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Socal MP, Wang Y, Plummer E, Anderson GF, Bai G. Spending on Dual Over-the-Counter and Prescription Drugs in the Medicare Part D Program. JAMA 2024; 331:72-75. [PMID: 38095888 PMCID: PMC10722384 DOI: 10.1001/jama.2023.23126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/23/2023] [Indexed: 12/17/2023]
Abstract
This study compares Medicare and patient spending for dual over-the-counter and prescription drugs with their over-the-counter cash prices.
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Affiliation(s)
- Mariana P. Socal
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Yuchen Wang
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Gerard F. Anderson
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Ge Bai
- Johns Hopkins Carey Business School, Washington, DC
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Elhage KG, Yousif J, Kwa M, Gold LS. The online acne market: analyzing ingredients and price of over-the-counter acne products. Arch Dermatol Res 2023; 315:2715-2716. [PMID: 37420140 DOI: 10.1007/s00403-023-02665-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/20/2023] [Accepted: 06/25/2023] [Indexed: 07/09/2023]
Affiliation(s)
| | | | - Michael Kwa
- Department of Dermatology, Henry Ford Health, 3031 West Grand Boulevard, Suite 800, Detroit, MI, 48202, USA
| | - Linda Stein Gold
- Department of Dermatology, Henry Ford Health, 3031 West Grand Boulevard, Suite 800, Detroit, MI, 48202, USA.
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Robertson C, Braman A. The New Over-the-Counter Oral Contraceptive Pill - Assessing Financial Barriers to Access. N Engl J Med 2023; 389:1352-1354. [PMID: 37815227 DOI: 10.1056/nejmp2308720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Affiliation(s)
| | - Anna Braman
- From Boston University School of Law, Boston
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Karlsson P, Nakitanda AO, Löfling L, Cesta CE. Patterns of prescription dispensation and over-the-counter medication sales in Sweden during the COVID-19 pandemic. PLoS One 2021; 16:e0253944. [PMID: 34388166 PMCID: PMC8362980 DOI: 10.1371/journal.pone.0253944] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 06/15/2021] [Indexed: 12/01/2022] Open
Abstract
Introduction On February 26th 2020, a high alert was issued in Sweden in response to the diagnosis of the first few coronavirus disease 2019 (COVID-19) cases in the country. Subsequently, a decreased supply of essential goods, including medical products, was anticipated. We aimed to explore the weekly patterns of prescription dispensing and over-the-counter (OTC) medication sales in Sweden in 2020 compared with previous years, to assess the influence of the government restrictions on medication sales, and to assess whether there is evidence of medication stockpiling in the population. Methods Aggregated data on the weekly volume of defined daily doses (DDDs) of prescription medication dispensed and OTC sales from 2015 to 2020 were examined. From 2015–2019 data, the predicted weekly volume of DDDs for 2020 was estimated and compared to the observed volume for each ATC anatomical main group and therapeutic subgroup. Results From mid-February to mid-March 2020, there were increases in the weekly volumes of dispensed medication, peaking in the second week of March with a 46% increase in the observed versus predicted number of DDDs dispensed (16,440 vs 11,260 DDDs per 1000 inhabitants). A similar pattern was found in all age groups, in both sexes, and across metropolitan and non-metropolitan regions. In the same week in March, there was a 96% increase in the volume of OTC sold (2,504 vs 1,277 DDDs per 1000 inhabitants), specifically in ATC therapeutic subgroups including vitamins, antipyretics, painkillers, and nasal, throat, cough and cold preparations. Conclusion Beginning in mid-February 2020, there were significant changes in the volume of prescription medication dispensed and OTC drugs sold. The weekly volume of DDDs quickly decreased following recommendations from public authorities. Overall, our findings suggest stockpiling behavior over a surge in new users of medication.
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Affiliation(s)
- Pär Karlsson
- Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden
| | | | - Lukas Löfling
- Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden
- Department of Research, Etiological Research Unit, Cancer Registry of Norway, Oslo, Norway
| | - Carolyn E. Cesta
- Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
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Moreno P, Cerón A, Sosa K, Morales M, Grajeda LM, Lopez MR, McCraken JP, Cordón-Rosales C, Palmer GH, Call DR, Ramay BM. Availability of over-the-counter antibiotics in Guatemalan corner stores. PLoS One 2020; 15:e0239873. [PMID: 32976542 PMCID: PMC7518585 DOI: 10.1371/journal.pone.0239873] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 09/14/2020] [Indexed: 11/19/2022] Open
Abstract
Widespread availability of antibiotics without prescription potentially facilitates overuse and contributes to selection pressure for antimicrobial resistant bacteria. Prior to this study, anecdotal observations in Guatemala identified corner stores as primary antibiotic dispensaries, where people purchase antibiotics without prescriptions. We carried out a cross sectional study to document the number and types of antibiotics available in corner stores, in four study areas in Guatemala. A total of 443 corner stores were surveyed, of which 295 (67%) sold antibiotics. The most commonly available antibiotics were amoxicillin, found in 246/295 (83%) stores, and tetracycline, found in 195/295 (66%) stores. Over the counter sales result from laissez-faire enforcement of antibiotic dispensing regulations in Guatemala combined with patient demand. This study serves as a baseline to document changes in the availability of antibiotics in informal establishments in light of new pharmacy regulations for antibiotic dispensing, which were adopted after this study was completed.
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Affiliation(s)
- Purificación Moreno
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
- Department of Pharmaceutical Chemistry, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Alejandro Cerón
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
- Department of Anthropology, University of Denver, Denver, CO, United States of America
| | - Karen Sosa
- Department of Pharmaceutical Chemistry, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Marinees Morales
- Department of Pharmaceutical Chemistry, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Laura M. Grajeda
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Maria Renee Lopez
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - John P. McCraken
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Celia Cordón-Rosales
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Guy H. Palmer
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, United States of America
| | - Douglas R. Call
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, United States of America
| | - Brooke M. Ramay
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
- Department of Pharmaceutical Chemistry, Universidad del Valle de Guatemala, Guatemala City, Guatemala
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, United States of America
- * E-mail:
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Zhang D, Lyu JT, Zhang B, Zhang XM, Jiang H, Lin ZJ. Comparative efficacy, safety and cost of oral Chinese patent medicines for rheumatoid arthritis: a Bayesian network meta-analysis. BMC Complement Med Ther 2020; 20:210. [PMID: 32631398 PMCID: PMC7339567 DOI: 10.1186/s12906-020-03004-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 06/26/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Rheumatoid arthritis (RA) is a common inflammatory disease with a substantial burden for society and economic worldwide. Chinese patent medicines (CPMs) have gained attention as alternative remedies due to they can exert the satisfactory therapeutic effects via holistic regulation. Currently, several oral Chinese patent medicines are routinely recommended for managing and treating RA. Therefore, a network meta-analysis (NMA), which tries to synthesize evidences for a decision making by evaluating the comparative effectiveness of multiple interventions against the same disease, was undertaken to identify the optimal intervention according to their efficacy in clinical treatment and symptom remission, safety profile and daily cost. METHODS Randomized controlled trials (RCTs) regarding CPMs to treat RA were comprehensive retrieved from 3 foreign databases and 4 Chinese databases, and the retrieved results were last updated on January 10, 2019. The bias of the selected trials was assessed by two individuals independently through RoB2. A random-effects model was adopted during the meta-analytic procedures, and outcomes concerning efficacy and safety were evaluated as odds ratios (OR), mean differences (MD) and 95% credible intervals (CI) utilizing Stata 14.1 and WinBUGS 1.4.3 software. Furthermore, the cluster analysis and comprehensive investigation were preformed concerning the comparative efficacy, safety and cost of oral CPMs. RESULTS One hundred sixteen RCTs involving 10,213 individuals met the inclusion criteria and were enrolled into current NMA. The results from existing evidence indicated that Biqi capsule and Yuxuebi capsule probably had a favorable balance in consideration of benefits, tolerability and daily cost. Furthermore, as the least expensive choice, glucosides of Tripterygium Wilfordii tablet was associated with displaying a trend of relieving joint tenderness, joint swelling, and morning stiffness for patients with RA. CONCLUSION Biqi capsule, Yuxuebi capsule and glucosides of Tripterygium Wilfordii tablet were recommended for treating RA based on the favorable benefits in both clinical efficacy and symptoms, and they, meanwhile, might be associated with the more tolerable and acceptable therapeutic alternative in terms of safety profile and daily cost. Nevertheless, the additional results from high-quality, multi-center and head-to-head trials would be pivotal for supporting our findings.
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Affiliation(s)
- Dan Zhang
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, 102488, China
| | - Jin-Tao Lyu
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, 102488, China
| | - Bing Zhang
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, 102488, China.
| | - Xiao-Meng Zhang
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, 102488, China
| | - Hao Jiang
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, 102488, China
| | - Zhi-Jian Lin
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, 102488, China
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Chen J, Wang Y, Chen X, Hesketh T. Widespread illegal sales of antibiotics in Chinese pharmacies - a nationwide cross-sectional study. Antimicrob Resist Infect Control 2020; 9:12. [PMID: 31956401 PMCID: PMC6961359 DOI: 10.1186/s13756-019-0655-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 11/15/2019] [Indexed: 01/21/2023] Open
Abstract
Background Access to antibiotics without a prescription from retail pharmacies has been described as a major contributor to anti-microbial resistance (AMR) globally. In the context of high rates of AMR, the Chinese government has recently introduced strict policies regarding hospital antibiotic use, but the existing ban on antibiotic sales without prescription in retail pharmacies has not been strongly enforced. In 2016, a goal of prescription-only antibiotics by 2020 was announced. The objective of the study was to determine progress towards the 2020 goal, through estimating the proportion of retail pharmacies selling antibiotics without prescription across the three regions of mainland China. Methods Using the Simulated Patient method, we conducted a cross-sectional survey across purposively-sampled retail pharmacies in urban and rural areas of 13 provinces in eastern, central and western China. Medical students presented a scenario of a mild upper respiratory tract infection, following a strict three-step protocol. They recorded the pharmacy characteristics, and details of their experience, including at which step antibiotics were offered. Results Complete data were obtained from 1106 pharmacies. Antibiotics were obtained in 925 (83.6, 95% CI: 81.5, 85.8%) pharmacies without a prescription, 279 (25.2%) at Stage 1 (symptoms only described), 576 (52.1%) at stage 2 (asked for antibiotics), and 70 (6.3%) at Stage 3 (asked for penicillin or cephalosporins). There were significant differences between provinces, with antibiotic access (at any stage) ranging from 57.0% (57/100) in Zhejiang (81/82) to 98.8% in Guizhou. However, there were no significant differences in access to antibiotics by level of city, county, township or village (P = 0.25), whether the pharmacy was part of a chain or independent (P = 0.23), whether a licensed pharmacist was attending (P = 0.82) or whether there was a sign saying that prescriptions were required for antibiotics (P = 0.19). Conclusions It is easy to obtain antibiotics without a prescription in retail pharmacies in China, despite the fact it is against the law. This must be addressed as part of the wider anti-microbial stewardship effort which could include intense enforcement of the existing law, supported by a public education campaign.
