modest (around 17%) but it is envisaged that in the next 5 years it will be able to produce a significant proportion of the medicines needed by the country, especially for the state sector. Public–private partnerships too have been incorporated and have helped to expand the production capacities and range of medicines subject to regulation by the NMRA.
2.8.4 Health technology assessment There is no specific unit undertaking health technology assessment (HTA) as its primary function. Despite the non-availability of a dedicated unit for HTA, the basic principles are taken into consideration when developing the Essential Drugs List for the country and also in the functions of the Medical Supplies Department for procurement of medicines and vaccines for the country. The MoH and National Authority on Tobacco and Alcohol (NATA) undertook an HTA to make recommendations for increasing the taxes imposed on cigarettes in 2016–2017. There have been a number of proposals to establish an HTA unit under the MoH, but this has not been realized as yet.
2.8.5 Regulation of capital investment There is no formal mechanism for the regulation of capital investments in the state sector. Health development projects are prioritized according to set criteria, though political considerations can also influence these decisions. The resources for capital investments are made available within the annual or longer-term budgetary allocations for the MoH. For private sector investments from sources within the country, there is no formal approval required, while for investments from outside Sri Lanka, the approval of the Board of Investment of Sri Lanka is mandatory.
2.9 Patient empowerment Patient empowerment has emerged as a relatively new paradigm that can help to improve patient health outcomes while lowering the costs of care. The concept seems particularly promising for the management of chronic diseases, because empowering patients can be instrumental in achieving success in managing these conditions. At a time when much medical information can be accessed via the Internet and easily communicated to health-care providers, patients and other experts, empowering patients would enable them to make use of the information and knowledge to achieve better outcomes.
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