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Wang Z, Wang K, Hua Y, Dong X, Zhang L. Impact and implications of national centralized drug procurement in China. Int J Clin Pharm 2024:10.1007/s11096-024-01767-1. [PMID: 38990456 DOI: 10.1007/s11096-024-01767-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 06/03/2024] [Indexed: 07/12/2024]
Abstract
The national centralized drug procurement (NCDP) policy, known as the "4 + 7" policy in China, has transformed pharmaceutical procurement and access by leveraging healthcare institutions' collective buying power to reduce drug prices substantially. This policy has profoundly impacted drug pricing mechanisms, healthcare expenditures, market dynamics, and the quality of available drugs. This commentary evaluates the efficacy, challenges, and broader implications of the NCDP, summarizes the current state of post-marketing monitoring of selected generic drugs for centralized procurement, and presents relevant considerations.
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Affiliation(s)
- Zhizhou Wang
- Department of Pharmacy, Xuanwu Hospital, The First Clinical Medical College of Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing, 100053, China
| | - Ke Wang
- Department of Pharmacy, Xuanwu Hospital, The First Clinical Medical College of Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing, 100053, China
| | - Yiming Hua
- Department of Pharmacy, Xuanwu Hospital, The First Clinical Medical College of Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing, 100053, China
| | - Xianzhe Dong
- Department of Pharmacy, Xuanwu Hospital, The First Clinical Medical College of Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing, 100053, China
| | - Lan Zhang
- Department of Pharmacy, Xuanwu Hospital, The First Clinical Medical College of Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing, 100053, China.
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Wang H, Zhong G, Ji H, Chen S, Xie Q, Shen Z, Jia Y. Contrastive analysis on the safety of brand and generic nebivolol: a real-world pharmacovigilance study based on the FDA adverse event reporting system. Front Pharmacol 2024; 15:1280201. [PMID: 38357307 PMCID: PMC10864489 DOI: 10.3389/fphar.2024.1280201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 01/22/2024] [Indexed: 02/16/2024] Open
Abstract
Background: The equivalence of generic drugs to their brand-name counterparts is a controversial issue. Current literature indicates disparities between the generic nebivolol (GN) and the brand nebivolol (BN). Aim: The study is designed to investigate the safety difference between GN and BN and provide reference information for clinical practice. Methods: We reviewed adverse event (AE) reports that recorded nebivolol as the primary suspect drug in the FDA Adverse Event Reporting System (FAERS) database from 2004 to 2022, conducted a disproportional analysis to detect signals for the GN and BN respectively, and compared the AE heterogeneity between them using the Breslow-Day test. Results: A total of 2613 AE reports of nebivolol were recorded in the FAERS database from 2004 to 2022, of which 2,200 were classified as BN, 346 as GN, and 67 unclassifiable AE reports were excluded. The signals of 37 AEs distributed in cardiac, gastrointestinal, psychiatric, and nervous systems were detected in disproportional analysis. 33 out of 37 AEs were positive signals, with 21 not previously listed on the drug label, indicating an unrecognized risk with nebivolol. In the heterogeneity analysis of AE signals between GN and BN, the GN generally showed a higher AE signal value than BN, especially 15 AEs distributed in the cardiac, neurological, and psychiatric systems that showed statistically significantly higher risk by taking GN. Conclusion: Our study shows some previously overlooked adverse effects of nebivolol. It suggests that the risk of GN's adverse effects may be higher than those in BN, which deserves further attention and investigation by healthcare professionals, regulators, and others.
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Affiliation(s)
- Hongli Wang
- Department of Pharmacy, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
- College of Pharmacy, Chongqing Medical University, Chongqing, China
| | - Guizun Zhong
- Department of Pharmacy, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
- College of Pharmacy, Chongqing Medical University, Chongqing, China
| | - Huanhuan Ji
- Department of Pharmacy Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing, China
| | - Siqi Chen
- College of Pharmacy, Chongqing Medical University, Chongqing, China
| | - Qinqin Xie
- College of Pharmacy, Chongqing Medical University, Chongqing, China
| | - Zhengze Shen
- Department of Pharmacy, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Yuntao Jia
- Department of Pharmacy Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing, China
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Reported Pericardial Toxicities Associated with Acute Myelogenous Leukemia Treatments: A Pharmacovigilance Analysis of the FDA Adverse Reporting Database. Curr Probl Cardiol 2022; 47:101345. [DOI: 10.1016/j.cpcardiol.2022.101345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 07/29/2022] [Indexed: 11/24/2022]