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Affiliation(s)
- Jie Chen
- Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, 310058 People’s Republic of China
| | - Yanmei Wang
- Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, 310058 People’s Republic of China
| | - Xuejie Chen
- Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, 310058 People’s Republic of China
- Department of Gastroenterology, Third Xiangya Hospital, Central South University, Changsha, 410013 Hunan Province People’s Republic of China
| | - Therese Hesketh
- Centre for Global Health, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, 310058 People’s Republic of China
- Institute for Global Health, University College London, 30 Guilford St, London, WC1N1EH UK
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Abstract
IMPORTANCE Despite the increasingly important role of pharmacies in the implementation of naloxone access laws, there is limited information on the impact of such laws at the local level. OBJECTIVE To evaluate the availability (with or without a prescription) and cost of naloxone nasal spray at pharmacies in Philadelphia, Pennsylvania, following a statewide standing order enacted in Pennsylvania in August 2015 to allow pharmacies to dispense naloxone without a prescription. DESIGN, SETTING, AND PARTICIPANTS A survey study was conducted by telephone of all pharmacies in Philadelphia between February and August 2017. Pharmacies were geocoded and linked with the American Community Survey (2011-2015) to obtain information on the demographic characteristics of census tracts and the Medical Examiner's Office of the Philadelphia Department of Public Health to derive information on the number of opioid overdose deaths per 100 000 people for each planning district. Data were analyzed from March 2018 to February 2019. MAIN OUTCOMES AND MEASURES Availability and out-of-pocket cost of naloxone nasal spray (with or without a prescription) at Philadelphia pharmacies overall and by pharmacy and neighborhood characteristics. RESULTS Of 454 eligible pharmacies, 418 were surveyed (92.1% response rate). One in 3 pharmacies (34.2%) had naloxone nasal spray in stock; of these, 61.5% indicated it was available without a prescription. There were significant differences in the availability of naloxone by pharmacy type and neighborhood characteristics. Naloxone was both more likely to be in stock (45.9% vs 27.8%; difference, 18.0%; 95% CI, 8.3%-27.8%; P < .001) and available without a prescription (80.6% vs 42.2%; difference, 38.4%; 95% CI, 23.0%-53.8%; P < .001) in chain stores than in independent stores. Naloxone was also less likely to be available in planning districts with very elevated rates of opioid overdose death (≥50 per 100 000 people) compared with those with lower rates (31.1% vs 38.5%). The median (interquartile range) out-of-pocket cost among pharmacies offering naloxone without a prescription was $145 ($119-$150); costs were greatest in independent pharmacies and planning districts with elevated rates of opioid overdose death. CONCLUSIONS AND RELEVANCE Despite the implementation of a statewide standing order in Pennsylvania more than 3 years prior to this study, only one-third of Philadelphia pharmacies carried naloxone nasal spray and many also required a physician's prescription. Efforts to strengthen the implementation of naloxone access laws and better ensure naloxone supply at local pharmacies are warranted, especially in localities with the highest rates of overdose death.
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Affiliation(s)
- Jenny S. Guadamuz
- Institute of Minority Health Research, College of Medicine, University of Illinois at Chicago
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago
| | - G. Caleb Alexander
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland
- Center for Drug Safety and Effectiveness, Johns Hopkins School of Public Health, Baltimore, Maryland
| | - Tanya Chaudhri
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago
| | - Rebecca Trotzky-Sirr
- Department of Emergency Medicine, Keck School of Medicine, University of Southern California, Los Angeles
- Los Angeles County Department of Health Services, Los Angeles, California
| | - Dima M. Qato
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago
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Rikhi R. Transparency of Medication Costs: A Method of Building Patient Trust. Acad Med 2019; 94:615. [PMID: 30681443 DOI: 10.1097/acm.0000000000002604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Rishi Rikhi
- Resident, Cleveland Clinic Foundation, Cleveland, Ohio;
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Parkinson B, Gumbie M, Cutler H, Gauld N, Mumford V, Haywood P. Cost-Effectiveness of Reclassifying Triptans in Australia: Application of an Economic Evaluation Approach to Regulatory Decisions. Value Health 2019; 22:293-302. [PMID: 30832967 DOI: 10.1016/j.jval.2018.09.2840] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 09/05/2018] [Accepted: 09/14/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Migraine is a common, chronic, disabling headache disorder. Triptans, used as an acute treatment for migraine, are available via prescription in Australia. An Australian Therapeutic Goods Administration (TGA) committee rejected reclassifying sumatriptan and zolmitriptan from prescription medicine to pharmacist-only between 2005 and 2009, largely on the basis of concerns about patient risk. Nevertheless, pharmacist-only triptans may reduce migraine duration and free up healthcare resources. OBJECTIVES To estimate the cost-effectiveness of reclassifying triptans from prescription-only to pharmacist-only in Australia. METHODS The study design included decision-analytic modeling combining data from various sources. Behavior before and after reclassification was estimated using medical practitioner and patient surveys and also administrative data. Health outcomes included migraine frequency and duration as well as adverse events (AEs) discussed by the TGA committee. Efficacy and AEs were estimated using randomized controlled trials and observational studies. RESULTS Reclassifying triptans will reduce migraine duration but increase AEs. This will result in 337 quality-adjusted life-years gained at an increased cost of A$5.9 million over 10 years for all Australian adults older than 15 years (19.6 million). The incremental cost-effectiveness ratio was estimated to be A$17 412/quality-adjusted life-year gained. CONCLUSIONS The incremental cost-effectiveness ratio is likely to be considered cost-effective by Australian decision makers. Serotonin syndrome, a key concern of the TGA committee, had little impact on the results. Further research is needed regarding pharmacist-only triptan use by migraineurs currently using over-the-counter medicines and by nonmigraineurs, the efficacy of triptans, and the risk of cardiovascular and cerebrovascular AEs and chronic headaches with triptans.
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Affiliation(s)
- Bonny Parkinson
- Centre for the Health Economy, Macquarie University, Sydney, NSW, Australia.
| | - Mutsa Gumbie
- Centre for the Health Economy, Macquarie University, Sydney, NSW, Australia
| | - Henry Cutler
- Centre for the Health Economy, Macquarie University, Sydney, NSW, Australia
| | - Natalie Gauld
- School of Pharmacy, University of Auckland, Auckland, New Zealand
| | - Virginia Mumford
- Australian Institute for Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Philip Haywood
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia
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Davies A, Green MA, Singleton AD. Using machine learning to investigate self-medication purchasing in England via high street retailer loyalty card data. PLoS One 2018; 13:e0207523. [PMID: 30452481 PMCID: PMC6242371 DOI: 10.1371/journal.pone.0207523] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 10/31/2018] [Indexed: 11/26/2022] Open
Abstract
The availability alongside growing awareness of medicine has led to increased self-treatment of minor ailments. Self-medication is where one ‘self’ diagnoses and prescribes over the counter medicines for treatment. The self-care movement has important policy implications, perceived to relieve the National Health Service (NHS) burden, increasing patient subsistence and freeing resources for more serious ailments. However, there has been little research exploring how self-medication behaviours vary between population groups due to a lack of available data. The aim of our study is to evaluate how high street retailer loyalty card data can help inform our understanding of how individuals self-medicate in England. Transaction level loyalty card data was acquired from a national high street retailer for England for 2012–2014. We calculated the proportion of loyalty card customers (n ~ 10 million) within Lower Super Output Areas who purchased the following medicines: ‘coughs and colds’, ‘Hayfever’, ‘pain relief’ and ‘sun preps’. Machine learning was used to explore how 50 sociodemographic and health accessibility features were associated towards explaining purchasing of each product group. Random Forests are used as a baseline and Gradient Boosting as our final model. Our results showed that pain relief was the most common medicine purchased. There was little difference in purchasing behaviours by sex other than for sun preps. The gradient boosting models demonstrated that socioeconomic status of areas, as well as air pollution, were important predictors of each medicine. Our study adds to the self-medication literature through demonstrating the usefulness of loyalty card records for producing insights about how self-medication varies at the national level. Big data offer novel insights that add to and address issues that traditional studies are unable to consider. New forms of data through data linkage may offer opportunities to improve current public health decision making surrounding at risk population groups within self-medication behaviours.
