The July/August issue of Health Affairs, the leading U.S.-based health policy journal, focuses on China and India. The special issue includes an article on China’s pharmaceutical policy by five contributors to Prescribing Cultures and Pharmaceutical Policy in the Asia-Pacific, a book forthcoming in 2009 from the Shorenstein Asia-Pacific Research Center series with Brookings Institution Press. Chapters on Korea and Japan by Soonman Kwon (Seoul National University) and Toshiaki Iizuka (Aoyama Gakuin University) also appear in Chinese translation in the journal Bijiao (Comparative Studies), along with an overview paper (“Pharmaceutical policy reforms to separate prescribing from dispensing in Japan and South Korea: Possible implications for China”) by Karen Eggleston, Asian Health Policy Program Director.

As Eggleston writes in the introduction to Prescribing Cultures, pharmaceuticals and their regulation play an increasingly important and often contentious role in the health care systems of the Asia Pacific.  For example, some economies such as China have extraordinarily high drug spending as a percentage of total health spending; India and a few others host thriving domestic pharmaceutical industries of global importance, while controversy surrounds patents, trade-related aspects of intellectual property (TRIPS), and pharmaceutical pricing within bilateral trade agreements (Australia-US, Republic of Korea-US); nations throughout the region struggle with appropriate regulation of drugs, from patents to evidence-based purchasing (e.g., Australia’s Pharmaceuticals Benefit Scheme) and direct-to-consumer advertising; deeply-rooted traditions of indigenous medicine are modernizing and integrating into broader health care systems; and policies to separate prescribing and dispensing re-write the professional roles of physicians and pharmacists, with modifications to accommodate cultural norms and strong economic interests. Effective prescribing and pharmaceutical use will be central to controlling infectious diseases, both old and emerging; protecting the global public good of antimicrobial effectiveness; and treating the growing burden of chronic disease in the Asia Pacific.

The forthcoming book will explore these issues in detail, through a multi-disciplinary lens. The first section of the book features chapters on pharmaceutical policy within seven selected health care systems of the Asia Pacific: South Korea, Japan, Thailand, Taiwan, Australia, India, and China. The second section focuses on the cross-cutting themes of prescribing cultures and access versus innovation. Taken as a whole, the contributions aim to provide an evidence base for policy while acknowledging the historical and cultural context that makes policies distinctive.

Clear evidence suggests the importance of health service provider payment incentives for achieving efficiency, equal access, and quality, including attention to primary, secondary, and tertiary prevention. “Pay for performance” may be on the cusp of significant expansion in Asia, and reform away from fee-for-service has been underway for several years in several economies. Yet despite the policy relevance, the evidence base for evaluating payment reforms in Asia is still very limited.

China in particular has been undertaking significant reforms to its health care system in both rural and urban areas. With the expansion of insurance coverage and need to resolve incentive problems like “supporting medical care through drug sales,” there is an urgent need for evaluating alternative ways of paying health service providers. Evidence from policy reforms in specific regions of China, as well as other economies of the Asia-Pacific, can provide valuable evidence to help inform policy decisions about how to align provider incentives with policy goals of quality care at reasonable cost.

To illuminate these questions, the Asia Health Policy Program and several collaborating institutions are planning to convene a conference on health care provider payment incentives on November 7-8, 2008 in Beijing. The conference will highlight and seek to distill “best-practice” lessons from rigorous and policy-relevant evaluations of recent reforms in China and elsewhere in the Asia Pacific.

The organizing committee – including health economists from Shorenstein APARC, Peking University, Tsinghua University, and Seoul National University – reviewed submissions in June 2008 and accepted sixteen. The conference papers cover payment issues in Korea, Japan, China, Taiwan, Thailand, Tajikistan, the Philippines, and the US, and the disciplines of economics, health services research/health policy, public health, medicine, and ethics. Topics include institutionalized informal payments; the impact of global budget policies on high-cost patients; public-private partnerships; public-sector physicians owning private pharmacies; evidence-informed case payment rates; payment and hospital quality; bonuses and physician satisfaction; physician prescription choice between brand-name and generic drugs; and differences in pharmaceutical utilization across insurance plans that pay providers differently (fee-for-service versus capitation).

