Governing drug reimbursement policy in Poland: The role of the state, civil society and the private sector

Piotr Ozieranski, Lawrence Peter King

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

This article investigates the distribution of power in Poland’s drug reimbursement policy in the early 2000s. We examine competing theoretical expectations suggested by neopluralism, historical institutionalism, corporate domination, and clique theory of the post-communist state, using data from a purposive sample of 109 semi-structured interviews and documentary sources. We have four concrete findings. First, we uncovered rapid growth in budgetary spending on expensive drugs for narrow groups of patients. Second, to achieve these favorable policy outcomes drug companies employed two prevalent methods of lobbying: informal persuasion of key members of local cliques and endorsements expressed by patient organizations acting as seemingly independent “third parties.” Third, medical experts were co-opted by multinational drug companies because they relied on these firms for scientific and financial resources that were crucial for their professional success. Finally, there was one-way social mobility from the state to the pharmaceutical sector, not the “revolving door” pattern familiar from advanced capitalist countries, with deleterious consequences for state capacity. Overall, the data best supported a combination of corporate domination and clique theory: drug reimbursement in Poland was dominated by Western multinationals in collaboration with domestically based cliques.

Original languageEnglish
Pages (from-to)577-610
Number of pages34
JournalTheory and society
Volume46
Issue number6
Early online date3 Nov 2017
DOIs
Publication statusPublished - 31 Dec 2017

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drug policy
Poland
civil society
private sector
drug
domination
institutionalism
distribution of power
Social Mobility
persuasion
pharmaceutical
expert
firm
interview
resources
Private Sector
Civil Society
Drugs
Group

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Governing drug reimbursement policy in Poland: The role of the state, civil society and the private sector. / Ozieranski, Piotr; King, Lawrence Peter.

In: Theory and society, Vol. 46, No. 6, 31.12.2017, p. 577-610.

Research output: Contribution to journalArticle

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