فهرست نشریات علمی دسترسی آزاد ایران

Background and Objectives: Iran’s pharmaceutical sector has faced persistent challenges in ensuring equitable access, affordability, and supply continuity—exacerbated by sanctions and macroeconomic instability. In 2022, the government launched the Darooyar plan to reform drug subsidies, shifting from subsidized foreign exchange to insurance-based reimbursement. This study explores the historical evolution of pharmaceutical policy in Iran and identifies key barriers in the implementation of Darooyar.   Methods: A mixed-methods approach was used. First, a scoping review of academic literature, policy documents, and official reports from 1979 to 2024 was conducted to trace long-term policy trends. Second, a qualitative study was carried out, including 18 semi-structured interviews with policymakers, insurance officials, pharmacists, health experts, researchers, and patients to examine the implementation process and its challenges, with interview data analyzed using thematic analysis.   Results: The historical analysis revealed four main policy patterns: state-driven pricing, prolonged subsidy dependency, economic volatility, and fragmented governance. Interview findings highlighted five major challenges to Darooyar’s execution: limited coordination among institutions, financial liquidity problems for manufacturers, increased cost pressures on providers, rising out-of-pocket expenses for patients, and insufficient digital infrastructure for monitoring and oversight.   Conclusion: Although Darooyar represents a significant policy shift, its impact has been constrained by entrenched structural and operational barriers. To enhance reform effectiveness, Iran must prioritize intersectoral coordination, stabilize insurance financing, invest in integrated digital systems, and align pharmaceutical governance with broader health system goals. A strategic, system-oriented approach is essential to achieve equitable and sustainable access to medicines.