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Affiliation(s)
- Alec Davies
- Geographic Data Science Lab, Department of Geography & Planning, University of Liverpool, Liverpool, United Kingdom
- * E-mail:
| | - Mark A. Green
- Geographic Data Science Lab, Department of Geography & Planning, University of Liverpool, Liverpool, United Kingdom
| | - Alex D. Singleton
- Geographic Data Science Lab, Department of Geography & Planning, University of Liverpool, Liverpool, United Kingdom
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Prudhomme O’Meara W, Menya D, Laktabai J, Platt A, Saran I, Maffioli E, Kipkoech J, Mohanan M, Turner EL. Improving rational use of ACTs through diagnosis-dependent subsidies: Evidence from a cluster-randomized controlled trial in western Kenya. PLoS Med 2018; 15:e1002607. [PMID: 30016316 PMCID: PMC6049880 DOI: 10.1371/journal.pmed.1002607] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 06/08/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND More than half of artemisinin combination therapies (ACTs) consumed globally are dispensed in the retail sector, where diagnostic testing is uncommon, leading to overconsumption and poor targeting. In many malaria-endemic countries, ACTs sold over the counter are available at heavily subsidized prices, further contributing to their misuse. Inappropriate use of ACTs can have serious implications for the spread of drug resistance and leads to poor outcomes for nonmalaria patients treated with incorrect drugs. We evaluated the public health impact of an innovative strategy that targets ACT subsidies to confirmed malaria cases by coupling free diagnostic testing with a diagnosis-dependent ACT subsidy. METHODS AND FINDINGS We conducted a cluster-randomized controlled trial in 32 community clusters in western Kenya (population approximately 160,000). Eligible clusters had retail outlets selling ACTs and existing community health worker (CHW) programs and were randomly assigned 1:1 to control and intervention arms. In intervention areas, CHWs were available in their villages to perform malaria rapid diagnostic tests (RDTs) on demand for any individual >1 year of age experiencing a malaria-like illness. Malaria RDT-positive individuals received a voucher for a discount on a quality-assured ACT, redeemable at a participating retail medicine outlet. In control areas, CHWs offered a standard package of health education, prevention, and referral services. We conducted 4 population-based surveys-at baseline, 6 months, 12 months, and 18 months-of a random sample of households with fever in the last 4 weeks to evaluate predefined, individual-level outcomes. The primary outcome was uptake of malaria diagnostic testing at 12 months. The main secondary outcome was rational ACT use, defined as the proportion of ACTs used by test-positive individuals. Analyses followed the intention-to-treat principle using generalized estimating equations (GEEs) to account for clustering with prespecified adjustment for gender, age, education, and wealth. All descriptive statistics and regressions were weighted to account for sampling design. Between July 2015 and May 2017, 32,404 participants were tested for malaria, and 10,870 vouchers were issued. A total of 7,416 randomly selected participants with recent fever from all 32 clusters were surveyed. The majority of recent fevers were in children under 18 years (62.9%, n = 4,653). The gender of enrolled participants was balanced in children (49.8%, n = 2,318 boys versus 50.2%, n = 2,335 girls), but more adult women were enrolled than men (78.0%, n = 2,139 versus 22.0%, n = 604). At baseline, 67.6% (n = 1,362) of participants took an ACT for their illness, and 40.3% (n = 810) of all participants took an ACT purchased from a retail outlet. At 12 months, 50.5% (n = 454) in the intervention arm and 43.4% (n = 389) in the control arm had a malaria diagnostic test for their recent fever (adjusted risk difference [RD] = 9 percentage points [pp]; 95% CI 2-15 pp; p = 0.015; adjusted risk ratio [RR] = 1.20; 95% CI 1.05-1.38; p = 0.015). By 18 months, the ARR had increased to 1.25 (95% CI 1.09-1.44; p = 0.005). Rational use of ACTs in the intervention area increased from 41.7% (n = 279) at baseline to 59.6% (n = 403) and was 40% higher in the intervention arm at 18 months (ARR 1.40; 95% CI 1.19-1.64; p < 0.001). While intervention effects increased between 12 and 18 months, we were not able to estimate longer-term impact of the intervention and could not independently evaluate the effects of the free testing and the voucher on uptake of testing. CONCLUSIONS Diagnosis-dependent ACT subsidies and community-based interventions that include the private sector can have an important impact on diagnostic testing and population-wide rational use of ACTs. Targeting of the ACT subsidy itself to those with a positive malaria diagnostic test may also improve sustainability and reduce the cost of retail-sector ACT subsidies. TRIAL REGISTRATION ClinicalTrials.gov NCT02461628.
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Affiliation(s)
- Wendy Prudhomme O’Meara
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Moi University School of Public Health, College of Health Sciences, Eldoret, Kenya
| | - Diana Menya
- Moi University School of Public Health, College of Health Sciences, Eldoret, Kenya
| | - Jeremiah Laktabai
- Moi University School of Medicine, College of Health Sciences, Eldoret, Kenya
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Alyssa Platt
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, United States of America
| | - Indrani Saran
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Elisa Maffioli
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Department of Economics, Duke University, Durham, North Carolina, United States of America
| | - Joseph Kipkoech
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Manoj Mohanan
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Department of Economics, Duke University, Durham, North Carolina, United States of America
- Sanford School of Public Policy, Duke University, Durham, North Carolina, United States of America
| | - Elizabeth L. Turner
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, United States of America
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Abstract
BACKGROUND In Argentina, varicella vaccination was included in the national schedule for mandatory immunizations in 2015. The vaccine has been shown to substantially reduce the morbidity and mortality associated with the virus. The purpose of this study was to evaluate the clinical and economic burden associated with varicella in Argentina prior to vaccine introduction. METHODS This was a multi-center, retrospective chart review study among patients aged 1-12 years with a primary varicella diagnosis in 2009-2014 in Argentina. Healthcare resource utilization (HCRU) associated with varicella and its complications, unit costs, and work loss were used to estimate direct and indirect costs. All costs are presented in 2015 United States dollars (USD). RESULTS One hundred and fifty children with varicella were included (75 outpatients, 75 inpatients), with a mean age of 3.8 (SD = 2.4) and 2.9 (SD = 2.2) years, respectively. One or more complications were experienced by 28.0% of outpatients and 98.7% of inpatients, the most common being skin and soft tissue infections, pneumonia, sepsis, cerebellitis, and febrile seizure. HCRU estimates included use of over-the-counter (OTC) medications (58.7% outpatients, 94.7% inpatients), prescription medications (26.7% outpatients, 77.3% inpatients), tests/procedures (13.3% outpatients, 70.7% inpatients), and consultation with allied health professionals (1.3% outpatients, 32.0% inpatients). The average duration of hospital stay was 4.9 (95% CI = 4.2-5.7) days, and the average duration of ICU stay was 4.8 (95% CI = 1.6-14.1) days. The total combined direct and indirect cost per varicella case was 2947.7 USD (inpatients) and 322.7 USD (outpatients). The overall annual cost of varicella in Argentina for children aged ≤14 years in 2015 was estimated at 40,054,378.0 USD. CONCLUSION The clinical burden of varicella in Argentina was associated with utilization of significant amounts of healthcare resources, resulting in substantial economic costs. These costs should be reduced with the recent implementation of routine vaccination of children.
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Affiliation(s)
- Norberto Giglio
- a Hospital de Niños Ricardo Gutierrez , Buenos Aires , Argentina
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Aziz MM, Masood I, Yousaf M, Saleem H, Ye D, Fang Y. Pattern of medication selling and self-medication practices: A study from Punjab, Pakistan. PLoS One 2018; 13:e0194240. [PMID: 29566014 PMCID: PMC5863987 DOI: 10.1371/journal.pone.0194240] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 02/14/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Access to medicines without prescription is a major contributing factor for self-medication practices. This study was designed to examine the ratio of non-prescribed medicines sales and self-medication practices in Punjab, Pakistan. This study also evaluates the reasons for self-medication within its communities. METHODS An observational study was conducted in 272 systemically selected pharmacies to analyze medicines-related sales, with or without prescription. A cross-sectional survey was performed between June 2015 and November 2016. Consumers were interviewed about their self-medication practices. RESULTS Of the pharmacies surveyed, 65.3% participated in the study. A total of 4348 medicines were purchased for self-medication by 3037 consumers (15.2% of all study participants), of which 873 (28.7%) participated in an interview. Majority (81.2%) medicine purchaser, (90.9%) interview participants, and (59.4%) drug users were male. On average, each community pharmacy sold 7.9 medicines without prescription each day, to an average of 5.5 customers. Many participants (28.9%) had matriculation in their formal education. The medicines most often sold for self-medication were analgesics and antipyretics(39.4%). More than 25% of participants reported fever symptoms and 47.8% assumed their illness was too trivial to consult a doctor. Media advertisements were the most common source of information for participants (46.7%). CONCLUSION Many types of medicines were often sold without prescription from community pharmacies. Self-medication was common practice for a wide range of illnesses. Pakistan also needs effective implementation of policies to monitor medication sales. Public education about rational medication and limits to advertising medicine are very necessary.
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Affiliation(s)
- Muhammad Majid Aziz
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’anJiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- The Global Health Institute, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an, China
| | - Imran Masood
- Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur, Punjab, Pakistan
| | - Mahreen Yousaf
- Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - Hammad Saleem
- Institute of Pharmaceutical Sciences, University of Veterinary & Animal Sciences, Lahore, Pakistan
| | - Dan Ye
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’anJiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- The Global Health Institute, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an, China
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’anJiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- The Global Health Institute, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an, China
- * E-mail:
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16
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Newlands RS, Power A, Young L, Watson M. Quality improvement of community pharmacy services: a prioritisation exercise. Int J Pharm Pract 2018; 26:39-48. [PMID: 28349646 PMCID: PMC5811898 DOI: 10.1111/ijpp.12354] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 01/18/2017] [Indexed: 01/13/2023]
Abstract
OBJECTIVES Effective strategies are needed to translate knowledge (evidence) into practice to improve the quality of community pharmacy services. We report the first step of a novel knowledge translation process which involved the systematic identification and prioritisation of community pharmacy services in Scotland which were perceived to require improvement and/or guideline development. METHODS This process involved three stages and a stakeholder group comprising community pharmacists, policy makers, lay and pharmacy organisation representatives. A modified nominal group technique (NGT) was used for topic generation (August 2013) followed by an electronic Delphi survey (eDelphi), October-December 2013) and topic rationalisation (December 2013) based on feasibility, acceptability, and potential impact for practice improvement. KEY FINDINGS In total, 63 items were identified during the modified NGT which were categorised into 20 topics to form the starting point of the eDelphi. In total, 74 individuals (mostly community pharmacists) indicated an interest in the eDelphi, which achieved response rates of 63.5%, 67.6%, and 70.3%, respectively in Rounds 1, 2, and 3. Consensus was achieved with six topics: promoting the appropriate sale and supply of over-the-counter medicines; patient counselling for prescribed medication; pharmaceutical care to promote medication adherence; promotion and delivery of a Minor Ailment Scheme; pharmaceutical care of vulnerable patients; and effective use of community pharmacy workforce. Of these, the priority topic selected for the next stage of the programme was promoting the appropriate sale and supply of over-the-counter medicines. CONCLUSIONS This study adopted a systematic, inclusive, and rapid approach to identify priorities for community pharmacy practice improvement in Scotland.
