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Pharmaceutical policy Part 1 The challenge to pharmacists to engage in policy development

Morrow, Norman C
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em 10/02/2015 EN
Relevância na Pesquisa
46.31%
Across the world medicines are the ubiquitous technology in the diagnosis, treatment and prevention of disease. Pharmaceutical policy, as part of national health care policy, is concerned with the provision and use of medicines. Pharmacists are critical to the medicines management process, yet are often largely detached from policy development. Logically, they should inform Government policies which impact on their work or where their skills could be best applied to implement health care policy and medicines utilisation in particular. It therefore makes it critically important that the pharmaceutical profession engages with national policy makers and in the strategic planning for health care.

Impact of pharmaceutical policy interventions on utilization of antipsychotic medicines in Finland and Portugal in times of economic recession: interrupted time series analyses

Leopold, Christine; Zhang, Fang; Mantel-Teeuwisse, Aukje K; Vogler, Sabine; Valkova, Silvia; Ross-Degnan, Dennis; Wagner, Anita K
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
46.39%
Objectives: To analyze the impacts of pharmaceutical sector policies implemented to contain country spending during the economic recession – a reference price system in Finland and a mix of policies including changes in reimbursement rates, a generic promotion campaign and discounts granted to the public payer in Portugal – on utilization of, as a proxy for access to, antipsychotic medicines. Methodology We obtained monthly IMS Health sales data in standard units of antipsychotic medicines in Portugal and Finland for the period January 2007 to December 2011. We used an interrupted time series design to estimate changes in overall use and generic market shares by comparing pre-policy and post-policy levels and trends. Results: Both countries’ policy approaches were associated with slight, likely unintended, decreases in overall use of antipsychotic medicines and with increases in generic market shares of major antipsychotic products. In Finland, quetiapine and risperidone generic market shares increased substantially (estimates one year post-policy compared to before, quetiapine: 6.80% [3.92%, 9.68%]; risperidone: 11.13% [6.79%, 15.48%]. The policy interventions in Portugal resulted in a substantially increased generic market share for amisulpride (estimate one year post-policy compared to before: 22.95% [21.01%...

Effect of the economic recession on pharmaceutical policy and medicine sales in eight European countries

Leopold, Christine; Mantel-Teeuwisse, Aukje K; Vogler, Sabine; Valkova, Silvia; de Joncheere, Kees; Leufkens, Hubert GM; Wagner, Anita K; Ross-Degnan, Dennis; Laing, Richard
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
46.46%
Abstract Objective: To identify pharmaceutical policy changes during the economic recession in eight European countries and to determine whether policy measures resulted in lower sales of, and less expenditure on, pharmaceuticals. Methods: Information on pharmaceutical policy changes between 2008 and 2011 in eight European countries was obtained from publications and pharmaceutical policy databases. Data on the volume and value of the quarterly sales of products between 2006 and 2011 in the 10 highest-selling therapeutic classes in each country were obtained from a pharmaceutical market research database. We compared these indicators in economically stable countries; Austria, Estonia and Finland, to those in economically less stable countries, Greece, Ireland, Portugal, Slovakia and Spain. Findings: Economically stable countries implemented two to seven policy changes each, whereas less stable countries implemented 10 to 22 each. Of the 88 policy changes identified, 33 occurred in 2010 and 40 in 2011. They involved changing out-of-pocket payments for patients in 16 cases, price mark-up schemes in 13 and price cuts in 11. Sales volumes increased moderately in all countries except Greece and Portugal, which experienced slight declines after 2009. Sales values decreased in both groups of countries...

