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Purpose – To examine how drug prices for specific diseases vary across payers in the United States and how insurer and patient out-of-pocket (OOP) costs vary by payer type.

Methodology – This study uses data from the Medical Expenditure Panel Survey (MEPS) from 1996 to 2006. We estimate multivariate price regressions for four major drug product classes (antihypertensive, antidepressant, antiasthma drugs, and non-steroidal anti-inflammatory drugs (NSAIDs)). Separate models are estimated for brand and generic drugs within each of these drug product classes. In addition to estimating overall transaction price equations for brands and generics, the study estimates patient OOP payments and insurer payments for drugs.

Findings – We find relatively modest differences among payers in terms of total prices (e.g., insurer plus OOP). The main difference is in terms of how prices were shared between insurers and patients. Medicaid paid significantly more than other payers for each drug class, while Medicaid beneficiaries paid significantly less.

Research implications – Our results shed light on how drug prices vary by different payers and how drug prices are shared by third party payers and patients. The relatively modest differences in total drug prices across payer type suggest that these payers do not differ greatly in terms of their ability to negotiate price concessions from their suppliers. Instead, larger differences emerge in terms of how total costs are shared among the payer and their patients. Understanding the reasons for these variations, and their implications for health outcomes, are important directions for further research.

This study aims to investigate the antihypertensive effect of camel milk hydrolysate in rats with fructose-induced hypertension.

The antihypertensive effect of fermented camel milk was determined using 6 groups comprising 36 Wistar male rats. Blood pressure of rats was altered via exposure to a 10% fructose (w/v) diet in drinking water for 3 weeks before conducting 21 days of treatment. The authors conducted the experiment for short and long term using different doses of 800 and 1,200 mg/kg body weight. Serum was used to assay total cholesterol (TC), triglyceride (TG), glucose and insulin levels using standard biochemical kits.

The group that received 1,200 mg hydrolysate camel milk (HM) has significantly (p = 0.003) reduced systolic and diastolic blood pressure after a short exposure time (4–8 h). These effects were significantly (p = 0.005) comparable to the nifedipine (NIF) drug group. Similar long-term (21 days) effects on blood pressure were observed in 1,200 mg HM and NIF groups. Angiotensin-converting enzyme (ACE) activity and levels were also reduced in a correlation with blood pressure reduction only in HM1200 and HM800 treated groups. The authors observed no significant effect on blood pressure in groups receiving the 800 mg HM or 1,200 mg unhydrolyzed camel milk (UM). Rats receiving the 10% fructose diet showed significant differences from control rats regarding their blood biochemistry, including TG, TC, blood glucose and insulin levels. Rats in groups NIF, HM1200 and HM800 showed a significant (p < 0.05) reduction in serum glucose, insulin, TG and TC levels toward the baseline level.

Further mechanistic investigation on the HM antihypertensive activity is highly recommended before suggesting HM as a product to reduce blood pressure. While drug–food interaction between HM and antihypertensive drugs, especially ACE inhibitors, is probable, UM seems not to affect blood pressure or ACE activity and therefore is expected to have no or minimal effects on the activity of other antihypertensive drugs. Investigation of ACE expression from various organs including lungs and leukocytes is highly recommended in future works using sodium dodecyl-sulfate polyacrylamide gel electrophoresis and western blot analysis or reverse transcription polymerase chain reaction.

No previous studies have measured the antihypertensive activity of milk hydrolysate mediated by the reduction of ACE activity and levels in plasma. Mechanisms involved in attenuating the levels of ACE warrant further investigation.

The purpose of this paper is to examine the role of tacit knowledge in incremental innovation, which has hitherto been neglected.

Qualitative case analysis was used to focus on two large Japanese pharmaceutical companies’ development of new antihypertensive drugs. The study uses interview data and documentary research materials to explore the knowledge bases of the companies’ research teams as they refined an existing drug to produce new products – a process of incremental innovation.

Explicit knowledge (chemical structure of preceding drug) was used in both successful and failed cases of drug discovery. In the two successful cases, the tacit knowledge of key researchers, based on their long-term experience of related research, provided insight into developing compounds with good in vivo efficacy, which led to successful clinical development.

The findings suggest that tacit knowledge may play an important role in incremental innovation processes, and that its influence on product development should be considered in such ways as team and organization structure.

This study addresses a gap in the literature regarding the impact of tacit knowledge on incremental innovation processes. It is often assumed that incremental innovation is based on existing technology. This study suggests that tacit knowledge may play a hitherto largely unrecognized role in incremental product development.

