasto de bolsillo en salud es de 32 por ciento del total, uno de los más altos entre los países de la OCDE. De este gasto, 40 por ciento corresponde a la adquisición de medicamentos. 40 por ciento de los medicamentos ambulatorios a los que accede la población chilena son adquiridos de forma particular en el mercado del retail a través de farmacias privadas. Este trabajo cuantifica cuánto podrían ahorrar los hogares si compraran medicamentos genéricos sin marca en vez de sus equivalentes de marca. Adicionalmente, estima cómo se distribuiría este ahorro por nivel socioeconómico y calcula su costo de oportunidad en términos de gasto de bolsillo y consumo de otros bienes en el hogar. Los resultados indican que existe la posibilidad de sustitución para 29 por ciento del valor del mercado y que el ahorro potencial alcanzaría los 315 millones de dólares anuales. Esto corresponde a un ahorro potencial de 48 por ciento en este segmento. Adicionalmente, para 51 por ciento del mercado no hay sustitutos genéricos disponibles a pesar de que los medicamentos de este segmento perdieron la patente y existen alternativas genéricas con registro sanitario en Chile u otros países. El ahorro potencial de sustituir productos de marca por productos genéricos reduciría 4 por ciento el gasto total en salud de los hogares y 10 por ciento el gasto en medicamentos. Los ahorros son más importantes para hogares con menor nivel educativo entre 12 y 17 por ciento del gasto en medicamentos. Para ilustrar la importancia en términos de otros gastos del hogar, este ahorro permitiría a los hogares con menor nivel educativo pagar cerca de 50 días de transporte por año o más de 2 meses de transporte de días laborales.
Más salud por peso invertido: beneficios potenciales de mejorar la eficiencia en el gasto de salud
Obtener más de nuestro gasto actual en salud es una forma inteligente para mejorar el desempeño del sistema de salud. Eso es particularmente cierto en el contexto actual: los presupuestos son limitados y se proyecta que los gastos en salud aumenten 3% por año en términos reales. Aumentar los retornos del gasto en salud es bueno para los resultados en salud y puede ayudar a argumentar a favor de aumentar el gasto relativamente bajo en salud en la región.
Two pager: Room for improvement: Performance of public hospitals in four LAC health systems
Hospitals are a key component of health systems and health spending in Latin America and the Caribbean. Across the region, hospital care already accounts for about 1/3 of total health spending and it is expected to increase in absolute and relative terms as populations age and medical technology improves. The public sector has a substantial role in providing and paying for hospital services, through ownership and management of public hospitals and through public insurance schemes
Smart health spending: How to make every peso count
Libros y monografías
An aging population, increasing prevalence of chronic diseases, and the global COVID-19 pandemic have intensified demand for more healthcare. However, the health budget is very limited and mobilizing new resources is a difficult challenge. Now more than ever, the Latin American and Caribbean region needs to spend smarter on health. This report presents key concepts, tools, and strategies for making smarter health spending decisions, and guides readers to resources that provide practical examples and detailed explanations.
The hidden costs of high-cost medications: Colombia Case
The hidden costs of high-cost medications: Colombia Case
Two pager: More health per peso invested: potential benefits of improving efficiency in health spending
Getting more for our current spending is a smart way to improve health system performance. That rings especially true in the current context: budgets are tight and health expenditures are projected to increase by 3% annually in real terms. Increasing the returns to health spending is good for health outcomes and it can support the argument for increasing the relatively low spending on health across the region.
What is the Opportunity Cost of Financing High-Cost Drugs? The Case of Colombia
Libros y monografías

We find ourselves in a fortunate yet challenging situation: we have access to more beneficial health technologies than we can afford to finance. However, this increased availability, coupled with an ageing population and epidemiological changes, is straining health spending worldwide. To ensure that higher spending actually maximizes benefits, it is crucial for this growth to be sustainable, to not divert resources from other important investments and to be in line with the goals of the health system. Given limited resources, allocating funds to one technology means forgoing allocation to others. Like many Latin American countries, Colombia grapples with the financial burden of covering high-cost drugssome of which are highly-effective, while others show reduced clinical effectiveness. Each of these drugs carries an opportunity cost in terms of the health gains lost by allocating these resources elsewhere.

To achieve this, we analyzed ten drugs selected based on their significant budgetary impact or high cost per case. These drugs were oncologic, for autoimmune and orphan diseases, and one for diabetes. In Colombia, financing these drugs instead of the best available alternatives results in an additional cost of US$453 million for the duration of treatments for all current recipients. The quality adjusted life years (QALY) provided by these technologies average (per patient and for the duration of the treatments) is less than a year of perfect health (0.73 QALY). Alternatively, if these resources were redirected to expand and enhance existing health system services, the net gain would amount to 88,000 life years in perfect health.

In other words, defunding certain services to finance the ten selected high-cost drugs would result in Colombians losing 88,000 life years of perfect health. In this article, we aim to quantify the opportunity cost of financing high-cost drugs in Colombia

What is the Opportunity-Cost of Financing High-Cost Drugs? The case of the Dominican Republic
Libros y monografías

In the last decades, there has been a remarkable increase in therapeutic innovations, many of which have significantly improved life expectancy and quality of life for populations. However, they have also placed pressure on health systems, increasing the need to prioritize interventions in line with the goals of those systems.

Determining coverage and financing in solidarity-based systems with limited resources is a complex challenge. To make this task easier, analytical methods have been developed over the last two decades to quantify intervention benefits and determine the extent to which an investment provides value in terms of the systems goals, beginning with reducing mortality and improving quality of life.

In this context, the evaluation of health technologies and the economic evaluation of health technologies have played an important role in informing decisions regarding their coverage. Firstly, there is a need to prove the clinical and therapeutic benefits of these technologies (and to quantify them). Secondly, there is a consensus that understanding a technologys value requires evaluating it in the context of all alternative possible uses in the system to the resources it demands. In other words, the additional Benefit must be compared to its opportunity cost, defined as the health benefits foregone by investing resources in that technology instead of another within the system.

This article quantifies the opportunity cost, in terms of population health, of the coverage and purchases of high-cost drugs for the Dominican Republic. After this introduction, in section 2 we present the countrys drug coverage context; in section 3 we discuss the methodology used to estimate the opportunity cost; in section 4 we present the evaluation results; and in section 5 we provide our main conclusions and lessons learned.