Toward an Understanding of High Performance Pharmaceutical Policy Systems: A “Triple-A” Framework and Example Analysis

Drawing on international examples of published policy objectives for national pharmaceutical policies, we propose a framework for gauging system performance on the health-related goals of policy in the pharmaceutical sector. We review basic policy structures and performance indicators for the seven participating countries of the Commonwealth Fund"s 2007 International Health Policy Survey. We explore performance on three inter-related objectives that support overarching health goals: promoting the accessibility, appropriateness, and affordability of medicines. Indicators of performance along these dimensions are compared across countries and stratified by age, income and morbidity. Though no country appears uniformly strong in all areas, several appear to have done well to manage sometimes-difficult tensions in the pharmaceutical sector.