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Affiliation(s)
- Rumana S. Newlands
- Health Services Research UnitUniversity of AberdeenForesterhillAberdeenUK
| | | | - Linda Young
- NHS Education for ScotlandDundee Dental Education CentreDundeeUK
| | - Margaret Watson
- Department of Pharmacy and PharmacologyUniversity of BathBath, UK
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Abstract
AIM The aim of this review was to identify the international evidence that is currently available on the economic value of self-care through responsible self-medication, in terms of the measures related to access to treatment, time, and productivity. METHODS A targeted literature search was conducted for 1990-2016, including data gathered from members of the World Self-Medication Industry and searches on PubMed, EBSCOHost, and Google Scholar. Specific searches of individual drug classes known to be switched to non-prescription status in this period were also conducted. RESULTS A total of 71 articles were identified, of which 17 (11 modeling studies, six retrospective analyses) were included in the review. Evidence from modeling studies and retrospective analyses of grouped data across a range of common conditions for which non-prescription medications are available in different countries/regions showed that the use of non-prescription products for the treatment of common conditions or for symptom management (e.g. allergies, chronic pain, migraine, vaginitis, gastrointestinal symptoms, or common cold symptoms) had considerable value to patients, payers, and employers alike in terms of cost savings and improved productivity. Potential benefits of self-medication were also identified in preventative healthcare strategies, such as those for cardiovascular health and osteoporosis. LIMITATIONS This review was limited by a targeted, but non-systematic approach to literature retrieval, as well as the inclusion of unpublished reports/white papers and patient self-reported data. CONCLUSIONS The evidence identified in this literature review shows that responsible, appropriate self-medication with non-prescription products can provide significant economic benefits for patients, employers, and healthcare systems worldwide.
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Affiliation(s)
- Joshua Noone
- a Precision Health Economics , Huntersville , NC , USA
| | - Christopher M Blanchette
- a Precision Health Economics , Huntersville , NC , USA
- b University of North Carolina , Charlotte , NC , USA
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18
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Steiner DJ. Pharmaceuticals and Medical Devices: Cost Savings. Issue Brief Health Policy Track Serv 2017; 2017:1-31. [PMID: 29361657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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19
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Badzi CD, Ackumey MM. Factors influencing use of analgesics among construction workers in the Ga-Eastmunicipality of the Greater Accra region, Ghana. Ghana Med J 2017; 51:156-163. [PMID: 29622829 PMCID: PMC5870788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Analgesics also known as painkillers are widely used for pain relief. There are severe health implications associated with excessive use of analgesics. This paper examines factors influencing the use of analgesics among construction workers in the Ga-East Municipality (GEM) of the Greater Accra region of Ghana. METHODS This is a cross-sectional study involving 206 construction workers randomly sampled from 7 construction sites in the GEM. A structured questionnaire was used to elicit responses on knowledge of analgesics, types of analgesics used and factors influencing the use of analgesics. Chi-square test analysis was used to examine factors influencing analgesic use. RESULTS The majority of workers were aged between 15 to 44 years (89.8%) and 51.9 percent of respondents had completed Junior high school. Many respondents (68.0%) used Brand 1 a locally manufactured analgesic with paracetamol, aspirin and caffeine as the active ingredients and 31.6 percent of respondents had no knowledge of possible side effects of continuous use of analgesics. Chi square analysis showed that age was significantly associated with use of analgesics (p<0.01). Knowledge of the types of analgesics, dosage and side effects did not influence use (p>0.05). Television and radio advertisements influenced use of analgesics (p<0.01). CONCLUSION Knowledge on analgesic use and knowledge of probable serious side effects was inadequate. Pharmacists and chemists involvement in education of clients of the side effects of analgesics is highly recommended to minimise misuse. The Food and Drugs Authority should regulate the proliferation of advertisements for analgesics in the media. FUNDING None declared.
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Affiliation(s)
- Caroline D Badzi
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon
| | - Mercy M Ackumey
- Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Legon
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Juneja S, Gupta A, Moon S, Resch S. Projected savings through public health voluntary licences of HIV drugs negotiated by the Medicines Patent Pool (MPP). PLoS One 2017; 12:e0177770. [PMID: 28542239 PMCID: PMC5444652 DOI: 10.1371/journal.pone.0177770] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 05/03/2017] [Indexed: 11/19/2022] Open
Abstract
The Medicines Patent Pool (MPP) was established in 2010 to ensure timely access to low-cost generic versions of patented antiretroviral (ARV) medicines in low- and middle-income countries (LMICs) through the negotiation of voluntary licences with patent holders. While robust data on the savings generated by MPP and other major global public health initiatives is important, it is also difficult to quantify. In this study, we estimate the savings generated by licences negotiated by the MPP for ARV medicines to treat HIV/AIDS in LMICs for the period 2010–2028 and generate a cost-benefit ratio–based on people living with HIV (PLHIVs) in any new countries which gain access to an ARV due to MPP licences and the price differential between originator’s tiered price and generics price, within the period where that ARV is patented. We found that the direct savings generated by the MPP are estimated to be USD 2.3 billion (net present value) by 2028, representing an estimated cost-benefit ratio of 1:43, which means for every USD 1 spent on MPP, the global public health community saves USD 43. The saving of USD 2.3 billion is equivalent to more than 24 million PLHIV receiving first-line ART in LMICs for 1 year at average prices today.
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Affiliation(s)
| | - Aastha Gupta
- Medicines Patent Pool, Geneva, Switzerland
- * E-mail:
| | - Suerie Moon
- Harvard T.H. Chan School of Public Health, Boston, United States of America
| | - Stephen Resch
- Harvard T.H. Chan School of Public Health, Boston, United States of America
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Sanwald A, Theurl E. Out-of-pocket expenditures for pharmaceuticals: lessons from the Austrian household budget survey. Eur J Health Econ 2017; 18:435-447. [PMID: 27137847 PMCID: PMC5387003 DOI: 10.1007/s10198-016-0797-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 03/31/2016] [Indexed: 05/05/2023]
Abstract
BACKGROUND Paying pharmaceuticals out of pocket is an important source of financing pharmaceutical consumption. Only limited empirical knowledge is available on the determinants of these expenditures. OBJECTIVES In this article we analyze which characteristics of private households influence out-of-pocket pharmaceutical expenditure (OOPPE) in Austria. DESIGN AND METHODS We use cross-sectional information on OOPPE and household characteristics provided by the Austrian household budget survey 2009/10. We split pharmaceutical expenditures into the two components prescription fees and over-the-counter (OTC) expenditures. To adjust for the specific characteristics of the data, we compare different econometric approaches: a two-part model, hurdle model, generalized linear model and zero-inflated negative binomial regression model. FINDINGS The finally selected econometric approaches give a quite consistent picture. The probability of expenditures of both types is strongly influenced by the household structure. It increases with age, doctoral visits and the presence of a female householder. The education level and income only increase the probability of OTC pharmaceuticals. The level of OTC expenditures remains widely unexplained while the household structure and age influence the expenditures for prescription fees. Insurance characteristics of private households, either private or public, play a minor role in explaining the expenditure levels in all specifications. This refers to a homogeneous and comprehensive provision of pharmaceuticals in the public part of the Austrian health care system. CONCLUSIONS The article gives useful insights into the determinants of pharmaceutical expenditures of private households and supplements the previous research that focuses on the individual level.
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Affiliation(s)
- Alice Sanwald
- Department of Economics and Statistics, University of Innsbruck, Universitätsstrasse 15, 6020 Innsbruck, Austria
| | - Engelbert Theurl
- Department of Economics and Statistics, University of Innsbruck, Universitätsstrasse 15, 6020 Innsbruck, Austria
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Morrow T. $850 Per Bowel Movement?! Hard To Justify That Cost. Manag Care 2017; 26:36-37. [PMID: 28510525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Constipation can be a serious and painful problem, and we shouldn't dismiss other people's suffering. On the other hand there's a danger when new medications are compared against placebo rather than against over-the-counter products with a history of effectiveness.
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Awad AI, Al-Rasheedi A, Lemay J. Public Perceptions, Expectations, and Views of Community Pharmacy Practice in Kuwait. Med Princ Pract 2017; 26:438-446. [PMID: 28934755 PMCID: PMC5757534 DOI: 10.1159/000481662] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 09/20/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES This study was designed to determine public patterns for use of community pharmacies, perceptions of pharmacists, confidence and trust in pharmacists, and expectations about the pharmacist's roles, and to explore the public views and satisfaction with the current pharmacy services. SUBJECTS AND METHODS A descriptive, cross-sectional survey was performed using a pretested self-administered questionnaire on a sample of 481 individuals selected using a 2-stage stratified cluster sampling design. Descriptive and multivariate logistic regression analyses were used for data analysis. p < 0.05 was considered statistically significant. RESULTS The most common reasons for visiting a pharmacy were to purchase medications (prescription: n = 338 [78.1%] and nonprescription: n = 296 [68.4%]). Of the 433 respondents, 87 believed that pharmacists had a good balance between health and business matters; regarding any drug-related problem, 229 (52.9%) identified the physician as the first person to contact, followed by the pharmacist (n = 140; 32.3%); 255 (58.9%) agreed that they trust pharmacists, while 237 (54.8%) agreed that pharmacists have the ability to answer drug- or disease-related questions. Of the 433 respondents, 236 (54.5%) did not expect the pharmacist's role to include monitoring health progress to ensure safe and effective use of medications, and 258 (59.6%) were satisfied with the current pharmacy services. CONCLUSION The current study indicated that respondents had overall negative perceptions of community pharmacists, expressed moderate expectations of their role, and viewed the current pharmacy services as slightly positive. These findings highlight the need for designing multifaceted interventions targeting specific areas to advance the community pharmacy practice in Kuwait.
