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To review the importance of evidence-based methods in health insurance reimbursement for achieving universal health coverage in India. A narrative literature review was performed. The out-of-pocket (OOP) healthcare expenditure in India is among the highest in the world. This situation is despite the implementation of numerous government health schemes and the availability of a large number of health insurance programs, both public and private. Compromised quality of care in many public healthcare facilities is a major factor driving the average Indian citizen to increasingly depend upon private healthcare facilities, further escalating OOP spending. The low awareness and poor uptake of insurance policies among Indians is one of the biggest challenges in the implementation of universal health coverage (UHC) in India. The catastrophic burden of high OOP expenses on individual households could be reduced by taking steps to enhance health insurance uptake, which can be in turn achieved by strengthening the healthcare reimbursement system in India. The application of the principles of evidence-based healthcare for reimbursement requires the systematic assessment of all health technologies, which is already being done in developed countries. The enactment of health schemes such as Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana and setting up of Health Technology Assessment in India are steps toward reducing OOP expenditure and achieving UHC in India. We review the importance and challenges of evidence-based reimbursement and health technology assessment toward achieving UHC in India. • Indian households bear a high out-of-pocket expenditure on healthcare in India. • Introducing evidence-based reimbursement and health technology assessment would encourage the insurance uptake. • This would reduce the expenditure and improve the access to quality healthcare. • By launching the Ayushman Bharat public health insurance and assurance scheme, and by setting up Health Technology Assessment in India, the country is taking bold steps for providing universal health coverage to its citizens. [ABSTRACT FROM AUTHOR]

Most countries recommend that their healthcare personnel be vaccinated against influenza in order to protect themselves as well as their patients. However despite the strong scientific rationale, recommendations and advocacy from health organizations, influenza vaccination coverage among healthcare personnel remains low. This has been attributed to various obstacles and a range of strategies have been implemented to increase uptake with varying levels of success. To highlight the vaccination coverage, beliefs, and obstacles among healthcare personnel in India and to discuss strategies that can be implemented to improve influenza vaccination coverage. Various barriers are responsible for the low influenza vaccination coverage among Indian healthcare personnel. Many interventions are being practiced, but they need to be multidimensional keeping in mind that healthcare personnel value their autonomy in making decisions about vaccinations. • In 2018 (ie, the centenary year of the influenza pandemic), the world, including India, was burdened with significant mortality and morbidity due to influenza. • Evidence suggests healthcare personnel are a high-risk population. • Despite an array of attempted strategies, vaccination coverage among healthcare personnel has been observed to be low. • To improve this situation, several policies can be implemented, such as generating awareness to increase vaccination acceptance rates, vaccinating healthcare personnel on a priority basis, training them periodically, and increasing availability and access to vaccines. [ABSTRACT FROM AUTHOR]

Most of the industrial sectors of India have undergone major changes in the post-liberalization period. During this period, India has become self-reliant in drugs; however, still, 75% of the medical devices are imported in India. According to WHO, almost all devices present in the developing countries have been designed for use in the industrialized countries. With the increase in incidence of non-communicable diseases and decrease in communicable diseases; increase in survival rates and decrease in mortality rates, and increase in ageing population, the healthcare demands have changed in the last decade. In addition to these parameters, aware patients and healthcare professionals, requirement of achieving national targets of healthcare and close proximity to the developed world, is giving a push to the development of indigenous medical device industry. However, the rules and regulations governing medical devices are ambiguous and vague. The Health Ministry of India has notified Medical Devices Rules, 2016, for regulating manufacturing/import/sale/clinical investigation and other related matters concerning medical devices. In addition, the government is funding the start-up industries in medical devices sector. Furthermore, government has taken the initiative of inverted duty structure in India. Also, special med tech zones are being set-up, which will enhance the production at local levels for the local population and will also generate employment for local people. [ABSTRACT FROM AUTHOR]

Health economic studies provide information to decision makers for efficient use of available resources for maximizing health benefits. Economic evaluation is one part of health economics, and it is a tool for comparing costs and consequences of different interventions. Health technology assessment is a technique for economic evaluation that is well adapted by developed countries. The traditional classification of economic evaluation includes cost-minimization, cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis. There has been uncertainty in the conduct of such economic evaluations in India, due to some hesitancy with respect to the adoption of their guidelines. The biggest challenge in this evolutionary method is lack of understanding of methods in current use by all those involved in the provision and purchasing of health care. In some countries, different methods of economic evaluation have been adopted for decision making, most commonly to address the question of public subsidies for the purchase of medicines. There is limited evidence on the impact of health insurance on the health and economic well-being of beneficiaries in developing countries. India is currently pursuing several strategies to improve health services for its population, including investing in government-provided services as well as purchasing services from public and private providers through various schemes. Prospects for future growth and development in this field are required in India because rapid health care inflation, increasing rates of chronic conditions, aging population, and increasing technology diffusion will require greater economic efficiency into health care systems. [ABSTRACT FROM AUTHOR]

In an attempt to reduce costs of clinical trials and increase recruitments, pharmaceutical companies have been shifting their trials to offshore locations in Asia, Africa, the Middle East, Eastern Europe, and Latin America. Hence, methods for conducting clinical trials need to be adapted to the varying languages, cultures, ethnicities, and socioeconomic groups of these regions. This is of prime importance in the collection of patient-reported outcome (PRO) data. To ensure correct capturing of PRO data from multiregional sites, it is important that the tools for data collection are adapted to the respective cultures, and the data collected have the same interpretation across cultures (cross-cultural equivalence). This article deals with challenges involved in the adaptation of PRO measures to various cultures, especially of those used for multiregional trials being conducted in the developing world. [ABSTRACT FROM AUTHOR]