title: Resource allocation and purchasing arrangements to improve accessibility of medicines: Evidence from Iran.
abstract: OBJECTIVE
  The aim of this study was to review the current methods of pharmaceutical purchasing by Iranian insurance organizations within the World Bank conceptual framework model so as to provide applicable pharmaceutical resource allocation and purchasing (RAP) arrangements in Iran.
  
  
  METHODS
  This qualitative study was conducted through a qualitative document analysis (QDA), applying the four-step Scott method in document selection, and conducting 20 semi-structured interviews using a triangulation method. Furthermore, the data were analyzed applying five steps framework analysis using Atlas-ti software.
  
  
  RESULTS
  The QDA showed that the purchasers face many structural, financing, payment, delivery and service procurement and purchasing challenges. Moreover, the findings of interviews are provided in three sections including demand-side, supply-side and price and incentive regime.
  
  
  CONCLUSIONS
  Localizing RAP arrangements as a World Bank Framework in a developing country like Iran considers the following as the prerequisite for implementing strategic purchasing in pharmaceutical sector: The improvement of accessibility, subsidiary mechanisms, reimbursement of new drugs, rational use, uniform pharmacopeia, best supplier selection, reduction of induced demand and moral hazard, payment reform. It is obvious that for Iran, these customized aspects are more various and detailed than those proposed in a World Bank model for developing countries.
authors.affiliation: Department of Health Service Management, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Peivand
authors.initials: P
authors.lastname: Bastani
authors.affiliation: Department of Pharmacoeconomics and Pharma Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Gholamhossein
authors.initials: G
authors.lastname: Mehralian
authors.affiliation: Department of Pharmaceutical Sciences, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Rasoul
authors.initials: R
authors.lastname: Dinarvand
keywords: Insurance organization; Iran; pharmaceutical; resource allocation and purchasing arrangements; strategic purchasing