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Affiliation(s)
- Abdelmoneim I. Awad
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Safat, Kuwait
- *Abdelmoneim I. Awad, B. Pharm, M. Pharm, PhD, Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, PO Box 24923, Safat 13110 (Kuwait), E-Mail
| | | | - Jacinthe Lemay
- Department of Pharmacology and Therapeutics, Faculty of Pharmacy, Kuwait University, Safat, Kuwait
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Kliemann BS, Levin AS, Moura ML, Boszczowski I, Lewis JJ. Socioeconomic Determinants of Antibiotic Consumption in the State of São Paulo, Brazil: The Effect of Restricting Over-The-Counter Sales. PLoS One 2016; 11:e0167885. [PMID: 27941993 PMCID: PMC5152856 DOI: 10.1371/journal.pone.0167885] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 11/22/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Improper antibiotic use is one of the main drivers of bacterial resistance to antibiotics, increasing infectious diseases morbidity and mortality and raising costs of healthcare. The level of antibiotic consumption has been shown to vary according to socioeconomic determinants (SED) such as income and access to education. In many Latin American countries, antibiotics could be easily purchased without a medical prescription in private pharmacies before enforcement of restrictions on over-the-counter (OTC) sales in recent years. Brazil issued a law abolishing OTC sales in October 2010. This study seeks to find SED of antibiotic consumption in the Brazilian state of São Paulo (SSP) and to estimate the impact of the 2010 law. METHODS Data on all oral antibiotic sales having occurred in the private sector in SSP from 2008 to 2012 were pooled into the 645 municipalities of SSP. Linear regression was performed to estimate consumption levels that would have occurred in 2011 and 2012 if no law regulating OTC sales had been issued in 2010. These values were compared to actual observed levels, estimating the effect of this law. Linear regression was performed to find association of antibiotic consumption levels and of a greater effect of the law with municipality level data on SED obtained from a nationwide census. RESULTS Oral antibiotic consumption in SSP rose from 8.44 defined daily doses per 1,000 inhabitants per day (DID) in 2008 to 9.95 in 2010, and fell to 8.06 DID in 2012. Determinants of a higher consumption were higher human development index, percentage of urban population, density of private health establishments, life expectancy and percentage of females; lower illiteracy levels and lower percentage of population between 5 and 15 years old. A higher percentage of females was associated with a stronger effect of the law. CONCLUSIONS SSP had similar antibiotic consumption levels as the whole country of Brazil, and they were effectively reduced by the policy.
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Affiliation(s)
- Breno S. Kliemann
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Course of Medicine, Health Sciences Sector, Federal University of Paraná, Curitiba, Brazil
- * E-mail:
| | - Anna S. Levin
- Infection Control Department, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
- Department of Infectious Diseases and LIM54, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - M. Luísa Moura
- Infection Control Department, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
| | - Icaro Boszczowski
- Infection Control Department, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
| | - James J. Lewis
- MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Abstract
Making oral contraceptives (OCs) available over the counter (OTC) could help to reduce the high rate of unintended pregnancy in the United States. Surveys show widespread support for OTC access to OCs among US women. Studies indicate that women can accurately use checklists to identify contraindications to OCs. Continuation is as good or better among OTC users compared with women using OCs obtained by prescription. Women and clinicians have expressed concerns related to making OCs available OTC. These concerns can be addressed by existing data or through research required by the Food and Drug Administration as part of the application to make OCs available OTC.
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Affiliation(s)
- Daniel Grossman
- Ibis Reproductive Health, 1330 Broadway, Suite 1100, Oakland, CA 94612, USA; Department of Obstetrics, Gynecology and Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California, San Francisco, 1001 Potrero Avenue, San Francisco, CA 94110, USA.
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Kawabuchi K, Kabeya Y. Estimating the Impact of the New Income Deduction System for Over-the-Counter Drug Expenses. Jpn Hosp 2016:27-34. [PMID: 30226959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Zaprutko T, Koligat D, Michalak M, Wieczorek M, Józiak M, Ratajczak M, Szydłowska K, Miazek J, Kus K, Nowakowska E. Misuse of OTC drugs in Poland. Health Policy 2016; 120:875-81. [PMID: 27344198 DOI: 10.1016/j.healthpol.2016.06.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 05/27/2016] [Accepted: 06/13/2016] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The misuse of over-the-counter (OTC) drugs became a global public health concern. Although abuse with dextrometorphan (DXM), pseudoefedrine (PSD), codeine (COD) or benzydamine (BND) may lead even to psychosis, drugs containing these substances are relatively cheap and freely available. In Poland the Act on Counteracting Drug Addiction was amended in 2015, however it seems that there are still some points which could be improved. METHODS Study was conducted between October 2014 and June 2015 using a specially designed questionnaire delivered to pharmacists from the Greater Poland region. Questionnaire consisting of 11 closed questions was distributed by direct contact and via the Internet. From over 2500 distributed questionnaires, we received 761 sheets and 680 were included. RESULTS The misuse of OTC drugs is increasing in Poland from pharmacists point of view. The most popular substance was PSD followed by COD and DXM. The main reason of misuse of these drugs could be related to the use of Internet and free access to these medications. In respondents (58.2%) opinion OTC drugs containing analyzed substances should be moved into the prescription status. CONCLUSIONS The misuse of OTC drugs should be considered as a very dangerous phenomenon. Although the Act on Counteracting Drug Addiction was amended in Poland in 2015, there are some facets requiring improvement. Social education may play a key role in the limitation of misuse of OTC drugs.
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Affiliation(s)
- Tomasz Zaprutko
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, 79 Dąbrowskiego Street, 60529 Poznań, Poland.
| | - Dorota Koligat
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, 79 Dąbrowskiego Street, 60529 Poznań, Poland
| | - Michał Michalak
- Department of Computer Sciences and Statistics, Poznan University of Medical Sciences, 79 Dąbrowskiego Street, 60529 Poznań, Poland
| | - Marta Wieczorek
- Student Scientific Society, Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, 79 Dąbrowskiego Street, 60529 Poznań, Poland
| | - Malwina Józiak
- Student Scientific Society, Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, 79 Dąbrowskiego Street, 60529 Poznań, Poland
| | - Monika Ratajczak
- Student Scientific Society, Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, 79 Dąbrowskiego Street, 60529 Poznań, Poland
| | - Kinga Szydłowska
- Student Scientific Society, Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, 79 Dąbrowskiego Street, 60529 Poznań, Poland
| | - Joanna Miazek
- Student Scientific Society, Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, 79 Dąbrowskiego Street, 60529 Poznań, Poland
| | - Krzysztof Kus
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, 79 Dąbrowskiego Street, 60529 Poznań, Poland
| | - Elżbieta Nowakowska
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, 79 Dąbrowskiego Street, 60529 Poznań, Poland
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Abstract
Emergency contraception (EC) may help prevent pregnancy in various circumstances, such as contraceptive method failure, unprotected sexual intercourse, or sexual assault, yet it remains underused. There are 4 approved EC options in the United States. Although ulipristal acetate requires a provider's prescription, oral levonorgestrel (LNG) is available over the counter for women of all ages. The most effective method of EC is the copper intrauterine device, which can be left in place for up to 10 years for efficacious, cost-effective, hormone-free, and convenient long-term primary contraception. Ulipristal acetate tends to be more efficacious in pregnancy prevention than is LNG, especially when taken later than 72 hours postcoitus. The mechanism of action of oral EC is delay of ovulation, and current evidence reveals that it is ineffective postovulation. Women who weigh more than 75 kg or have a body mass index greater than 25 kg/m(2) may have a higher risk of unintended pregnancy when using oral LNG EC; therefore, ulipristal acetate or copper intrauterine devices are preferable in this setting. Providers are often unaware of the range of EC options or are unsure of how to counsel patients regarding the access and use of EC. This article critically reviews current EC literature, summarizes recommendations, and provides guidance for counseling women about EC. Useful tips for health care providers are provided, with a focus on special populations, including breast-feeding women and those transitioning to long-term contraception after EC use. When treating women of reproductive age, clinicians should be prepared to counsel them about EC options, provide EC appropriately, and, if needed, refer for EC in a timely manner.
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MESH Headings
- Administration, Oral
- Attitude of Health Personnel
- Body Mass Index
- Breast Feeding
- Contraception, Postcoital/adverse effects
- Contraception, Postcoital/economics
- Contraception, Postcoital/methods
- Contraceptive Agents, Female/administration & dosage
- Contraceptive Agents, Female/adverse effects
- Contraceptive Agents, Female/economics
- Contraceptive Agents, Female/supply & distribution
- Contraceptives, Postcoital/administration & dosage
- Contraceptives, Postcoital/adverse effects
- Contraceptives, Postcoital/economics
- Contraceptives, Postcoital/supply & distribution
- Female
- Health Knowledge, Attitudes, Practice
- Humans
- Intrauterine Devices, Copper/adverse effects
- Intrauterine Devices, Copper/economics
- Intrauterine Devices, Copper/supply & distribution
- Levonorgestrel/administration & dosage
- Levonorgestrel/adverse effects
- Levonorgestrel/economics
- Levonorgestrel/supply & distribution
- Nonprescription Drugs/economics
- Nonprescription Drugs/standards
- Nonprescription Drugs/supply & distribution
- Norpregnadienes/administration & dosage
- Norpregnadienes/adverse effects
- Norpregnadienes/economics
- Norpregnadienes/supply & distribution
- Ovulation/drug effects
- Patient Education as Topic/methods
- Pregnancy
- Prescription Drugs/economics
- Prescription Drugs/standards
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Affiliation(s)
- Pelin Batur
- Department of Internal Medicine, Primary Care Women's Health, Cleveland Clinic, Cleveland, OH
| | - Lisa N Kransdorf
- Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, AZ
| | - Petra M Casey
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN.
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Stomberg C, Albaugh M, Shiffman S, Sood N. A cost-effectiveness analysis of over-the-counter statins. Am J Manag Care 2016; 22:e294-e303. [PMID: 27266585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To estimate the costs and benefits of over-the-counter (OTC) statins under the 2013 American College of Cardiology/American Heart Association guidelines. STUDY DESIGN A 10-year cost-effectiveness model using a health system perspective was developed to analyze the impact of making an OTC statin drug available. METHODS We calibrated the model by using nationally representative survey data on statin use and cardiovascular risk, data from clinical studies on the safety and efficacy of statins, and data from a study on consumer decisions to use an OTC statin. RESULTS We estimated that OTC statins would result in 252,359 fewer major coronary events, 41,133 fewer strokes, and 135,299 fewer coronary revascularization procedures over 10 years, as well as reduce coronary heart disease- and stroke-related deaths by 68,534 over the same time frame. These averted events would save more than $10.8 billion in healthcare costs while the costs of drug therapy would increase by $28.3 billion. Increased statin utilization is estimated to cause 3864 more cases of rhabdomyolysis-a very rare but severe side effect of statins. The estimated incremental cost-effectiveness ratio (ICER) of OTC statins was $5667 per quality-adjusted life-year, and the 95% CI of the ICER was $1384 to $12,701. CONCLUSIONS With proper labeling and consumer education, it is highly likely that OTC statins would be cost-effective, as they significantly improve population health without large increases in healthcare costs.
