Introduction
This report has been prepared by NERA Economic Consulting for the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA).  It reviews recent experience in health care reform, placing particular emphasis on the ways in which getting incentives right contributes to successful reform, and how implementing weak or inappropriate incentives jeopardises the benefits of reform.  It is not intended to provide a comprehensive survey of recent health care reform.  Rather, it illustrates the effects of incentives through a diverse selection of case studies, drawing on the experience of eighteen countries.

Defining successful reform
Our report builds on previous work for the IFPMA which reviewed experience with health care reform and developed criteria against which health care systems' performance could be measured.   We use the experience from our case studies to show how incentives contribute to attaining these Global Principles for Better Health Care, which are:

• Fair access: Access to essential health care services and the contributions of individuals towards the cost of these services should be in line with the views of society about fairness.

• Efficiency:  The health care system should deliver the maximum improvement in health outcomes given the available resources.

• Responsiveness to society:  Services delivered and the level of funding should reflect citizens' views, based on high quality information.

• Innovation:  The health care system should encourage appropriate product, diagnostic, therapeutic, administrative and contracting innovation and its optimal application.