The quality and reliability of medical communication for branded drug adoption is extremely critical, not only for safeguarding patient interests but also for ensuring successful investments by multinational pharmaceutical firms. This paper predicts doctors’ prescribing intentions based on communication relationship among factors for late entrant branded drugs, compared with pioneering brand choice, for treating chronic diseases such as hypertension.

The constructs were validated with structural equation model for a sample set of 151 doctors from private hospitals in the National Capital Region of India.

This research reveals communication drivers and draws on theory to suggest that the doctor’s behavioural prescription intentions, subject to social influence from their colleagues, leads to lower adoption responses.

Given that limitations on sample size are often unavoidable, this study reveals that, due to the availability of substituting brands, alternate therapeutic routes and lack of availability of a practical guide for prescription, a communication model needs to be developed and validated.

Furthermore, managers of pharmaceutical firms should differentiate between the effects of direct and indirect communication–integration efforts for minimizing uncertainty in drug adoption in the context of the fragmented and unpredictable Indian market.

A late entrant may lose its dominant market share to alternate brands from other suppliers due to communication gaps in an unstructured market, leading to low adoption intentions. The study provides business theorists, drug marketers and health-care professionals with unique insights into specific communication drivers of prescribing decisions, aimed at ensuring reliable and appropriate drug adoption in Indian markets.

Increased outsourcing and importation of drugs from different parts of the world to the Latin America and the Caribbean (LAC) region result in the proliferation of substandard and fake medicines, posing a threat to public health. The presence of substandard and fake medications in LAC regions is a source of public health concern and causes an economic burden to the governments in these regions. Whereas testing and detecting medication quality can easily be achieved in developed countries, the situation is different in developing countries such as LAC. This paper aims to examine the public health challenges faced by LAC regarding substandard, fake and counterfeit medicines and how the region can tackle these challenges.

Databases such as Scopus, PubMed, ScienceDirect, Embase, HINARI, EBSCOhost, Google Scholar, unpublished data, conference abstracts and papers from World Health Organization, Pan-American Health Organization and electronic newspapers were searched concerning medicine quality and in LAC.

Drug treatment improves the quality of life while decreasing morbidity and mortality among diseased populations. Absence of or inadequate testing laboratories, old and ineffective legislature, lack of enforcement or willpower and lack of effective surveillance are challenges in LAC for the proliferation of substandard and falsified medicines (SFMs).

The most significant limitation of this study was the need for the reviewers to have used articles written in other languages besides English. The LAC region has a large population in non-English-speaking countries, and many articles are written using local languages. Hence, excluding those articles is a limitation worthy of note in this review. The articles accessed needed to provide adequate information on SFM markets and illegal pharmacies or hospitals but did not. Future reviews may focus on providing illegal substandard and falsified medicines markets in the region and how they can be minimized or eliminated.

This review highlights the challenges faced by LAC countries regarding substandard, fake and counterfeit medicines. The sources, prevalence and consequences of substandard and falsified drugs were identified to suggest the measures needed to curb the infiltration of low-quality medicines in LAC.

The purpose of this study is to determine the blood pressure (BP) lowing potential of some herbs used by the indigenous people of Zango Kataf, Kaduna State, Nigeria, to treat hypertension.

A total of 17 herbal healers and 15 hypertensive patients who use herbs to treat hypertension in Zango Kataf, Kaduna State, Nigeria, were consulted between 2019 and 2020. Participants were selected via purposeful sampling. BP was measured before and after the ingestion of a herbal preparation. Three plant preparations were screened: Newbouldia laevis, Hibiscus cannabinus and Pavetta crassipes.

H. cannabinus produced a significant decrease of 16, 12 and 14 mmHg in SBP at 2, 3 and 4 h, respectively (p = 0.001 at 2 h, p = 0.04 at 3 h, p = 0.01 at 4 h). While P. crassipes produced a significant decrease in SBP of 12, 15, 19 and 20 mmHg at 1, 2, 3 and 4 h, respectively (p = 0.04 at 1 h, p= 0.00 at 2 h, p = 0.00 at 3 h and p = 0.00 at 4 h). The findings for N. laevis were not reported due to incomplete information.

The sample size of this study was small. The researcher could not meet with some hypertensive clients owing to the poor cooperation of some herbal healers. Further, some hypertensive patients rejected the offer to participate in the study.

This study reveals that treatment with H. cannabinus and P. crassipes significantly decrease BP in hypertensive patients.