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Affiliation(s)
| | | | | | - Neeraj Sood
- University of Southern California, Sol Price School of Public Policy and Schaeffer Center for Health Policy and Economics, University Park Campus, Los Angeles, CA, USA 90089. E-mail:
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Moura ML, Boszczowski I, Mortari N, Barrozo LV, Neto FC, Lobo RD, Pedroso de Lima AC, Levin AS. The Impact of Restricting Over-the-Counter Sales of Antimicrobial Drugs: Preliminary Analysis of National Data. Medicine (Baltimore) 2015; 94:e1605. [PMID: 26402824 PMCID: PMC4635764 DOI: 10.1097/md.0000000000001605] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
To describe the nationwide impact of a restrictive law on over-the-counter sales of antimicrobial drugs, implemented in Brazil in November 2010. Approximately 75% of the population receives healthcare from the public health system and receives free-of-charge medication if prescribed. Total sales in private pharmacies as compared with other channels of sales of oral antibiotics were evaluated in this observational study before and after the law (2008-2012). Defined daily dose per 1000 inhabitants per day (DDD/TID) was used as standard unit. In private pharmacies the effect of the restrictive law was statistically significant (P < 0.001) with an estimated decrease in DDD/TID of 1.87 (s.e. = 0.18). In addition, the trend of DDD/TID before the restrictive law was greater than after the intervention (P < 0.001). Before November 2010, the slope for the trend line was estimated as 0.08 (s.e. = 0.01) whereas after the law, the estimated slope was 0.03 (s.e. = 0.01). As for the nonprivate channels, no difference in sales was observed (P = 0.643). The impact in the South and Southeast (more developed) regions was higher than in the North, Northeast, and Mid-West. The state capitals had a 19% decrease, compared with 0.8% increase in the rest of the states. Before the law, the sales of antimicrobial drugs were steadily increasing. From November 2010, with the restrictive law, there was an abrupt drop in sales followed by an increase albeit at a significantly lower rate. The impact was higher in regions with better socio-economic status.
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Affiliation(s)
- Maria Luísa Moura
- From the Infection Control Department, Hospital das Clínicas (MLM, IB, NM, RDL, ASL); Department of Geography, Faculdade de Filosofia, Letras e Ciências Humanas (LVB); Department of Epidemiology, Faculdade de Saúde Pública (FCN); Department of Statistics, Institute of Mathematics and Statistics, (ACPDL); and Department of Infectious Diseases and LIM 54, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil (ASL)
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Ito K, Weinberger KR, Robinson GS, Sheffield PE, Lall R, Mathes R, Ross Z, Kinney PL, Matte TD. The associations between daily spring pollen counts, over-the-counter allergy medication sales, and asthma syndrome emergency department visits in New York City, 2002-2012. Environ Health 2015; 14:71. [PMID: 26310854 PMCID: PMC4549916 DOI: 10.1186/s12940-015-0057-0] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 08/16/2015] [Indexed: 05/20/2023]
Abstract
BACKGROUND Many types of tree pollen trigger seasonal allergic illness, but their population-level impacts on allergy and asthma morbidity are not well established, likely due to the paucity of long records of daily pollen data that allow analysis of multi-day effects. Our objective in this study was therefore to determine the impacts of individual spring tree pollen types on over-the-counter allergy medication sales and asthma emergency department (ED) visits. METHODS Nine clinically-relevant spring tree pollen genera (elm, poplar, maple, birch, beech, ash, sycamore/London planetree, oak, and hickory) measured in Armonk, NY, were analyzed for their associations with over-the-counter allergy medication sales and daily asthma syndrome ED visits from patients' chief complaints or diagnosis codes in New York City during March 1st through June 10th, 2002-2012. Multi-day impacts of pollen on the outcomes (0-3 days and 0-7 days for the medication sales and ED visits, respectively) were estimated using a distributed lag Poisson time-series model adjusting for temporal trends, day-of-week, weather, and air pollution. For asthma syndrome ED visits, age groups were also analyzed. Year-to-year variation in the average peak dates and the 10th-to-90th percentile duration between pollen and the outcomes were also examined with Spearman's rank correlation. RESULTS Mid-spring pollen types (maple, birch, beech, ash, oak, and sycamore/London planetree) showed the strongest significant associations with both outcomes, with cumulative rate ratios up to 2.0 per 0-to-98th percentile pollen increase (e.g., 1.9 [95% CI: 1.7, 2.1] and 1.7 [95% CI: 1.5, 1.9] for the medication sales and ED visits, respectively, for ash). Lagged associations were longer for asthma syndrome ED visits than for the medication sales. Associations were strongest in children (ages 5-17; e.g., a cumulative rate ratio of 2.6 [95% CI: 2.1, 3.1] per 0-to-98th percentile increase in ash). The average peak dates and durations of some of these mid-spring pollen types were also associated with those of the outcomes. CONCLUSIONS Tree pollen peaking in mid-spring exhibit substantive impacts on allergy, and asthma exacerbations, particularly in children. Given the narrow time window of these pollen peak occurrences, public health and clinical approaches to anticipate and reduce allergy/asthma exacerbation should be developed.
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Affiliation(s)
- Kazuhiko Ito
- New York City Department of Health and Mental Hygiene, Bureau of Environmental Surveillance and Policy, New York, NY, 10013, USA.
| | - Kate R Weinberger
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032-3727, USA.
| | - Guy S Robinson
- Louis Calder Center, Biological Field Station, Fordham University, Armonk, New York, NY, 10504-1104, USA.
- Department of Natural Sciences, Fordham College at Lincoln Center, 113 West 60th Street, New York, NY, 10023, USA.
| | - Perry E Sheffield
- Departments of Pediatrics and Preventive Medicine, Mount Sinai School of Medicine, 1 Gustave L. Levy Pl., Box 1512, New York, NY, 10029, USA.
| | - Ramona Lall
- New York City Department of Health and Mental Hygiene, Bureau of Communicable Disease, Queens, NY, 11101, USA.
| | - Robert Mathes
- New York City Department of Health and Mental Hygiene, Bureau of Communicable Disease, Queens, NY, 11101, USA.
| | - Zev Ross
- ZevRoss Spatial Analysis, Ithaca, NY, 14850, USA.
| | - Patrick L Kinney
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032-3727, USA.
| | - Thomas D Matte
- New York City Department of Health and Mental Hygiene, Bureau of Environmental Surveillance and Policy, New York, NY, 10013, USA.
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Abstract
BACKGROUND Patent medicine vendors (PMVs) play an important role in the treatment of malaria, especially in the rural areas. Nigeria recently changed her antimalarial treatment policy from chloroquine to artemisinin-based combination therapy (ACT). OBJECTIVES To determine the response of PMVs to the new policy. METHODS A baseline study was conducted in two local government areas (LGAs) of Lagos state Nigeria as the first phase in an intervention study aimed at improving the malarial treatment practices of PMVs in rural Lagos. A mixed method design involving a questionnaire survey of 180 PMVs and four key informant interviews were used. An antimalarial drug (AMD) audit was also performed. RESULTS More than 80% of respondents were aware of the policy change in malaria treatment, but only 23.9% sold an ACT for the last case of malaria treated in an under five child. The main determining factor of the particular AMD sold was PMV's personal choice (70.6%). About half (58.9%) of the shops stocked ACTs, the newly recommended antimalarials. CONCLUSIONS The high awareness of the policy change did not translate to a commensurate increase in the sale of the new drugs. Factors beyond the PMVs need to be addressed for a successful adoption of the new policy.
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Affiliation(s)
- Abisoye Oyeyemi
- Department of Community Medicine, Faculty of Clinical Sciences, College of Health Sciences, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria
| | - Babatunde Ogunnowo
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
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Ozeki K, Noda T, Nakamura M, Ojima T. Weather and headache onset: a large-scale study of headache medicine purchases. Int J Biometeorol 2015; 59:447-451. [PMID: 24943052 DOI: 10.1007/s00484-014-0859-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 05/02/2014] [Accepted: 06/08/2014] [Indexed: 06/03/2023]
Abstract
It is widely recognized that weather changes can trigger headache onset. Most people who develop headaches choose to self-medicate rather than visit a hospital or clinic. We investigated the association between weather and headache onset using large-sample sales of the headache medicine, loxoprofen. We collected daily sales figures of loxoprofen and over-the-counter drugs over a 1-year period from a drugstore chain in western Shizuoka prefecture, Japan. To adjust for changes in daily sales of loxoprofen due to social environmental factors, we calculated a proportion of loxoprofen daily sales to over-the-counter drug daily sales. At the same time, we obtained weather data for the study region from the website of the Japan Meteorological Agency. We performed linear regression analysis to ascertain the association between weather conditions and the loxoprofen daily sales proportion. We also conducted a separate questionnaire survey at the same drugstores to determine the reason why people purchased loxoprofen. Over the study period, we surveyed the sale of hundreds of thousands of loxoprofen tablets. Most people purchased loxoprofen because they had a headache. We found that the sales proportion of loxoprofen increased when average barometric pressure decreased, and that precipitation, average humidity, and minimum humidity increased on loxoprofen purchase days compared to the previous day of purchases. This study, performed using a large dataset that was easy-to-collect and representative of the general population, revealed that sales of loxoprofen, which can represent the onset and aggravation of headache, significantly increased with worsening weather conditions.