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Zeng Y, Dai Y, Zhou Z, Yu X, Shi D. Hepatotoxicity-Related Adverse Effects of Proton Pump Inhibitors: A Cross-Sectional Study of Signal Mining and Analysis of the FDA Adverse Event Report System Database. Front Med (Lausanne) 2021; 8:648164. [PMID: 34869400 PMCID: PMC8636138 DOI: 10.3389/fmed.2021.648164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 10/25/2021] [Indexed: 12/21/2022] Open
Abstract
Background and Objectives: Mounting evidence demonstrates that proton pump inhibitors (PPIs) are associated with a number of adverse effects. However, the literatures about hepatotoxicity-related adverse effects (HRAEs) of PPIs are mostly case reports and a few clinical studies. Methods: We evaluated the association between PPIs and HAREs using the reporting odd ratio (ROR) for mining the adverse event report signals in the FDA Adverse Event Reporting System (FAERS) database. Results: There were 23,825 reports of PPIs as primary suspect drug or second suspect drug, of which 3,253 reports were HRAEs. The top five HRAE signals caused by PPIs were hepatitis cholestatic, cholestasis, fulminant hepatitis, subacute hepatic failure, and acute hepatitis. We also summarized the signals of the HRAEs caused by each PPI. The simultaneous signals were cholestasis and hepatitis cholestatic. For the cholestasis signal, esomeprazole showed an ROR of 21.556 (95% CI 17.592–26.413); pantoprazole showed the highest ROR of 22.611 (95% CI 17.794–28.733) in the hepatic cholestatic signal; lansoprazole was the only PPI with expression in the coma hepatic signal, with an ROR of 10.424 (95% CI 3.340–32.532). By analyzing the reports of pantoprazole-induced hepatic encephalopathy, we found that patients aged over 65 years and males reported the highest rate. And from the combination of drugs and indications of drugs, no significant results were obtained. Conclusions: The RORs of signals of “cholestasis” were generally higher than those of “hepatocellular injury.” And the signals about “cholestasis” in HRAE caused by PPIs are more reported.
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Affiliation(s)
- Yifan Zeng
- Computer Technology and Information Centre, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ying Dai
- Department of Pharmacy, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ziye Zhou
- Department of Pharmacy, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xuben Yu
- Department of Pharmacy, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Dawei Shi
- Department of Pharmacy, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Vial G, Gensous N, Savel H, Richez C, Lazaro E, Truchetet ME, Bonnet F, Pellegrin I, Thiebaut R, Blanco P, Duffau P. The impact of clopidogrel on plasma-soluble CD40 ligand levels in systemic lupus erythematosus patients: the CLOPUS phase I/II pilot study. Joint Bone Spine 2020; 88:105097. [PMID: 33152483 DOI: 10.1016/j.jbspin.2020.105097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/26/2020] [Indexed: 11/24/2022]
Affiliation(s)
- Guillaume Vial
- Department of Internal Medicine and Clinical Immunology, Saint Andre Hospital, University Hospital Centre of Bordeaux, 33000 Bordeaux, France.
| | - Noémie Gensous
- Department of Internal Medicine and Clinical Immunology, Saint Andre Hospital, University Hospital Centre of Bordeaux, 33000 Bordeaux, France
| | - Hélène Savel
- Methodological Support Unit for Clinical Research, University Hospital Centre of Bordeaux, 33000 Bordeaux, France
| | - Christophe Richez
- CNRS UMR 5164, Immuno ConcEpT, Bordeaux University, 33076 Bordeaux, France; Department of Rheumatology, Pellegrin Hospital, University Hospital Centre of Bordeaux, 33000 Bordeaux, France
| | - Estibaliz Lazaro
- CNRS UMR 5164, Immuno ConcEpT, Bordeaux University, 33076 Bordeaux, France; Department of Internal Medicine and Infectious Diseases, Haut Leveque Hospital, University Hospital Centre of Bordeaux, 33604 Pessac, France
| | - Marie-Elise Truchetet
- CNRS UMR 5164, Immuno ConcEpT, Bordeaux University, 33076 Bordeaux, France; Department of Rheumatology, Pellegrin Hospital, University Hospital Centre of Bordeaux, 33000 Bordeaux, France
| | - Fabrice Bonnet
- Department of Internal Medicine and Infectious Diseases, Saint Andre Hospital, University Hospital Centre of Bordeaux, 33000 Bordeaux, France
| | - Isabelle Pellegrin
- Department of Immunology and Immunogenetics, Pellegrin Hospital, University Hospital Centre of Bordeaux, 33000 Bordeaux, France
| | - Rodolphe Thiebaut
- Department of Public Health, University Hospital Centre of Bordeaux, 33000 Bordeaux, France
| | - Patrick Blanco
- Department of Immunology and Immunogenetics, Pellegrin Hospital, University Hospital Centre of Bordeaux, 33000 Bordeaux, France
| | - Pierre Duffau
- Department of Internal Medicine and Clinical Immunology, Saint Andre Hospital, University Hospital Centre of Bordeaux, 33000 Bordeaux, France; CNRS UMR 5164, Immuno ConcEpT, Bordeaux University, 33076 Bordeaux, France