Exploring the future of the U.S. pharmaceutical industry : a supply chain perspective

Lagarde, Loïc (Loïc Jean Georges)
Fonte: Massachusetts Institute of Technology Publicador: Massachusetts Institute of Technology
Tipo: Tese de Doutorado Formato: 91 p.
ENG
Relevância na Pesquisa
46.27%
This thesis uses an innovative approach to explore the much-analyzed U.S. Healthcare system. To be sure, we are fully aware of the challenges involved in making robust system level policy recommendations and how local inefficiencies and hidden uncertainties undermine attempts proposing sweeping changes. Hence, we propose to investigate the Healthcare system using a supply chain perspective, which is inherently cross-functional and typically involves numerous different stakeholders. This holistic view will force us to think beyond artificial functional boundaries that promote local inefficiencies in the Healthcare system. Since the future is increasingly uncertain, we chose to use the scenario planning technique to guide the research process of developing effective system level policies. We will also leverage our insights to recommend new research directions to investigate the redefined system boundaries suggested by our scenarios. Since a Fortune 50 pharmaceutical company was used as a case study, the research focused primarily on a subset of the U.S. Healthcare system namely the U.S. pharmaceutical industry. The research also benefited from a series of workshops with supply chain executives from a variety of industries.; (cont.) These workshops helped us refine and validate the scenario planning methodology as a tool to think and plan for the long-term future in uncertain times. Furthermore...

Pharmaceutical Reform : A Guide to Improving Performance and Equity

Roberts, Marc J.; Reich, Michael R.
Fonte: World Bank Publicador: World Bank
Relevância na Pesquisa
56.59%
This publication, which is based on the unique methodology and tools developed for the World Bank Institute/Harvard School of Public Health Flagship Course on Health System Reform and Sustainable Financing, provides a powerful set of resources to help policy makers better navigate the complicated process of reforming pharmaceutical systems. Its problem solving approach complements technical resources and training curricula available on the discrete elements of a pharmaceutical sector. The application of the flagship approach to the pharmaceutical sector is both useful and timely. Ensuring the availability of medicines and the effective management of their procurement and distribution is central to the drive to achieve coverage and access to basic health care that is both universal and financially sustainable. Together, the methodology and case materials contained in this publication provide a rich resource from which policy makers in developing countries may draw to guide their efforts to meet these challenges. This book is designed to help participants gain a better understanding of all that goes on in the pharmaceutical sector. As noted above...

A Practical Approach to Pharmaceutical Policy

Seiter, Andreas
Fonte: World Bank Publicador: World Bank
Relevância na Pesquisa
56.58%
This book discusses the wide range of challenges faced by policy makers in the pharmaceutical sector, presents the current know-how in terms of policy measures, and provides specific examples of policy packages that can be used in defined circumstances, even if one assumes a certain degree of political resistance and capacity limits on the side of the implementing agency. This book focuses on developing countries and tries to address the issues faced by both low- and middle-income countries. The book does not cover the vaccines market and its respective policies because too many differences exist between the markets for vaccines and pharmaceuticals to cover both subsectors in one publication of this type. The book ends with an outlook on how things might evolve in the longer term. It assumes that some form of convergence will take place toward "models that work," thus reducing the fragmentation of policies and enhancing regulatory and economic efficiencies over time-one hopes to the benefit of all stakeholders in the sector and...

Private Sector Pharmaceutical Supply and Distribution Channels in Africa : A Focus on Ghana, Malawi and Mali

McCabe, Ariane; Seiter, Andreas; Diack, Aissatou; Herbst, Christopher H.; Dutta, Sheila; Saleh, Karima
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
46.42%
Sustainable access to affordable, high-quality medicines is an important component in all health care systems but remains limited in many African countries. Supply and distribution of medicines are a fundamental aspect of the success of any health system. Disruptions to this supply undermine health outcomes as supply chains have an impact on the availability, cost, and quality of medicines for patients. Common problems associated with the supply and distribution of pharmaceuticals often include poor supply chain management, stock pilfering, insufficient human resources, and limited financing resulting in chronic stock outs. In resource-poor settings where public services fail to meet demand, the private and voluntary sectors are increasingly being called on, prompting some policy makers to consider private mechanisms as alternatives to state-run drug procurement and distribution systems. This study reviews some of the ways in which some countries in Africa organize their private pharmaceutical supply and distribution channels...