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Affiliation(s)
- Kayoko Ozeki
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashiku, Hamamatsu, Shizuoka, 431-3192, Japan,
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Fraeyman J, Peeters L, Van Hal G, Beutels P, De Meyer GRY, De Loof H. Consumer choice between common generic and brand medicines in a country with a small generic market. J Manag Care Spec Pharm 2015; 21:288-96. [PMID: 25803762 PMCID: PMC10398248 DOI: 10.18553/jmcp.2015.21.4.288] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Generic medicines offer an opportunity for governments to contain pharmaceutical expenditures, since generics are generally 10%-80% lower in price than brand medicines. Belgium has a small generic market that takes up 15% of the total pharmaceutical market in packages sold. OBJECTIVE To determine the knowledge of consumers about the different available packages of a common over-the-counter medicine (acetaminophen) with regard to price advantage, quality, and effectiveness in a country with a small generic market. METHODS We conducted an online survey in the general Flemish population using a questionnaire with 25 statements. The questionnaire also contained 2 informative interventions. First, we showed the price per package and per tablet that the patient would pay in the pharmacy. Second, we provided the respondent with general information about generic medication (equivalence, effectiveness, price, and recognition). Before and after the interventions, we probed for preferences and knowledge about the different packages. Multivariate logistic models were used to examine the independent effects of consumer characteristics on responses to the survey statements. RESULTS We obtained a sample of 1,636 respondents. The general attitude towards generic medication was positive-only 5% would rather not use a generic. Nevertheless, only 17% of the respondents were able to recognize a generic medicine. Older consumers (aged 60 years and above) were more often confused about the different packages (OR = 2.59, 95% CI = 1.76-3.80, P ≤ 0.001). Consumers without a higher education degree tended to be more doubtful about the difference in effectiveness and quality between the different brands (OR = 0.59, 95% CI = 0.44-0.79, P ≤ 0.001). Consumer recognition of the name of the active substance of acetaminophen was poor. When different brands were displayed, possible price advantage seemed to be an important motive to switch to a cheaper brand. Consumers generally found medicines to be too expensive; however, consumers with medical or paramedical training had a different opinion. CONCLUSIONS Two main recommendations can be made to increase the knowledge and enhance the trust in cheaper equivalent medicines. First, highlighting the name of the active substance on the label of medicine packages can reduce confusion and avoid health risks, especially among older consumers. Second, new investments or reallocation of budgets should be considered in order to provide consumers with authoritative information on the bioequivalence and price differences between the different available brands. This would be a cost-effective and potentially cost-saving investment for health care payers.
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Affiliation(s)
- Jessica Fraeyman
- University of Antwerp, Universiteitsplein 1, 2610 Wilrijk (Antwerp), Belgium.
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Bocquet F, Paubel P, Fusier I, Cordonnier AL, Sinègre M, Le Pen C. Biosimilar versus patented erythropoietins: learning from 5 years of European and Japanese experience. Appl Health Econ Health Policy 2015; 13:47-59. [PMID: 25189295 DOI: 10.1007/s40258-014-0125-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Patent expiries on leading biologics are creating new momentum in the market for biosimilars (copies of off-patent biologics), paving the way for their development. However, little is known about the factors influencing the competition between biosimilars and their reference products (REF). OBJECTIVES The aim of this study was to analyse key global erythropoietin (EPO) markets and factors affecting biosimilar EPO (BIOSIM-EPO) uptakes, and to identify countries where BIOSIM-EPOs have gained significant market shares. METHODS Inclusion criteria for countries in the study were a biosimilar regulatory framework similar to the EU framework, and biological market value higher than US$2.5 billion. Factors evaluated included EPO market size, EPO retail/hospital distribution mix, national incentives to use biosimilars and BIOSIM-EPO/REF price differences. IMS Health provided EPO consumption in volumes, values, and EPO ex-manufacturer prices from 2007 to 2012. RESULTS Japan: large-sized market, mixed retail/hospital distribution, no incentives, low BIOSIM-EPO uptake (6.8 % in 2012). France: large-sized market, dominant retail distribution, no incentives, low BIOSIM-EPO uptake (5.8 %). Spain and Italy: medium-sized market, dominant hospital distribution, no incentives, moderate BIOSIM-EPO uptakes (11.5 and 8.6 %). Germany: small-sized market, dominant retail distribution, presence of incentives, high BIOSIM-EPO uptake (30.4 %). UK: small-sized market, mixed retail/hospital distribution, no incentives, low BIOSIM-EPO uptake (2.0 %). BIOSIM-EPO/REF price differences play no role at a global level (-10.8 % in Germany and -26.9 % in Japan). CONCLUSIONS EPO markets have proven to be highly country-specific. EPO market sizes, EPO retail/hospital distribution mixes and BIOSIM-EPO/REF price differences may not be determining factors of BIOSIM-EPO uptakes. Prescription and substitution incentives to use BIOSIM-EPO appear to be determining factors in Germany. The heterogeneity of national EPO markets makes it impossible to outline country profile types with significant BIOSIM-EPO penetrations.
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Affiliation(s)
- François Bocquet
- Laboratory for the Economics and Management of Health Organizations, Dauphine University, Place du Maréchal de Lattre de Tassigny, 75775, Paris, CEDEX 16, France,
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4 easy ways to cut your drug spending. Minimizing your prescription drug costs is easier than it may seem. Harv Womens Health Watch 2014; 22:1, 7. [PMID: 26058101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Gauld NJ, Kelly FS, Kurosawa N, Bryant LJM, Emmerton LM, Buetow SA. Widening consumer access to medicines through switching medicines to non-prescription: a six country comparison. PLoS One 2014; 9:e107726. [PMID: 25251434 PMCID: PMC4175460 DOI: 10.1371/journal.pone.0107726] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 08/18/2014] [Indexed: 11/29/2022] Open
Abstract
Background Switching or reclassifying medicines with established safety profiles from prescription to non-prescription aims to increase timely consumer access to medicines, reduce under-treatment and enhance self-management. However, risks include suboptimal therapy and adverse effects. With a long-standing government policy supporting switching or reclassifying medicines from prescription to non-prescription, the United Kingdom is believed to lead the world in switch, but evidence for this is inconclusive. Interest in switching medicines for certain long-term conditions has arisen in the United Kingdom, United States, and Europe, but such switches have been contentious. The objective of this study was then to provide a comprehensive comparison of progress in switch for medicines across six developed countries: the United States; the United Kingdom; Australia; Japan; the Netherlands; and New Zealand. Methods A list of prescription-to-non-prescription medicine switches was systematically compiled. Three measures were used to compare switch activity across the countries: “progressive” switches from 2003 to 2013 (indicating incremental consumer benefit over current non-prescription medicines); “first-in-world” switches from 2003 to 2013; and switch date comparisons for selected medicines. Results New Zealand was the most active in progressive switches from 2003 to 2013, with the United Kingdom and Japan not far behind. The United States, Australia and the Netherlands showed the least activity in this period. Few medicines for long-term conditions were switched, even in the United Kingdom and New Zealand where first-in-world switches were most likely. Switch of certain medicines took considerably longer in some countries than others. For example, a consumer in the United Kingdom could self-medicate with a non-sedating antihistamine 19 years earlier than a consumer in the United States. Conclusion Proactivity in medicines switching, most notably in New Zealand and the United Kingdom, questions missed opportunities to enhance consumers' self-management in countries such as the United States.
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Affiliation(s)
- Natalie J. Gauld
- Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
- * E-mail:
| | - Fiona S. Kelly
- School of Pharmacy, University of Auckland, Auckland, New Zealand
- Griffith Health Institute, Griffith University, Brisbane, Queensland, Australia
| | - Nahoko Kurosawa
- Hokkaido Pharmaceutical University School of Pharmacy, Otaru, Hokkaido, Japan
| | - Linda J. M. Bryant
- Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
| | - Lynne M. Emmerton
- School of Pharmacy, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Stephen A. Buetow
- Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
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Top store brands at pharmacies. Consum Rep 2014; 79:7. [PMID: 24830075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Grindlay K, Foster DG, Grossman D. Attitudes toward over-the-counter access to oral contraceptives among a sample of abortion clients in the United States. Perspect Sex Reprod Health 2014; 46:83-89. [PMID: 24602230 DOI: 10.1363/46e0714] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
CONTEXT Women having abortions are at high risk for future unintended pregnancy, and removing the prescription requirement for oral contraceptives may increase continuation and adoption of this effective method. METHODS A survey fielded from May to July 2011 collected information from 651 women aged 15-46 seeking abortion services at six urban clinics from across the United States. Descriptive statistics, chi-square tests and logistic regression analyses were conducted to estimate women's interest in over-the-counter access to oral contraceptives. RESULTS Eighty-one percent of respondents supported over-the-counter access to oral contraceptives; while 42% of women planned to use the pill after their abortion, 61% said they would likely use this method if it were available over the counter. Thirty-three percent of women who planned to use no contraceptive following their abortion said they would use an over-the-counter pill, as did 38% who planned to use condoms afterward. In multivariable analysis, several subgroups had increased odds of likely over-the-counter use: women who were older than 19 (odds ratios, 1.8 for those aged 20-29 and 1.6 for those aged 30-46), were uninsured (1.5), had ever used the pill (1.4), had had difficulty obtaining a prescription refill for hormonal contraceptives (2.7) or planned to use the pill postabortion (13.0). By contrast, compared with white respondents, women of other races or ethnicities were less likely to say they would use over-the-counter pills (0.4-0.7). CONCLUSIONS Interest in a hypothetical over-the-counter oral contraceptive was high in this sample, and this delivery model has the potential to reduce unintended pregnancy among abortion patients.
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Big savings with new generic drugs. Consum Rep 2014; 79:12. [PMID: 24724211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Todd S, Diggle PJ, White PJ, Fearne A, Read JM. The spatiotemporal association of non-prescription retail sales with cases during the 2009 influenza pandemic in Great Britain. BMJ Open 2014; 4:e004869. [PMID: 24780494 PMCID: PMC4010812 DOI: 10.1136/bmjopen-2014-004869] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 04/09/2014] [Accepted: 04/10/2014] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To assess whether retail sales of non-prescription products can be used for syndromic surveillance and whether it can detect influenza activity at different spatial scales. A secondary objective was to assess whether changes in purchasing behaviour were related to public health advice or levels of media or public interest. SETTING The UK. PARTICIPANTS National and regional influenza case estimates and retail sales from a major British supermarket. OUTCOME MEASURES Weekly, seasonally adjusted sales of over-the-counter symptom remedies and non-pharmaceutical products; recommended as part of the advice offered by public health agencies; were compared with weekly influenza case estimates. Comparisons were made at national and regional spatial resolutions. We also compared sales to national measures of contemporaneous media output and public interest (Internet search volume) related to the pandemic. RESULTS At a national scale there was no significant correlation between retail sales of symptom remedies and cases for the whole pandemic period in 2009. At the regional scale, a minority of regions showed statistically significant positive correlations between cases and sales of adult 'cold and flu' remedies and cough remedies (3.2%, 5/156, 3.8%, 6/156), but a greater number of regions showed a significant positive correlation between cases and symptomatic remedies for children (35.6%, 55/156). Significant positive correlations between cases and sales of thermometers and antiviral hand gels/wash were seen at both spatial scales (Cor 0.477 (95% CI 0.171 to 0.699); 0.711 (95% CI 0.495 to 0.844)). We found no significant association between retail sales and media reporting or Internet search volume. CONCLUSIONS This study provides evidence that the British public responded appropriately to health messaging about hygiene. Non-prescription retail sales at a national level are not useful for the detection of cases. However, at finer spatial scales, in particular age-groups, retail sales may help augment existing surveillance and merit further study.
