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In the majority of the literature on the social organization of care work, care is often defined in more traditional terms to refer to work on or directly related to the body. In this paper, we would like to venture beyond the body to elaborate upon a particular type of care work – negotiating care – that involves negotiations and sometimes petitions for the purpose of securing care. It is a concept that was salient in a comparative study of the experiences of health care providers with the increasing management of health care in Canada and the United States. For physicians and nurses in both settings we find a sense of the increasing burden of negotiating for care for patients – particularly textually mediated negotiations – as the access to and amount of care is increasingly limited through managed care policies. Moreover, the contexts for these negotiations are continually in flux exacerbating the time devoted to negotiate care. It is in the U.S. context, however, that textual negotiation of care is most extensive and differs in terms of audience – insurers as opposed to providers – and purpose – securing payment and not just care.

Using the pharmaceutical sector as a microcosm of the health sector, we highlight the most prevalent structural and policy issues that make this sector susceptible to corruption and ways in which these vulnerabilities can be addressed. We conducted a literature review of publications from 2004 to 2015 that included books, peer-reviewed literature, as well as gray literature such as working papers, reports published by international organizations and donor agencies, and newspaper articles discussing this topic. We found that vulnerabilities to corruption in the pharmaceutical sector occur due to a lack of good governance, accountability, transparency, and proper oversight in each of the decision points of the pharmaceutical supply chain. What works best to limit corruption is context specific and linked to the complexity of the sector. At a global level, tackling corruption involves hard and soft international laws and the creation of international standards and guidelines for national governments and the pharmaceutical industry. At a national level, including civil society in decision-making and monitoring is also often cited as a positive mechanism against corruption. Anticorruption measures tend to be specific to the particular “site” of the pharmaceutical system and include improving institutional checks and balances like stronger and better implemented regulations and better oversight and protection for “whistle blowers,” financial incentives to refrain from engaging in corrupt behavior, and increasing the use of technology in processes to minimize human discretion. This chapter was adapted from a discussion piece published by Transparency International UK entitled Corruption in the Pharmaceutical Sector: Diagnosing the Challenges.

This chapter examines the relationship between health service restructuring and the health care experiences of women from rural and remote areas of Canada. Data were collected from 34 focus groups (237 women), 15 telephone interviews and 346 responses from an online survey. Access to services, care quality and satisfaction are salient themes in these data. Problems include: travel, shortage of providers, turnover in personnel, delays associated in accessing care, lack of knowledge of women's health issues and patronizing attitudes of some health care providers. Health care service restructuring has led to deterioration in service availability and quality. Key areas for policy development need to address health care access and quality improvement issues, including increasing access to more (particularly female) providers who are sensitive to women's health issues.

The main purpose of this paper is to identify and rank various barriers to pharmacovigilance (PV) in context of emerging economies and examine their interrelationships using the interpretive structural modeling (ISM) approach. The result is a model that offers insights about how to achieve rational and safe use of medicines and ensure patient safety as realized through robust national PV systems.

The paper develops a model to analyze the interactions among PV barriers using the ISM approach. Based on input from clinical and medical product development experts, PV barriers in emerging economies were identified and reviewed. The hierarchical interrelationships among these PV barriers were analyzed in context of their driving/dependence powers.

Findings of the study identify key PV barriers—lack of resources/infrastructure, weak legislation, unfair burden of disease, lack of PV capacity, training, and enforcement authority—that drive, or strongly influence, other barriers and thwart implementation of robust national PV systems in emerging economies. Pharmaceutical industry factors were PV barriers that were identified as autonomous, implying their relative disconnection from other barriers, and patient PV practices barrier was strongly dependent on other barriers.

The paper offers policy- and decision-makers alike with a framework to support further research into interdependencies among key PV barriers in emerging economies. It can serve as an impetus for further research with potential to broadening the understanding of how and why PV systems may be rendered ineffective. Future studies can be planned to apply the ISM approach to study PV barriers in the context of developed economies and draw lessons and implications for policy- and decision-makers by contrasting results from these studies.

This paper contributes to the understanding of the multifaceted nature of PV and its barriers. The proposed approach gives public health decision-makers a better comprehension of driver PV barriers that have most influence on others versus dependent PV barriers, which are most influenced by others. Also, knowledge, attitude and practices of patients and caregivers can also be critical PV barriers in emerging economies. This information can be instrumental for public health policymakers, government entities, and health/PV practitioners to identify the PV barriers that they should prioritize for improvement and how to manage trade-offs between these barriers.

PV barriers in emerging economies, as compared to developed economies, are inherently different and need to be examined in their specific context. The hierarchical ISM model suggests that resources and regulation initiatives by governments in emerging economies lead to through informed/enabled pharmaceutical supply chain players and eventually drive PV-specific knowledge, attitude, and practice outcomes improvements across their populace.

This paper highlights the deployment of ISM approach as a health policy decision support tool in the identifying and ranking barriers to effective PV systems in emerging economies, in terms of their contextual relationships, to achieve a better understanding as to how these interrelationships can affect national PV system outcomes.

