Current Issue : July - September Volume : 2013 Issue Number : 3 Articles : 7 Articles
Background: The belief that all new medicines bring a therapeutic innovation and better health outcomes is\r\nwidely shared among the public, health professionals and policy makers.\r\nObjectives: To examine the therapeutic value of new medicines marketed in Australia using two classification systems.\r\nMethods: The therapeutic value of new medicines was categorised using the Motolaââ?¬â?¢s s and the Ahlqvist-Rastadââ?¬â?¢s\r\nsystems for all approvals made by the Australian Therapeutics Goods Administration (TGA) between 2005 and 2007.\r\nScores were assigned independently by the three authors on the basis of the Public Summary Documents and\r\nPrescrireââ?¬â?¢ review articles.\r\nResults: Overall, 217 approval recommendations were made including 81 (37.3%) for new indications and 69\r\n(31.8%) for new medicines. In Motolaââ?¬â?¢s rating system, 31 (52.5%) of the 59 drugs were rated as pharmacological or\r\ntechnological innovations and 28 (47.5%) were rated as therapeutic innovations. Only seven of the 59 drugs (11.9%)\r\nwere rated as important innovations. In Ahlqvist-Rastadââ?¬â?¢s system, only a third of the new drugs were rated as\r\nââ?¬Å?added therapeutic valueââ?¬Â.\r\nConclusion: Only a minority of the new medicines marketed in Australia provide added therapeutic value\r\ncompared to existing treatments. Stricter regulatory approval criteria would ensure better safety of the public and\r\nsimplify the reimbursement processes....
Objective: The aim of this study was to explore Jordanian patients� perceptions toward generic medicines and to\r\nevaluate their opinions regarding generic substitution.\r\nMethod: A cross-sectional descriptive study involving Jordanian patients was undertaken, using a self-administrated\r\nanonymous questionnaire. The response rate was 80% (n=400/500).\r\nResults: The study showed that cost of medicines is high according to 83% of the patients. Most patients (92%)\r\npreferred to be prescribed the cheapest medicine. Majority of patients (79%) believed that cost should be\r\nconsidered before a drug is prescribed. Most patients (78%) accepted generic substitution and believed that it can\r\nprovide significant saving. Surveyed patients (78%) agreed that they should have the option of choosing between\r\ngeneric and originator and 74% believed that physicians should give them that choice. These results showed a\r\nsignificant statistical correlation with the monthly income of the patient, percentage cost they pay and number of\r\nmedicines prescribed (P<0.05).\r\nConclusion: The high cost of medicines in Jordan is believed to be the main driver for choosing generic medicines\r\nFurthermore; patients have positive attitudes towards generic medicines. The involvement of patients in the\r\ntreatment decision would result in more adherence and improvement in health. The insights gained from patients\r\nin this study will be useful to health organisations and policy makers to design a robust generic policy to use\r\nmedicines cost-effectively in Jordan....
Background: Clinicians often encounter information about drug-drug interactions (DDIs) during clinical practice.\r\nThis information is found within product information (hardcopy and electronic) and various electronic systems.\r\nPrescribers may receive medication-related communications in practice that are distributed by facsimile (fax), mail,\r\nor telephone from pharmacies and pharmacy benefit managers (PBMs). The purpose of this study was to determine\r\nif near-real time fax alerts for potential drug-drug interactions (PDDIs) would influence prescribing.\r\nMethods: A prospective study, in cooperation with a pharmacy benefit manager (PBM), was conducted targeting\r\n18 clinically important PDDIs. Fax alerts included an individualized letter to the prescriber with a list of the\r\ninteracting drugs, PDDI evidence summaries with citations, and recommended clinical management strategies.\r\nAmong the 18 PDDIs, 13 PDDIs could be assessed for prescription therapy changes using pharmacy claims data. A\r\nprospective cohort design was used to evaluate changes in prescription dispensing 90-days following a PDDI fax\r\nalert.\r\nResults: A total of 8,075 fax alerts were sent to prescribers and there were 4,712 alerts for the 13 PDDIs that could\r\nbe assessed for change using pharmacy claims data. There were 2,019 patients (interventions) for which fax alerts\r\nwere sent to their prescribers who were matched with a control group consisting of patients with the same PDDIs\r\nbut for whom no fax alert was sent. Overall, this study found 154 (7.6%) of patients in the fax alert group compared\r\nto 132 (6.5%) in the control group had changes in therapy (p = 0.177).\r\nConclusions: This fax alert intervention program observed no statistically significant differences in prescribing with\r\na fax alert compared to the control group. If PBMs chose to send individualized, evidence-based information to\r\nclinicians regarding drug-drug interactions, this study suggests it may not be an effective intervention to mitigate\r\nharm....