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Affiliation(s)
- Stacy Todd
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Peter J Diggle
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
- Lancaster Medical School, University of Lancaster, Lancaster, UK
| | - Peter J White
- Department of Infectious Disease Epidemiology, MRC Centre for Outbreak Analysis and Modelling, Imperial College School of Public Health, London, UK
- NIHR Health Protection Research Unit in Modelling Methodology, Department of Infectious Disease Epidemiology, Imperial College School of Public Health, London, UK
- Modelling and Economics Unit, Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | - Andrew Fearne
- Kent Business School, University of Kent, Canterbury, UK
| | - Jonathan M Read
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
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Weng G, Han S, Pu R, Pan WHT, Shi L. Exploration of approaches to adjusting brand-name drug prices in Mainland of China: based on comparison and analysis of some brand-name drug prices of Mainland and Taiwan, China. Chin Med J (Engl) 2014; 127:2222-2228. [PMID: 24931232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Under the circumstance of the New Medical Reform in Mainland of China, lowering drug prices has become an approach to relieving increase of medical expenses, and lowering brand-name medication price is a key strategy. This study, by comparing and analyzing brand-name medication prices between Mainland of China and Taiwan, explores how to adjust brand-name medication prices in Mainland of China in the consideration of the drug administrative strategies in Taiwan. METHODS By selecting brand-name drug with generic name and dose types matched in Mainland and Taiwan, calculate the average unit price and standard deviation and test it with the paired t-test. In the mean time, drug administrative strategies between Mainland and Taiwan are also compared systematically. RESULTS Among the 70 brand-name medications with generic names and matched dose types, 54 are at higher prices in Mainland of China than Taiwan, which is statistically significant in t-test. Also, among the 47 medications with all of matched generic names, dose types, and manufacturing enterprises, 38 are at higher prices in Mainland than Taiwan, and the gap is also statistically significant in t-test. In Mainland of China, brand-name medication took cost-plus pricing and price-based price adjustment, while in Taiwan, brand-name medication took internal and external reference pricing and market-based price adjustment. CONCLUSIONS Brand-name drug prices were higher in Mainland of China than in Taiwan. The adjustment strategies of drug prices are scientific in Taiwan and are worth reference by Mainland of China.
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Affiliation(s)
- Geng Weng
- School of Pharmaceutical Science, Peking University, Beijing 100191, China
| | - Sheng Han
- School of Public Health, Peking University, Beijing 100191, China; International Research Center of Medical Administration, Peking University, Beijing 100191, China
| | - Run Pu
- China National Center for Biotechnology Development (CNCBD), Beijing 100039, China
| | - Wynn H T Pan
- Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan 00222, China
| | - Luwen Shi
- School of Pharmaceutical Science, Peking University, Beijing 100191, China; International Research Center of Medical Administration, Peking University, Beijing 100191, China.
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Abstract
INTRODUCTION Triptans have been safely and effectively used in the management of migraine for more than fifteen years, and it seems reasonable to wonder what would be the economic impact of moving a specific triptan to OTC availability. The objective of this study was then to examine the economic impact of payer policies of a triptan Rx-to-OTC switch in six EU countries (France, UK, Spain, Italy, Germany and Poland). METHODS A decision model was used to model the budgetary impact of a triptan Rx-to-OTC switch from the third-party payer (TPP) and the societal perspectives, using a one-year timeframe. RESULTS From the TPP perspective, it is estimated that the current overall direct spending on the management of migraine attacks across the 6 EU Member States is €582 million annually, and that the savings would reach €75 million (13% of the overall direct economic burden of migraine). From the societal perspective, €86 million annually would be added. CONCLUSIONS Given evidence of effectiveness and safety, and given the potential savings, a triptan Rx-to-OTC switch is a reasonable public policy decision.
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Affiliation(s)
- Aurelie Millier
- Health Economics and Outcomes Research Department, Creativ-Ceutical, Paris, France
| | - Joshua Cohen
- Tufts Center for the Study of Drug Development, Tufts University, Boston, Massachusetts, United States of America
| | - Mondher Toumi
- Unité de Formation et de Recherche d'Odontologie, Université Claude Bernard Lyon I, Lyon, France
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In brief: Oxytrol OTC. Med Lett Drugs Ther 2013; 55:76. [PMID: 24043218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Kouros N. Pill to be available without prescription or age restriction. Monash Bioeth Rev 2013; 31:21. [PMID: 24844069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Surprising ways to cut your drug costs: even with insurance you might be paying too much. Consum Rep 2013; 78:26-30. [PMID: 23930299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Jalilian F, Hazavehei SMM, Vahidinia AA, Jalilian M, Moghimbeigi A. Prevalence and related factors for choosing self-medication among pharmacies visitors based on health belief model in Hamadan Province, west of Iran. J Res Health Sci 2013; 13:81-85. [PMID: 23772020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2012] [Revised: 12/01/2012] [Accepted: 03/18/2013] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Self-medication has increased in the last decade in Iran; can be followed several complications. The aim of this study was to determine the prevalence and factors influencing self-medication based on health belief model. METHODS A cross-sectional study was conducted among 1400 Hamadan Province pharmacies visitors, during spring and summer 2012 which was randomly selected with the proportional to size among different pharmacy at Hamadan for participation in this study. A structured questionnaire was applied for collecting data, which were analyzed by SPSS version 16 using bivariate correlations and logistic regression statistical tests. RESULTS 35.4% of the participants had self-medication. Pain medication (10.6%), antibiotics (7.3%) and anti-cough and cold medications (4.5%) had the largest consumption. The main reasons of self-medication among participants were previous use of medication, symptoms improve and similar prescribed. The best predictor for self-medication was perceived severity with odds ratio estimate of 0.790 [95% CI: 0.694, 0.900]. CONCLUSION It seems that designing and implementation of educational programs to increase seriousness about side effect of self-medication may be usefulness of the results in order to prevent of self-medication.
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Affiliation(s)
- Farzad Jalilian
- Department of Nursing, School of Basic Science, Islamic Azad University, Hamadan, Iran
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Grossman D, Grindlay K, Li R, Potter JE, Trussell J, Blanchard K. Interest in over-the-counter access to oral contraceptives among women in the United States. Contraception 2013; 88:544-52. [PMID: 23664627 DOI: 10.1016/j.contraception.2013.04.005] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 03/21/2013] [Accepted: 04/18/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND A growing body of evidence indicates that over-the-counter (OTC) access to oral contraceptive pills (OCPs) is safe and effective. STUDY DESIGN We performed a nationally representative survey of adult women at risk of unintended pregnancy using a probability-based online panel. In November-December 2011, 2046 eligible women completed the survey. Weighted proportions were calculated, and logistic regression was used to identify covariates associated with support for and interest in using an OTC OCP. RESULTS A total of 62.2% said they were strongly (31.4%) or somewhat (30.9%) in favor of OCPs being available OTC. A total of 37.1% of participants reported being likely to use OCPs if available OTC, including 58.7% of current users, 28.0% using no method and 32.7% using a less effective method. Covariates associated with a higher odds of reporting interest in using OTC OCPs were younger age; being divorced, being separated or living with a partner (versus married); being uninsured or having private insurance (versus public insurance); living in the south (versus northeast); and current use of OCPs or less effective methods, or nonuse of contraception (versus use of another hormonal method or intrauterine device). Among respondents who said they were likely to use OTC OCPs, the highest amount they were willing to pay was on average $20. CONCLUSIONS US women are supportive of OTC access to OCPs, and many would obtain refills OTC or start using OCPs if they were available OTC.
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Affiliation(s)
- Daniel Grossman
- Ibis Reproductive Health, Oakland, CA, USA; Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA.
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Liu TY, Sanders JL, Tsui FC, Espino JU, Dato VM, Suyama J. Association of over-the-counter pharmaceutical sales with influenza-like-illnesses to patient volume in an urgent care setting. PLoS One 2013; 8:e59273. [PMID: 23555647 PMCID: PMC3605458 DOI: 10.1371/journal.pone.0059273] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Accepted: 02/13/2013] [Indexed: 12/03/2022] Open
Abstract
We studied the association between OTC pharmaceutical sales and volume of patients with influenza-like-illnesses (ILI) at an urgent care center over one year. OTC pharmaceutical sales explain 36% of the variance in the patient volume, and each standard deviation increase is associated with 4.7 more patient visits to the urgent care center (p<0.0001). Cross-correlation function analysis demonstrated that OTC pharmaceutical sales are significantly associated with patient volume during non-flu season (p<0.0001), but only the sales of cough and cold (p<0.0001) and thermometer (p<0.0001) categories were significant during flu season with a lag of two and one days, respectively. Our study is the first study to demonstrate and measure the relationship between OTC pharmaceutical sales and urgent care center patient volume, and presents strong evidence that OTC sales predict urgent care center patient volume year round.
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Affiliation(s)
- Timothy Y. Liu
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Jason L. Sanders
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Fu-Chiang Tsui
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Real-time Outbreak and Disease Surveillance Laboratory, Pittsburgh, Pennsylvania, United States of America
| | - Jeremy U. Espino
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Real-time Outbreak and Disease Surveillance Laboratory, Pittsburgh, Pennsylvania, United States of America
| | - Virginia M. Dato
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Pennsylvania Department of Health, Harrisburg, Pennsylvania, United States of America
| | - Joe Suyama
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- University of Pittsburgh Medical Center Urgent Care at Shadyside, Pittsburgh, Pennsylvania, United States of America
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