International Journal of Preventive Medicine (Int J Prev Med)2008-7802164202509072130EN1Student Research Committee, Faculty of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran, 2 Metabolic Liver Disease Research Center, Isfahan University of Medical Sciences, Isfahan3 Department of Pharmaceutics, Faculty of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd4 Department of Clinical Pharmacy, Faculty of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd5 Department of Community and Family Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan20250811<p>Background: The Health System Transformation Plan (HSTP) in Iran aimed to enhance universal health coverage through improved access and reduced out‑of‑pocket payments. However, rising healthcare expenditures have posed challenges. The Diagnosis‑Related Groups (DRG) payment system has been implemented in developed countries to reduce costs, improve efficiency, and enhance service quality. This study estimates the potential cost savings in pharmaceutical and inpatient services within the HSTP framework, focusing on public hospitals affiliated with Isfahan University of Medical Sciences (MUI). Methods: This study was conducted in three stages. First, a cross‑sectional study design was used to collect current inpatient and pharmaceutical costs from public hospitals affiliated with MUI before and after the health sector reform. Second, a meta‑analysis was conducted to determine the effects of implementing the DRG payment system on the costs of inpatient and pharmaceutical services. Finally, the possible costs of medication and hospitalization in 2015 were estimated by applying the annual inflation rate. The predicted costs were calculated by multiplying the impact values of the DRG payment system on the estimated expenses in 2015. The potential cost savings were calculated by subtracting the current expenses from the predicted expenses based on the DRG payment system. Results: Based on the assumption ratio of changes following the implementation of the DRG payment system, the study estimated cost savings of $60,282,055 in both inpatient and pharmaceutical expenses. Conclusions: Implementing the DRG payment system could have resulted in significant cost savings, equivalent to 9.2% of the total health sector expenditures of MUI.</p><p><span class="ej-journal-name" style="box-sizing: inherit; font-style: italic; font-weight: 500; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">International Journal of Preventive Medicine<span> </span></span><span id="ej-journal-date-volume-issue-pg" style="box-sizing: inherit; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"><a style="box-sizing: border-box; color: #005b92; text-decoration: none; background-color: transparent; cursor: pointer; outline: 0px;" href="https://journals.lww.com/ijom/toc/2025/04240">16():22, April 2025.</a></span><span style="box-sizing: inherit; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"><span> </span>|<span> </span></span><span class="ej-journal-doi" style="box-sizing: inherit; font-style: italic; font-weight: 500; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">DOI:<span> </span></span><span style="color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">10.4103/ijpvm.ijpvm_359_23</span></p><p style="margin: 1em 0px; color: #000000; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 12px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Corresponding Author: Dr. Reza Khadivi</p><p style="margin: 1em 0px; color: #000000; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 12px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">E‑mail:khadivi@med.mui.ac.ir</p><p style="margin: 1em 0px; color: #000000; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 12px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">You can also search for this author in: <a title="PubMed" href="https://pubmed.ncbi.nlm.nih.gov/?term=%28Reza+khadivi%2C%5BAuthor%5D%29+AND+%28Isfahan+University+of+Medical+Sciences%5BAffiliation%5D%29">PubMed</a> <a title="Google Scholar" href="https://scholar.google.com/citations?user=1MwsyQQAAAAJ&amp;hl=en">Google Scholar</a></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2991http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2991/717718832