Aims: To investigate the consumers� attitudes and intentions to exhibit brand loyal\r\nbehavior of Bangladeshi consumer on over the counter (OTC) drugs.\r\nStudy Design: A cross- sectional survey.\r\nPlace and Duration of Study: Consumers from the five major hospitals (Dhaka,\r\nBangladesh) had been surveyed between January 2012 and June 2012.\r\nMethodology: The study was conducted among 100 OTC consumers in Bangladesh.\r\nData were collected through questionnaire surveys and personal interviews.\r\nResults: The experimental data suggest that direct experience with the product, price\r\nrange and brand reliance are important determinants of repetitive purchase behavior on\r\nOTC drugs. Cost sensitivity had a vital effect on intention to further purchase (r = .02, p\r\n=0.05). Moreover, earlier experience with the brand was critical in determining\r\ntrustworthiness, beliefs, price sensitivity and purchase behavior. The behaviors of OTC\r\nconsumers are influenced by a different set of factors. Previous experience and price\r\nsensitivity is dependent (Chi square = 31.603; p = 0.01. Furthermore, medical experienceand buying an OTC product is dependent and the result were also found significant (Chi\r\nsquare = 32.292; p = 0.01).\r\nConclusion: Present study shows that branding and prior experience remains the major\r\ninfluences to buy an OTC drug in Bangladesh....
Background: The increasing burden of chronic disease is recognised globally. Within the English National Health\r\nService, patients with chronic disease comprise of half of all consultations in primary care, and 70% of inpatient bed\r\ndays. The cost of prescribing long-term medications for those with physical chronic diseases is rising and there is a\r\ndrive to reduce medicine wastage and costs. While current policies in England are focused on the latter, there has\r\nbeen little previous research on patient experience of ordering and obtaining regular medication for their chronic\r\ndisease. This paper presents findings from England of a qualitative study and survey of patients and their carersââ?¬â?¢\r\nexperiences of community and primary care based services for physical chronic diseases. Although not the primary\r\nfocus of the study, the results highlighted particular issues around service delivery of repeat prescriptions.\r\nMethods: We conducted 21 qualitative in-depth interviews with 30 patients and family carersââ?¬â?¢ in two Primary Care\r\nTrusts in England. Participants were receiving community based care for diabetes, respiratory, neurological or\r\ncomplex co-morbidities, and ranged in age from 39ââ?¬â??92 years old. We used a broadly inductive approach to enable\r\nthemes around patient experience to emerge from the data.\r\nResults: While the study sought to gain an overview of patient experience, the findings suggested that the\r\nprocesses associated with ordering and obtaining regular medication ââ?¬â?? the repeat prescription, was most frequently\r\ndescribed as a recurring hassle of managing a long-term condition. Issues for patients and carers included multiple\r\njourneys to the surgery and pharmacy, lack of synchrony and dissatisfaction with the length of prescriptions.\r\nConclusion: Much literature exists around medication waste and cost, which led to encouragement from the NHS\r\nin England to reduce dosage units to a 28-day supply. While there has been an acknowledgement that longer\r\nsupplies may be suitable for people with stable chronic conditions, it appears that there is limited evidence on the\r\nimpact of shorter length prescriptions on patient and carer experience, adherence and health outcomes. Recent\r\npolicy documents within England also fail to address possible links between patient experience, adherence and\r\nflaws within repeat prescription service delivery....