Assessment of Governance and Corruption in the Pharmaceutical Sector : Lessons Learned from Low and Middle Income Countries

Diack, Aissatou; Seiter, Andreas; Hawkins, Loraine; Dweik, Imad Subhi
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
46.53%
Pharmaceuticals are a critical input for the health sector. At the same time, the drug business sustains many individual and corporate livelihoods and produces handsome returns for those involved in the trade. Good governance is critical for the sector to maximize returns for public health and minimize risks for patients from ineffective or contaminated drugs. Given the large financial volume of the market, the potential for corruption is significant. Vulnerable points are those at which decisions about market access and purchasing are made. This includes institutional functions such as licensing, inclusion into formularies and public procurement as well as the individual prescriber, who selects drugs for a specific patient. Given the political and institutional resistance against more transparency from the beneficiaries of the status quo, assessment of governance and corruption in the sector is not a straightforward exercise. The authors developed a more indirect approach that relies on a broader assessment of the functioning of the sector and detection of patterns that suggest governance or management problems. From a developmental perspective...

Generic Drug Policies in Latin America

Homedes, Núria; López Linares, Roberto; Ugalde, Antonio
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
46.46%
The World Health Organization and pharmaceutical experts have recommended that Generic Drug Policies be implemented to improve the availability of affordable medicines. This document reports on the status of generic drug policies in Latin America. The data presented are based on several sources: a survey conducted in 2003, archival information, and official health and pharmaceutical policy documents. The survey revealed that countries use different definitions for the terms generic and bioequivalence severely curtailing the ability to make comparisons across countries. There is also ample variability in the periods allowed for drug registration and registration charges. Although most countries in the region are becoming increasingly dependent on pharmaceutical imports, many have sizeable local pharmaceutical manufacturing capacity. The need to adopt common definitions for technical terms, the urgency of improving quality controls and the importance of strengthening generic drug programs are highlighted.

The Indian Pharmaceutical Sector : Issues and Options for Health Sector Reform

Govindaraj, Ramesh; Chellaraj, Gnanaraj
Fonte: Washington, DC: World Bank Publicador: Washington, DC: World Bank
EN_US
Relevância na Pesquisa
46.49%
This report assesses the pharmaceutical sector in India, particularly focusing on four key issues related to the production, procurement, and distribution of drugs in India: a) availability, b) affordability; c) quality, and d) the rational use of drugs. The results of a survey of three states indicate considerable variation across states in the above four areas in both public and private sectors. The report concludes that problems with the availability, affordability, and rational use of good quality, cost-effective, essential drugs have persisted in most parts of India, and that these health-related issues need be addressed as a priority. An overarching recommendation is the need to focus on strengthening the implementation and regulation of the pharmaceutical sector at the state level, rather than on simply introducing new regulations. Adequate pharmaceutical quality assurance needs to be particularly emphasized as, in its absence, other reform measures could be rendered moot. Similarly, the rational use of drugs needs to be emphasized as it is likely to yield significant cost savings to the government and to consumers...

Evaluating pharmaceutical policy impacts using interrupted time series analysis: An Australian case study

