Tehran University of Medical Sciences Health Technology Assessment in Action 2645-3835 10 1 2026 05 10 Enhancing Transparency in the Public Pharmaceutical Sector to Reduce Corruption While Increasing Trust: A Policy Brief for a Developing Country 387 387 Yasaman Herandi Department of Pharmacoeconomics and Pharmaceutical Administration, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Hossein Bouzarjomehri National Center for Health Insurance Research, Tehran, Iran 2025 01 07 2025 09 28 Transparency plays a pivotal role in good governance and is a key tool for achieving it. As the pharmaceutical sector is considered a critical component of the health governance framework, evaluating its performance and providing policy recommendations can remarkably contribute to this goal. Therefore, a policy brief was prepared using qualitative data from our previous study that evaluated transparency in Iran’s pharmaceutical regulatory sector. Twenty-one semi-structured interviews were conducted in the mentioned study between November 2016 and July 2017, and its quantitative results have been published previously.  To update the data, current laws and regulations were also reviewed to understand the context in 2024. In addition, the main findings and suggestions of Esfandiari et al (2021)were meticulously reviewed to help improve the recommendations. The policy recommendations derived from the interviewees’ discussions confirmed the necessity of creating and implement more transparent guidelines, enhancing accountability mechanisms, mandating the transparency of clinical trials, establishing evidence-based selection processes, and implementing transparent procurement systems. https://htainaction.tums.ac.ir/index.php/hta/article/view/387 https://htainaction.tums.ac.ir/index.php/hta/article/download/387/223
w, semi-structured interviews, and Delphi method. The scoping review followed the Arksey and O’Malley protocol. Experts were interviewed to adapt global evidence to Iran. Thematic analysis was used to generate and evaluate policy options for managing the conflict of interests in health system payment methods. Moreover, the Delphi process and analytic hierarchy process prioritized these options based on effectiveness, feasibility, economic efficiency, and budget requirements. Results: Overall, 1,031 articles were initially identified, with 22 meeting the inclusion criteria after a rigorous selection process. Three policy options were evaluated, including modified per capita with pay for performance (MPCP4P), modified salary with P4P, and modified fee for service with P4P. MPCP4P emerged as the top choice due to its superior economic benefits and effectiveness. It was revealed that MPCP4P mitigates financial risks for providers while ensuring high-quality care, making it the most suitable option for the country’s payment system. Conclusion: The MPCP4P method, with risk adjustment and quality indicators, reduced conflicts and service reduction in capitation systems. The implementation solution includes determining quality and performance indicators, establishing a risk adjustment framework, and managing referrals. Rigorous oversight and continuous evaluation are also essential. https://htainaction.tums.ac.ir/index.php/hta/article/view/343 https://htainaction.tums.ac.ir/index.php/hta/article/download/343/217