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Agewall S. Focus on subpopulations of atrial fibrillation patients. EUROPEAN HEART JOURNAL. CARDIOVASCULAR PHARMACOTHERAPY 2020; 6:131-132. [DOI: 10.1093/ehjcvp/pvaa034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Stefan Agewall
- Editor-in-Chief, Oslo University Hospital Ullevål and Institute of Clinical Sciences, University of Oslo, Oslo, Norway
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Patsourakos NG, Kouvari M, Kotidis A, Kalantzi KI, Tsoumani ME, Anastasiadis F, Andronikos P, Aslanidou T, Efraimidis P, Georgiopoulos A, Gerakiou K, Grigoriadou-Skouta E, Grigoropoulos P, Hatzopoulos D, Kartalis A, Lyras A, Markatos G, Mikrogeorgiou A, Myroforou I, Orkopoulos A, Pavlidis P, Petras C, Riga M, Skouloudi M, Smyrnioudis N, Thomaidis K, Tsikouri GE, Tsikouris EI, Zisimos K, Vavoulis P, Vitali MG, Vitsas G, Vogiatzidis C, Chantanis S, Fousas S, Panagiotakos DB, Tselepis AD. The incidence of recurrent cardiovascular events among acute coronary syndrome patients treated with generic or original clopidogrel in relation to their sociodemographic and clinical characteristics. The Aegean study. Arch Med Sci 2020; 16:1013-1021. [PMID: 32863989 PMCID: PMC7444691 DOI: 10.5114/aoms.2020.95878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 12/09/2019] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The use of generic drugs is continuously growing; however, there are limited epidemiological data regarding the therapeutic equivalence of each original drug formulation with its generic counterparts. We evaluated the 12-month composite endpoint of recurrent acute myocardial infarction, ischaemic stroke, cardiac deaths, or hospitalisation due to a major bleeding in acute coronary syndrome (ACS) patients treated with original clopidogrel or a generic clopidogrel formulation, in relation to sociodemographic and clinical characteristics. MATERIAL AND METHODS Consecutive Greek ACS patients (n = 1194) hospitalised in the Aegean islands and the Attica region were enrolled. Clopidogrel treatment was recorded either as original clopidogrel hydrogen sulphate (Plavix®/Iscover®) or as a generic clopidogrel besylate formulation (Clovelen®). The composite endpoint was recorded at 12-month follow-up. RESULTS The 12-month composite endpoint was 3.9% (4.6% in the Aegean islands and 3.5% in the Attica area, p > 0.05). The respective incidence in men was 4.0% and in women 3.8% (p > 0.05). Overall, generic and original clopidogrel use was 87% and 13% of patients, respectively. No significant differences were observed between original and generic clopidogrel use and 12-month composite endpoint incidence. Subgroup analysis with gender, region of residence, and clinical and lifestyle factors as strata did not reveal any significant outcomes. Haemorrhage incidence did not exceed 1% in the total sample. CONCLUSIONS The use of a generic clopidogrel besylate formulation was quite high in both urban and insular areas of Greece and had similar efficacy and safety profile with the original clopidogrel salt, supporting the routine use of this low-cost generic clopidogrel in the management of cardiovascular disease patients.
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Affiliation(s)
| | - Matina Kouvari
- School of Health Science and Education, Harokopio University of Athens, Athens, Greece
| | | | | | - Maria E. Tsoumani
- Atherothrombosis Research Centre, University of Ioannina, Ioannina, Greece
| | | | | | - Theano Aslanidou
- Atherothrombosis Research Centre, University of Ioannina, Ioannina, Greece
| | - Petros Efraimidis
- Atherothrombosis Research Centre, University of Ioannina, Ioannina, Greece
| | | | - Kalliopi Gerakiou
- Atherothrombosis Research Centre, University of Ioannina, Ioannina, Greece
| | | | | | | | - Athanasios Kartalis
- Cardiology Department, ‘Skylitseio’ General Hospital of Chios, Chios, Greece
| | - Anastasios Lyras
- Atherothrombosis Research Centre, University of Ioannina, Ioannina, Greece
| | - Gerasimos Markatos
- Atherothrombosis Research Centre, University of Ioannina, Ioannina, Greece
| | | | - Ioannis Myroforou
- Atherothrombosis Research Centre, University of Ioannina, Ioannina, Greece
| | - Anestis Orkopoulos
- Atherothrombosis Research Centre, University of Ioannina, Ioannina, Greece
| | - Pavlos Pavlidis
- Atherothrombosis Research Centre, University of Ioannina, Ioannina, Greece
| | - Charalampos Petras
- Atherothrombosis Research Centre, University of Ioannina, Ioannina, Greece
| | - Maria Riga
- Atherothrombosis Research Centre, University of Ioannina, Ioannina, Greece
| | - Marina Skouloudi
- Atherothrombosis Research Centre, University of Ioannina, Ioannina, Greece
| | | | | | | | | | | | | | | | - George Vitsas
- Atherothrombosis Research Centre, University of Ioannina, Ioannina, Greece
| | | | | | - Stefanos Fousas
- Cardiology Department, Tzaneio Hospital of Piraeus, Piraeus, Greece
| | - Demosthenes B. Panagiotakos
- School of Health Science and Education, Harokopio University of Athens, Athens, Greece
- Atherothrombosis Research Centre, University of Ioannina, Ioannina, Greece
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