Nutrition, as a science, is poorly understood, both professionally and publicly. The confusion that surrounds this science makes it very difficult, if not impossible, to formulate public health policy, which creates opportunities for political manipulation and control. Nutrition, for a century or more, has been variously described as a summation of the physiological and biochemical properties of individual nutrients in food rather than the whole food itself. This infers that isolated nutrients in supplements will function in the same way as nutrients in food. It also infers that removing or minimizing “undesirable” nutrients from food will make the food more healthful. This arises from the highly reductionist way that we focus on individual nutrients minus their natural context, both the context within the foods of which they are a part and the context within biological systems where they function. The shortcomings of this belief system may be illustrated by hugely costly mistakes made in the past, even more than a century ago, that corrupt current practices. Such mistakes have become so embedded in the contemporary narrative on nutritional science, both fundamentally and practically, that we fail to recognize the damage they continue to cause.

Alternatively, when nutritional effects are considered more within their natural contexts, that is, more wholistically, then it helps to explain, for example, the remarkable ability of nutrition, as provided by a whole food plant-based diet, to prevent even to cure varied types of cardiovascular disease. Furthermore, the breadth of this nutritional effect for a wide variety of illnesses and diseases suggests that nutrition, properly provided by a whole food plant-based diet, is more efficacious than a combination of all the contemporary pills and procedures combined. It also suggests that genetic determinism is not the explanation for disease that is widely advanced. And finally, among still more consequences, there are many societal outcomes that can be substantially mitigated, including the escalating cost of health care and the dangerously increasing array of destructive practices that damage the environment. Many of the momentous health, economic, environmental and sociopolitical problems currently faced may be traced to a misunderstanding of the effects of food and nutrition. The task therefore is how to bring this message to the attention of a public who for too long have gradually adopted flawed food production and healthcare systems that are on the verge of collapse, threatening the collapse of entire societies as we know them. More specifically, a public and professional dialog on the meaning of nutrition, especially its wholistic properties, is desperately needed, especially in medical schools where nutrition as a science is almost totally ignored.

The purpose of this paper is to examine consumer attitudes toward direct‐to‐consumer (DTC) advertising and whether consumer attitudes regarding these types of advertisements differ based on income.

A sample of 168 consumers completed the survey on‐site at a pharmacy while waiting for their prescription(s) to be filled.

The findings indicated that low‐income consumers were more likely than higher income customers to: report being persuaded by DTC advertising to ask for an advertised drug; go to the doctor based on symptoms described in DTC advertising; and to prefer branded medication over generic alternatives.

The results provide useful information to policy makers and drug companies. The finding that these advertisements appear to impact lower income consumers to a greater extent than their higher‐income counterparts has both positive and negative implications. On the positive side, these ads appear to influence unhealthy, low‐income consumers to seek medical treatment. The negative implication concerns the effectiveness of DTC advertising in persuading low‐income consumer to prefer more expensive, branded drugs over generic alternatives.

Limited research has been done on the relationship between consumer perceptions of DTC advertising and differences in consumer groups based on income.

Pharmaceutical sales representatives (PSRs) have been shown to influence the prescribing patterns of physicians. Some of the blame has been shifted from physicians to PSRs due to perceived inadequacies in PSRs' education and certification. The purpose of this paper is to review the literature regarding the current certification requirements for PSRs, motivation for nationally standardized certification and the controversy surrounding pharmaceutical detailing impact on physicians' prescribing behavior.

Articles related to certification for PSRs were identified via searches of PubMed and IPA from inception to March 2011. Search terms included PSRs, PSRs certification, PSRs registration, PSRs education, and PSRs requirements. Articles describing the roles and responsibilities of PSRs, physician and public perception of PSRs, certification processes, and the future of PSRs' roles were included. An internet search was also performed to identify articles in the lay press related to this topic.

This paper shows that the certification for PSRs may become necessary, or even required, to help ensure that the prescribing patterns of physicians are not negatively affected due to false information coming from the PSRs. Therefore, ensuring that PSRs are well certified can lead to better health outcomes for patients. Although pharmaceutical companies do not require certification to gain employment as a sales representative, the certification provides a good knowledge base and insight into the industry.

The paper shows that appropriate training and certification of PSRs may be on the rise for this career path.

The study aims to explore the interplay between open innovation and intellectual property. Differently from previous studies, we argue that open innovation fosters firm's patenting activity.

We use linear regression analysis to test model's hypotheses. Data are drawn from the Eurostat statistics and refer to a large sample of European firms (NACE Rev.2).

The findings confirm that open innovation fosters patenting activity in health care, also thanks to huge governments' expenditures in this market.

The study focuses solely on European firms and it adopts a traditional linear approach. So, we cannot exclude that different dynamics may occur across European borders. Future research should address this concern by focusing on multi-country comparative studies.

Open innovation is the most suitable model for health industry, because it improves both innovation performance and intellectual capital of firms.

The study tackles an existing gap of the literature by considering how the presence of large customers impacts the strength of intellectual property protection.

Public health policy often excludes access to essential medicines. Drawing on an in-depth case study examining access to essential medicines in the context of the HIV/AIDS pandemic in South Africa, and more briefly, making reference to the U.S. diabetes epidemic, we highlight the relationship between the need for essential medicines in world populations, and the role of groups external to government in promoting access to essential medicines in public health policy. We consider how, in the context of health stratification, the activities of patient advocacy groups, and “third way” social policies of the pharmaceutical industry generate “social capital,” creating enhanced access to essential medicines for a few, and promoting the ideal of the right to access for all. The implications for the development of public health policy inclusive of essential medicines are discussed.