Kemp, A.; Preen, D.; Sanfilippo, F.; Glover, J.; Semmens, J.; Roughead, E.
Fonte: Nova Science Publishers, Inc Publicador: Nova Science Publishers, Inc
Tipo: Artigo de Revista Científica
Publicado em //2011 EN
Relevância na Pesquisa
46.36%
Determining the impacts of policy on health outcomes is important for policy makers, clinicians and consumers. Interrupted time series analysis is a powerful quasi-experimental method for quantifying change in an outcome after policy implementation. We illustrate the use of interrupted time series analysis for policy evaluation with an Australian case study. Use of prescription medicines in Australia were examined before and after the implementation of pharmaceutical-subsidy changes. METHODS: Interrupted time series analysis compares longitudinal data, aggregated into time-units, before and after a change-point. A line of best fit is calculated for the period before and after the change-point and the differences in the level (i.e. height) and trend (i.e. slope) of these lines are quantified. In our case study, dispensings of specified medicines in Australia were compared for 60 months before and 33 months after a substantial increase in prescription costs in January 2005. RESULTS: Interrupted time series analysis quantifies level and trend changes occurring after a change-point and indicates when, and for how long, changes occur. Significant change in the level of a series indicates an immediate policy impact while a significant trend change indicates an on-going impact on an outcome. We found significant decreases in the level or trend of dispensings for 12 medicine classes indicating both immediate and on-going declines in use. Declines were largest for low income patients and for medicines used preventatively to treat asymptomatic conditions. CONCLUSIONS: Interrupted time series analysis provides a simple and feasible method of evaluating the impact of already-implemented policies on health outcomes. Findings from the case study...

Starting from Scratch in Timor-Leste : Establishing a Pharmaceutical and Medical Supplies System in a Post-Conflict Context

Huff-Rousselle, Maggie
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Working Paper; Publications & Research
ENGLISH; EN_US
Relevância na Pesquisa
46.43%
This case study analyses the challenges of establishing a pharmaceutical and medical supplies system in a Timor-Leste post-conflict context. In the aftermath of its separation from Indonesia, the Timor-Leste health infrastructure was in total disarray, with more than a third of health facilities destroyed, and those remaining severely damaged. The crisis in human resources was severe, as more than 80 percent of qualified public-sector staff had returned to Indonesia. The resultant heavy dependence on expatriates was complicated by language incompatibility, and nationals were not well integrated into planning and implementation processes, as an entire public sector infrastructure was being established de nouveau. Despite the fledgling status of the public sector, a sophisticated organizational framework was envisioned for the establishment of the health sector supply system: an autonomous agency that would be a non-profit wholesaler or revolving drug fund and a public sector monopoly. The case study reviews the development of the policy and legal framework for the pharmaceutical sector...

The Pharmaceutical Sector of the Western Balkan Countries

Imasheva, Aizhan; Seiter, Andreas
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Working Paper; Publications & Research
ENGLISH; EN_US
Relevância na Pesquisa
46.48%
There is a strong political will in the Western Balkan states to align the region's pharmaceutical legislation and practice with that of the European Union. Accordingly, recent policy changes were aimed at harmonization of policies with other European countries. Several national drug laws were updated or completely re-written in the last several years. More specifically, provisions were made for the simplification of drug registration requirements, licensing of professionals and businesses in the sector, implementation of ethics standards, price controls and reimbursement of drugs through national health insurance systems. Countries in the region have introduced various measures for cost containment, mostly through positive lists with various co-payment levels or expenditure caps for prescribing physicians. Some institutional buyers are using pooled procurement with open tenders to ensure lower prices. Nevertheless, there are still a number of challenges such as lack of enforcement of rules and standards...

Políticas de saúde, desenvolvimento tecnológico e medicamentos : lições do caso brasileiro; Health policies, technological development and drugs : lessons from the Brazilian case

Camila Lins Rodrigues
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 10/02/2012 PT
Relevância na Pesquisa
46.38%
As nações desenvolvidas conseguiram consolidar tanto a construção de Sistemas de Proteção Social, quanto a construção de Sistemas de Inovação. Por um lado, políticas sociais em áreas fundamentais e estratégicas como saúde, educação e previdência ganharam espaço privilegiado em suas agendas de governo. Por outro lado, esses países realizaram processos bem sucedidos de catching up, consolidando suas bases industriais e se tornando líderes mundiais na produção de ciência e tecnologia. Outra realidade, no entanto, vivem os países periféricos. Ao mesmo tempo em que ainda caminham no sentido de construir um Sistema de Proteção Social, com a persistência de problemas sociais graves, esses países também apresentam dependência econômica e atraso tecnológico em relação aos países centrais. No caso específico do Brasil, o setor saúde, representado pelo seu complexo industrial, pode ser um importante componente estratégico para o desenvolvimento simultâneo do Sistema de Proteção Social e do Sistema de Inovação, condição necessária para que o país abandone sua condição periférica. Avanços nas indústrias deste complexo podem, de um lado, trazer benefícios econômicos para o país e, de outro...

