Assessment of Influential Variables in the Pricing of Locally Manufactured Pharmaceuticals: Current Challenging Situation in Iran.

The lack of transparency and predictability seems to remain one of the major complaints in the pharmaceutical pricing procedure in Iran, but there is not enough official evidence to support it. The main objective of this study was to identify influential variables officially or unofficially influencing the pharmaceuticals pricing in Iran and also clarifying the degree of importance of each variable from the viewpoints of two groups: the pricing Commission members (owners of pricing procedure) and other stakeholders in the pharmaceutical sector. Semi-structured interviews with experts were performed to extract the influential variables. A Likert scale questionnaire was designed based on extracted variables and used in above-mentioned two groups of experts. The validity and reliability of the questionnaire were assessed before use. About 68 influential variables were extracted which classified into eight categories or domains. Less than 50% of extracted influential variables on pharmaceutical pricing have been mentioned in Iran pricing regulations. There were statistically significant differences between the two group's viewpoints in terms of importance and effect of some variables on pricing procedure. Conflict of interest, lack of transparency and a sound framework were found as the main problems in Iran pharmaceutical pricing procedure and may lead to "case-by-case" decision making. As such, the output of the pricing commission is not transparent and predictable for its beneficiaries.