Hypertension is a common disease among elderly. Adherence to antihypertensive medication is a key predictor of optimal blood pressure control that prevents the risk of cardiovascular disease and potentially death. The purpose of this paper is to assess adherence to antihypertension and identify associated factors among the elderly in a rural area, Buengkan province, Thailand.

A health facilities based cross-sectional study was conducted in Buengkan district. A simple random sampling method was used to select 408 participants. A structured questionnaire adapted from the World Health Organization STEPwise approach was used to collect data. The medication adherence level was identified by pill count with percentage ⩾70 defined as good adherence. Descriptive and summary statistics were used. Bivariate analysis was done using Pearson’s χ² test, and multivariable analyses were also carried out.

A total of 408 (143 males and 265 females) elderly hypertension patients with uncontrolled blood pressure participated in this study. Most of the participants were found to have lower adherence to medication treatment (86.8 percent), whereas the remaining ones (13.2 percent) were found to have good adherence. The multivariable logistic regression analysis showed that having a daughter as a care taker (adjust odd ratio=7.99, 95% confidence interval: 1.23–51.778) was significantly associated with high medical adherence.

Hypertension medication adherence among elderly patients with uncontrolled blood pressure was poor. Having a care taker, especially a daughter, is a key to improve adherence. Effective strategy to improve adherence should focus on and involve family participation into the program.

This paper aims to evaluate systolic blood pressure (SBP), serum sodium/potassium levels and cardiac antioxidants after Artemisia herba-alba oral administration in spontaneous hypertensive rats (SHR).

Hypertension is a silent killer disease. The SHR model was used in this study due to the similarity of high blood pressure in human and rat. The SBP, serum sodium and potassium, urinary sodium and potassium, cardiac antioxidants and heart histology were examined in SHR after oral administration with 10 and 20% of the LD₅₀ of Artemisia herba-alba during four weeks.

The LD₅₀ of Artemisia herba-alba was found to be 1000 mg/kg. Doses of 100 mg/kg (10% LD₅₀) and 200 mg/kg (20% LD₅₀) were considered in the present study. The oral administration of SHR rats with Artemisia extract at 100 and 200 mg/kg decreased (p < 0.01) the body weights, SBP and serum sodium and potassium. Meanwhile, cardiac superoxide dismutase and gluthatione peroxidase were increased in SHR-treated rats. Histology of SHR cardiac tissues showed tissue degenerative but oral intake of 100 and 200 mg/kg artemisia exhibited normal muscle fibers, acidophilic cytoplasm and central nuclei.

The cardiovascular diseases are the first reason for high death rate in Western countries and collapsing economies due to hypertensive patients suffering high health-care costs. The advantage of hypertension Herba l treatment occurred due to its cheap and available source. Artemisia herba-alba leaves restored SBP, attenuated serum sodium/potassium levels and prevented cardiac oxidative stress in SHR.

The purpose of this paper is to study serum lipids, lipoproteins, homocysteine (Hcy) and platelet-derived growth factor (PDGF), and to evaluate the relationship between serum lipids, lipoproteins, Hcy and PDGF in patients with hypertension.

In total, 85 patients with hypertension (34 males, 51 females) were recruited from October to December 2015 at Saraphi Hospital, Chiang Mai Province using purposive sampling. PDGF mRNA levels of the patients were analyzed using the RT-PCR method. Hcy was analyzed by high-performance liquid chromatography. An enzymatic-colorimetric method was used to measure serum cholesterol, high-density lipoprotein cholesterol and triglyceride. A low-density lipoprotein cholesterol (LDL-C) level was calculated using Friedewald’s formula. Descriptive statistics and the Pearson product moment were also used in the analysis.

Among the patients with hypertension, hypercholesterolemia, high levels of LDL-C, hypertriglyceridemia and hyperhomocysteinemia were found in 54.1, 70.7, 25.9 and 44.7 percent, respectively. In addition, PDGF was significantly correlated with Hcy (r=0.705; p<0.005). There was no association between serum lipids or lipoproteins and Hcy or PDGF in patients with hypertension.

The results of this study provide direction on how serum lipids, lipoproteins, Hcy and PDGF can be used as a guide to improving dietary management as a means of reducing cardiovascular disease, and stroke in patients with hypertension.

This manuscript is not currently under consideration, in press or published elsewhere. This manuscript is truthful original work without fabrication, fraud or plagiarism. The authors have made important scientific contributions to this study. The authors are familiar with the primary data, and have read the entire manuscript and take responsibility for it content. No benefits were received by the authors or any member of the authors’ family or the research team, from any commercial source, directly or indirectly related to this work. Moreover, no one affiliated with has any financial interest related to the subject matter of this manuscript.