Final Report with Recommendations for Reforming Bulgaria’s Pharmaceutical Sector

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Tipo: Report; Economic & Sector Work; Economic & Sector Work :: Other Health Study
ENGLISH; EN_US
Relevância na Pesquisa
56.5%
This report presents a review of current issues in the pharmaceutical sector in Bulgaria, examining drug policy, regulation, pricing, formulary selection, distribution, expenditure, and to the extent possible, patterns of use in Bulgaria. Its recommendations are intended to serve as options for reform, by articulating short and long term strategies for managing pharmaceutical expenditure, improving system sustainability, and driving value for money in Bulgaria, thereby improving efficiency, equity, affordability and ultimately, access to prescription medicines. Although small, the Bulgarian pharmaceutical market is showing strong growth. Medicines comprise not only a disproportionate share of health care expenditure (38 percent of total health expenditure, compared with an EU average of around 25 percent), the burden of out of pocket (OOP) costs is also excessive, possibly as high as 81 percent of total pharmaceutical expenditure. Of perhaps greatest concern is that rapid expenditure growth is taking place without obvious improvements in health outcomes...

Regulating under constraint: The case of EU pharmaceutical policy.

Permanand, Govin
Fonte: London School of Economics and Political Science Thesis Publicador: London School of Economics and Political Science Thesis
Tipo: Thesis; NonPeerReviewed Formato: application/pdf
Publicado em //2003 EN
Relevância na Pesquisa
46.36%
This study is concerned with the making of regulatory policy for pharmaceuticals in the European Union. It proposes that an ad hoc development of Community competencies which does not amount to coherent strategy, far less a single medicines market, has resulted in a regulatory framework which favours the interests of industry. This is important on two fronts. First, it appears to run counter to contemporary research into EU regulation, which finds that consumer interests prevail over those of producers generally. Second, this pro-industry leaning seems not to be in keeping with member states' regulatory frameworks at home, which developed primarily as a means of protecting consumers' health (patients) following the Thalidomide tragedy. In providing support for this contention, rather than adopting an economic frame of analysis to assess - quantitatively - how the industry benefits, the study instead proposes a political perspective to understand how policy decisions have been taken. Specifically, the study examines how supranational policy for pharmaceuticals is made with the context of a clash between the European Community's free movement of goods principles and, via the principle of subsidiarity, the right of the member states to decide their national healthcare priorities. The agenda and roles of the European Commission...

Educational innovations: categories of bulletin board postings designed to increase awareness of contemporary pharmaceutical policy issues

Painter,Jacob T.; Fink III,Joseph L.
Fonte: Pharmacy Practice (Internet) Publicador: Pharmacy Practice (Internet)
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/12/2010 ENG
Relevância na Pesquisa
56.33%
Objective: The goal of this project was to categorize and classify bulletin board postings pertaining to pharmaceutical policy from both the professional and lay press. Methods: Bulletin board postings were used to supplement in-class discussion to keep students, faculty and staff up-to-date on emerging trends. A bulletin board located in the main classroom area of the College of Pharmacy Building where students would pass by on the way to class and congregate during break periods was used to display articles from various sources concerning topics related to pharmaceutical policy. Information is presented about the primary subject matters addressed in the articles, the types of publications from which they were drawn, and the top ten sources of articles displayed. Results: This project showed that coverage of issues related to pharmacists is predominantly seen in newspapers and most pertinent issues are business related. Conclusions: It can be seen from this analysis that the issues facing pharmacists are varied. The pharmaceutical policy field is transforming and many of these changes are very relevant to the general population. This is seen from the coverage of all of these issues in the lay press.