Policymakers from China’s National Development and Reform Commission and Ministry of Health will also speak at the conference. Selected research papers will be published through the Shorenstein Asia-Pacific Research Center either in a special volume or in a special issue of an English-language health policy journal.

The Asia Health Policy Program of the Shorenstein Asia-Pacific Research Center invites scholars from multiple disciplines to join the Asia-Pacific Health Policy Forum (APHPF) by creating your own account on our website.  Your information will be saved in our online database, searchable by name, country or region of focus, discipline, and topic.  

The mission of the Asia-Pacific Health Policy Forum (APHPF) is to serve as a resource for social science research, teaching, and evidence-based policymaking about health and healthcare in the Asia-Pacific region. 

Specifically, APHPF aims to

• encourage collaboration among social scientists doing research on health policy in the Asia-Pacific region;
• serve as a resource for teaching about health and healthcare in specific countries and regions within the Asia-Pacific;
• provide analysis to inform policy, by offering a forum for rapid dissemination of policy-relevant research results, as well as by linking organizations, programs, conferences and white papers about specific health policy issues; and
• raise awareness and foster dialogue among researchers, policymakers, and business about cross-cutting themes and global challenges of health and healthcare access, quality, and cost, within the specific historical and cultural contexts of the diverse nations of the Asia-Pacific. 

We encourage all researchers with an interest in health and healthcare in the Asia-Pacific to create an account and to submit information about upcoming conferences and sessions within larger disciplinary conferences that focus on any aspect of health policy in the Asia-Pacific to the Forum coordinator, Karen Eggleston. 

There are no membership dues, as the Forum is currently supported by the Asian Health Policy Program of the Shorenstein Asia-Pacific Research Center at Stanford University.

The Asia-Pacific Health Policy Forum represents a multidisciplinary effort to build organizational linkages and work toward developing an Asia-Pacific parallel to the European Observatory on Health Systems and Policy.

With your help, the APHPF can develop into a vibrant resource and networking support for all of us seeking to understand and improve health and healthcare systems in the region.

The Asian health policy program is pleased to announce that a conference on "Provider Payment Incentives in the Asia Pacific" will be held November 7-8, 2008, at the China Center for Economic Research at Peking University in Beijing, P.R. China.

Organizers of the conference include health economists at the Shorenstein Asia-Pacific Research Center at Stanford University; the China Center for Economic Research at Peking University; Tsinghua University School of Economics and Management Department of Economics; and Seoul National University School of Public Health.

We welcome empirical and theoretical research analyzing how reimbursement incentives shape health and healthcare behavior in the economies of the Asia Pacific. We especially welcome evaluations of policy reforms and natural experiments impacting health service provider incentives. The papers can examine payment incentives in one country, region, or healthcare setting, or include comparative analysis of two or more regions in the Asia Pacific.

Please email papers or extended abstracts (about 500 words) to Karen Eggleston. The submissions deadline is June 1, 2008. The selection committee will notify authors by July 1, 2008.

We also encourage inquiries from researchers that may have access to relevant payment reform data but are interested in support regarding their research design or analytic methods. We will work with you to identify appropriate collaborators and possible financial support for completing the research.

Authors of papers selected for presentation will receive partial subsidy for their participation in the conference as well as opportunity to publish their research in a special volume through the Shorenstein Asia-Pacific Research Center at Stanford University or in a special issue of an English-language health policy journal.

Stanford University's Walter H. Shorenstein Asia-Pacific Research Center is pleased to announce the establishment of a postdoctoral fellowship in comparative health policy for the 2008-09 academic year. The fellowship will support a junior scholar who will conduct research and writing on contemporary health or healthcare in two or more countries of the Asia-Pacific. We welcome applications from scholars from a variety of disciplines, such as sociology, political science, economics, anthropology, public policy, law, health services research and related fields.