India has a high prevalence of diabetes mellitus and the numbers are increasing at an alarming rate. In India alone, diabetes is expected to increase from 40.6 million in 2006 to 79.4 million by 2030. In India, a wide range of outcomes for different groups is buried within the average diabetes prevalence of 8%. Prevalence is only 0.7% for non-obese, physically active, rural Indians. It reaches 11% for obese, sedentary, urban Indians; and it peaks at 20% in the Ernakulum district of Kerala, one of India’s most urbanized states. Among lifestyle factors predicting the incidence of diabetes in India, some are familiar from the West, whereas others turn expectations upside down. The risk factors peculiar for developing diabetes among Indians include high familial aggregation, central obesity, insulin resistance and life style changes due to urbanization. In India very few data available on the prevalence of diabetes and its complications. Furthermore, there were very few studies of the urban / rural prevalence of diabetes and its complications. Pharmacoepidemiolgy Study of Diabetes and Diabetes Induced Complications with Recent Therapeutic Approach in Gujarat designed to answer the above questions. This study was initially planned as a cross-sectional study to evolve later into a prospective follow up study. The study was conducted in 26 districts of Gujarat which divided in four zones. The total sample sizes of 260 doctors were selected from 26 districts. Data of 5403 patients were collected from selected doctors’ clinic with predesigned questionnaires. The study was conducted in two phases. Phase one epidemiology study of diabetes, phase two study of diabetes with their complications. Among diabetic patients with complications, type 2 diabetes mellitus (89.98%) was found more prevalent than type 1 diabetes mellitus (10.02%) in Gujarat state. In type-1 diabetic patients, complications were found more prevalent in age more than 60 years (5.50% of total diabetic patients and 54.86% of total type-1 diabetic patients) while in type-2 diabetic patients, complications were found more prevalent in age from 41 to 60 years (49.33% of total diabetic patients and 54.82% of total type-2 diabetic patients). In our study the prevalence of type 2 diabetes was shifted in young age of study populations. Among the various complications prevalence of hypertension (70.5%) as a single complication was found more common than CHD (3.6%), heart failure (4.4%), renal dysfunction (3.3%), neuropathy (5.9%), stroke (2.3%), retinopathy (3.4%), and nontraumatic lower limb amputations (6.6%). This showed that the hypertension is the major complication in diabetic patients compared to other complications in different territories of Gujarat state. For treatment of diabetes drugs like combination of Sulphonylurea with Biguanides were found to be prescribed more in Gujarat than single drugs. For the treatment of high blood pressure in diabetic patients ACE inhibitors were found more commonly prescribed than AT1 receptor antagonist, calcium channel blocker, beta blocker and diuretics. More interestingly in present study the diabetic patients were found to follow regular meditation/yoga with allopathic treatment. There are various therapies available for diabetes and diabetes induced complications but overall, they are not sufficiently control diabetes induced complications in a better way. Patients’ awareness and education regarding diabetes and its complications must be necessary in the society. If diabetes is properly controlled with therapeutic and non-therapeutic approach then it may also reduced the complications and treatment cost of diabetes and diabetes induced complications....
Equations are changing in Indian pharmaceutical houses like never before especially after closing down or waning of much-talked about reverse engineering in biggest democracy of the world. Being a signatory country in GATT, India is bound to follow rules in treaty. Pipeline may yield some fruitful drug candidates in coming years, but so far drug discovery scenario in India is not commendable. Recently, using compulsory license provision, Hyderabad based Natco pharma got success in launching generic version of Nexavar (Nexavar is manufactured by Bayer HealthCare AG, Leverkusen, Germany for Bayer Pharmaceuticals Corporation, West Haven, Conn. and by Onyx Pharmaceuticals, Inc., Emeryville, California) and made history by becoming the first pharma industry in India to make use of compulsory license by state intervention. This article will take reader through various provisions of compulsory license, legal battle besides ramification of this ruling of Indian court in the favour of Natco pharma....
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