Medicines in Mexico, 1990-2004: systematic review of research on access and use

Wirtz,Veronika J; Reich,Michael R; Leyva Flores,René; Dreser,Anahí
Fonte: Instituto Nacional de Salud Pública Publicador: Instituto Nacional de Salud Pública
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2008 EN
Relevância na Pesquisa
46.33%
OBJECTIVE: To review original research studies published between 1990 and 2004 on the access and use of medicines in Mexico to assess the knowledge base for reforming Mexico's pharmaceutical policy. MATERIAL AND METHODS: A literature review using electronic databases was conducted of original studies published in the last 15 years about access and use of medicines in Mexico. In addition, a manual search of six relevant journals was performed. Excluded were publications on herbal, complementary and alternative medicines. RESULTS: Were identified 108 original articles as being relevant, out of 2289 titles reviewed, highlighting four policy-related problems: irrational prescribing, harmful self-medication, inequitable access, and frequent drug stock shortage in public health centers. CONCLUSIONS: This review identified two priorities for Mexico's pharmaceutical policy and strategies: tackling the irrational use of medicines and the inadequate access of medicines. These are critical priorities for a new national pharmaceutical policy.

Medicines in Mexico, 1990-2004: systematic review of research on access and use

Wirtz,Veronika J; Reich,Michael R; Leyva Flores,René; Dreser,Anahí
Fonte: Instituto Nacional de Salud Pública Publicador: Instituto Nacional de Salud Pública
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2008 EN
Relevância na Pesquisa
46.33%
OBJECTIVE: To review original research studies published between 1990 and 2004 on the access and use of medicines in Mexico to assess the knowledge base for reforming Mexico's pharmaceutical policy. MATERIAL AND METHODS: A literature review using electronic databases was conducted of original studies published in the last 15 years about access and use of medicines in Mexico. In addition, a manual search of six relevant journals was performed. Excluded were publications on herbal, complementary and alternative medicines. RESULTS: Were identified 108 original articles as being relevant, out of 2289 titles reviewed, highlighting four policy-related problems: irrational prescribing, harmful self-medication, inequitable access, and frequent drug stock shortage in public health centers. CONCLUSIONS: This review identified two priorities for Mexico's pharmaceutical policy and strategies: tackling the irrational use of medicines and the inadequate access of medicines. These are critical priorities for a new national pharmaceutical policy.

Effect of the economic recession on pharmaceutical policy and medicine sales in eight European countries

Leopold,Christine; Mantel-Teeuwisse,Aukje K; Vogler,Sabine; Valkova,Silvia; Joncheere,Kees de; Leufkens,Hubert GM; Wagner,Anita K; Ross-Degnan,Dennis; Laing,Richard
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2014 EN
Relevância na Pesquisa
46.46%
Objective To identify pharmaceutical policy changes during the economic recession in eight European countries and to determine whether policy measures resulted in lower sales of, and less expenditure on, pharmaceuticals. Methods Information on pharmaceutical policy changes between 2008 and 2011 in eight European countries was obtained from publications and pharmaceutical policy databases. Data on the volume and value of the quarterly sales of products between 2006 and 2011 in the 10 highest-selling therapeutic classes in each country were obtained from a pharmaceutical market research database. We compared these indicators in economically stable countries; Austria, Estonia and Finland, to those in economically less stable countries, Greece, Ireland, Portugal, Slovakia and Spain. Findings Economically stable countries implemented two to seven policy changes each, whereas less stable countries implemented 10 to 22 each. Of the 88 policy changes identified, 33 occurred in 2010 and 40 in 2011. They involved changing out-of-pocket payments for patients in 16 cases, price mark-up schemes in 13 and price cuts in 11. Sales volumes increased moderately in all countries except Greece and Portugal, which experienced slight declines after 2009. Sales values decreased in both groups of countries...