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Comprehensive taxonomy and worldwide trends in pharmaceutical policies in relation to country income status
Background
Rapidly evolving socioeconomic and technological trends make it challenging to improve access, effectiveness and efficiency in the use of pharmaceuticals. This paper identifies and systematically classifies the prevailing pharmaceutical policies worldwide in relation to a country’s income status.
Methods
A literature search was undertaken to identify and taxonomize prevailing policies worldwide. Countries that apply those policies and those that do not were then grouped by income status.
Results
Pharmaceutical policies are linked to a country’s socioeconomics. Developed countries have universal coverage and control pharmaceuticals with external and internal price referencing systems, and indirect price–cost controls; they carry out health technology assessments and demand utilization controls. Price-volume and risk-sharing agreements are also evolving. Developing countries are underperforming in terms of coverage and they rely mostly on restrictive state controls to regulate prices and expenditure.
Conclusions
There are significant disparities worldwide in the access to pharmaceuticals, their use, and the reimbursement of costs. The challenge in high-income countries is to maintain access to care whilst dealing with trends in technology and aging. Essential drugs should be available to all; however, many low- and middle-income countries still provide most of their population with only poor access to medicines. As economies grow, there should be greater investment in pharmaceutical care, looking to the policies of high-income countries to increase efficiency. Pharmaceutical companies could also develop special access schemes with low prices to facilitate coverage in low-income countries.
Journal Article
Breakthroughs in Medicinal Chemistry: New Targets and Mechanisms, New Drugs, New Hopes–7
Breakthroughs in Medicinal Chemistry: New Targets and Mechanisms, New Drugs, New Hopes is a series of editorials which is published on a biannual basis by the Editorial Board of the Medicinal Chemistry section of the journal Molecules [...]
Journal Article
Toward appropriate criteria in medication adherence assessment in older persons: Position Paper
Nonadherence to medication regimens is a worldwide challenge; adherence rates range from 38 to 57 % in older populations with an average rate of less than 45 % and nonadherence contributes to adverse drug events, increased emergency visits and hospitalisations. Accurate measurement of medication adherence is important in terms of both research and clinical practice. However, the identification of an objective approach to measure nonadherence is still an ongoing challenge. The aim of this Position Paper is to describe the advantages and disadvantages of the known medication adherence tools (self-report, pill count, medication event monitoring system (MEMS) and electronic monitoring devices, therapeutic drug monitoring, pharmacy records based on pharmacy refill and pharmacy claims databases) to provide the appropriate criteria to assess medication adherence in older persons. To the best of our knowledge, no gold standard has been identified in adherence measurement and no single method is sufficiently reliable and accurate. A combination of methods appears to be the most suitable. Secondly, adherence assessment should always consider tools enabling polypharmacy adherence assessment. Moreover, it is increasingly evident that adherence, as a process, has to be assessed over time and not just at one evaluation time point (drug discontinuation). When cognitive deficits or functional impairments may impair reliability of adherence assessment, a comprehensive geriatric assessment should be performed and the caregiver involved. Finally, studies considering the possible implementation in clinical practice of adherence assessment tools validated in research are needed.
Journal Article
NMR Spectroscopy in Pharmaceutical Analysis
For almost a decade, quantitative NMR spectroscopy (qNMR) has been established as a valuable tool in drug analysis. In all disciplines, such as drug identification, impurity profiling and assay, qNMR can be utilized. Separation techniques such as high performance liquid chromatography, gas chromatography, super fluid chromatography and capillary electrophoresis techniques, govern the purity evaluation of drugs. However, these techniques are not always able to solve the analytical problems often resulting from insufficient methods. Nevertheless, such methods find their way into international pharmacopoeias. Thus, the aim of this book is to describe the possibilities of qNMR in pharmaceutical analysis. Besides the introduction to the physical fundamentals and techniques, the principles of the application in drug analysis are described: Quality evaluation of drugs, Polymer characterization, Natural products and corresponding reference compounds, Metabolism, and Solid phase NMR spectroscopy for the characterization drug substances, e.g. the water content, polymorphism, and drug formulations, e.g. tablets, powders. This part is accompanied by more special chapters dealing with representative examples that give more detailed information by means of concrete examples.
eBook
Role of Social Media Promotion of Prescription Drugs on Patient Belief-system and Behaviour
In the current scenario, extremely little information exists on the uses, benefits, and limitations of social media for health communication among the patients and health professionals. Further, how it is affecting the patient belief system and behavior is even less studied, but it is emerging on the research horizon due to its growing significance in this digital age. This is a review article using a systematic approach. We performed a systematic literature search for papers that address social media–related challenges and opportunities for pharmaceutical drugs. It identifies the needs that propel patients to take recourse to SMPs; the benefits they derive from these and their limitations. This review article confirms that healthcare information provided by the social media sites has been found to be beneficial in many ways for the stakeholders and that it complements existing patient-physician interaction. However, it has limitations that need to be explored and understood to avoid ill consequences.
Journal Article