Evidence on effectiveness of these policies on reducing prices of, and improving access to, medicines was mixed. Key facilitators were favourable policy environment on essential medicines, strong political will and international support. Key contextual barriers to implementation were limited awareness about policies, lack of regulatory capacity and lack of price transparency in external reference pricing process. Main actors involved were government, wholesalers, manufacturers, retailers, professional bodies, community members and private and public health facilities. These were in four domains: targeted public subsides, regulatory frameworks and direct price control, generic medicine policies and purchasing policies. The results showed thirteen pricing policies were implemented across SSA between 20. Of the 5595 studies identified, 31 met the inclusion criteria. The review followed best practices and reported using PRISMA guidelines. A structured template guided the data extraction, and data analysis followed thematic narrative synthesis. We searched five databases and grey literature screening was done in two stages following clear inclusion criteria. We identified policies and examined implementation processes, key actors involved, contextual influences on and impact of these policies. Therefore, to bridge this knowledge gap, we reviewed published evidence and answered the question: what are the key determinants of implementation of medicines pricing policies in SSA countries? Methods Different medicine pricing policies are implemented to improve affordability and availability however, evidence on the experiences of implementations of these policies in SSA settings appears limited. Many patients with limited resources in sub-Saharan Africa (SSA) are confronted with out-of-pocket charges, constraining their access to medicines.
High medicine prices contribute to increasing cost of healthcare worldwide.
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