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1 – 10 of over 14000Patrice François, Dominique Bertrand, Jose Labarere, Magali Fourny and Jean Calop
This paper aims to evaluate the effectiveness of a program designed to improve the quality of drug prescription‐writing at a university hospital in France. Improvement…
Abstract
This paper aims to evaluate the effectiveness of a program designed to improve the quality of drug prescription‐writing at a university hospital in France. Improvement actions included feed‐back from yearly audits and the dissemination of recommendations on how best to write the prescriptions. A random sample of 30 stays was selected from among the hospitalizations for the year 1996. From each patient, medical records were searched for the first prescription order of the stay and its quality was assessed according to standards. A total of 872 records were relevant and included 3,289 medications. The results were compared to those obtained for the two previous years. Actions to sensitize prescribers resulted in an insufficient improvement of most indicators of prescription‐writing quality with results remaining well below ideal standards. The hospital staff concerned had a positive opinion of the program which led to an awareness of prescription problems. This assessment showed that the program had a moderate impact on prescribers’ practice and efforts must be continued.
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Kheng Yong Ong, Li Li Chen, Jane Ai Wong, Jin Cheng Lim, Doris Bee Hoon Teo and Mui Chai Tan
The purpose of this paper is to assess the safety and efficiency of, and acceptance by, patients for an express refill service (ERS).
Abstract
Purpose
The purpose of this paper is to assess the safety and efficiency of, and acceptance by, patients for an express refill service (ERS).
Design/methodology/approach
A pilot uncontrolled, cross-sectional, single-centred study was conducted at the outpatient pharmacy of a tertiary acute care hospital. Under ERS, prescriptions were dispensed without clinical review and counselling for patients refilling prescription medications. Efficiency was assessed by comparing processing times of ERS prescriptions with regular prescriptions. Safety was assessed by independent review of prescriptions by two pharmacists. Patient acceptance was assessed by a survey.
Findings
ERS reduced processing time of prescriptions by more than 30 per cent compared to the regular fill process. ERS was generally safe for patients, with drug-related problems identified in only one prescription which may have warranted closer monitoring. It was accepted by patients who opted for the service, as 91.4 per cent agreed or strongly agreed that they were satisfied with the service.
Research limitations/implications
The study was conducted on a small convenience sample of patients in a single centre, with no control group.
Practical implications
Results showed that ERS was efficient, safe and well-accepted for select patients refilling their prescriptions. This leads to shorter waiting times and greater patient satisfaction.
Originality/value
This is the first published study that has explored the feasibility of an express prescription refill service. Despite some limitations, this study showed that omitting prospective clinical review and patient counselling for a defined population segment is safe, and can reduce processing time and improve patient satisfaction.
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Xiaoyan Qian, Hao Yin and Xiaotong Li
This paper aims to explore the influence of marketing investment on drug diffusion processes, to analyze the heterogeneity of the diffusion characteristics and to…
Abstract
Purpose
This paper aims to explore the influence of marketing investment on drug diffusion processes, to analyze the heterogeneity of the diffusion characteristics and to understand the drug diffusion patterns in the prescription and over-the-counter (OTC) markets.
Design/methodology/approach
The study introduces marketing investment into the Bass model. The authors use the Generalized Bass Model (GBM) to examine the influence of marketing efforts on drug diffusion in Chinese prescription and OTC markets.
Findings
The results of this study suggest that the imitation effect in the prescription drug market is greater than that in the OTC drug market; drug diffusion in the OTC market reaches saturation earlier in the diffusion process. Before reaching the critical state, the effect of marketing investment on drug diffusion in the OTC market is greater than that in the prescription market, and after the critical state, drug diffusion in the prescription market is more sensitive to marketing investment.
Originality/value
The study demonstrates the value of the GBM in empirical analyses of drug diffusion across two distinct markets, and the marketing regulation policies governments adopt have a powerful impact on the speed at which drugs become available in different markets. It enriches the extant product diffusion literature by highlighting the different diffusion patterns of the two segments of pharmaceutical market.
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Sandra Diehl, Barbara Mueller and Ralf Terlutter
The purpose of this investigation is to add to the body of knowledge regarding consumer skepticism toward advertising in general, and toward pharmaceutical advertising in…
Abstract
The purpose of this investigation is to add to the body of knowledge regarding consumer skepticism toward advertising in general, and toward pharmaceutical advertising in particular. The study was conducted in the U.S. and in Germany. Skepticism toward advertising for both prescription and non-prescription pharmaceuticals was analyzed. Additional variables explored include: health consciousness, product involvement with pharmaceuticals, satisfaction with information in pharmaceutical advertising, and the importance of pharmaceutical advertising as a source of information. Furthermore, differences in the cultural value of uncertainty avoidance between U.S. and German consumers were examined and related to skepticism toward pharmaceutical advertising. Three hundred and forty-one Americans and 447 Germans were surveyed. A significant finding of this research revealed that skepticism toward pharmaceutical advertising is lower than skepticism toward advertising in general. Results also indicated that consumers showed no difference in their level of skepticism toward advertising for prescription versus non-prescription drugs. This is a particularly relevant finding as it relates directly to the ongoing discussion in Europe regarding whether or not to lift the ban on advertising for prescription drugs. Skepticism toward pharmaceutical advertising was found to be significantly negatively related to involvement with pharmaceuticals, to satisfaction with the informational content of the advertisements, to satisfaction with the comprehensibility of the advertisements, and to the importance placed on advertising as a source of health information. Regarding cultural differences, U.S. consumers appear to be less skeptical toward advertising in general, and toward advertising for prescription and non-prescription drugs in particular, than German consumers. This may be due to the lower degree of uncertainty avoidance in the U.S. Differences between the two countries related to the additional variables examined in the study are addressed as well. Implications for consumer protection policies are discussed, and recommendations for advertisers of pharmaceutical products are provided. The authors provide a cultural explanation for differences in the degree of skepticism between U.S. and German audiences.
Teresa Bernard Gibson, Catherine G. McLaughlin and Dean G. Smith
Purpose – The purpose of this study is to estimate the own- and cross-price elasticity of brand-name outpatient prescription drug cost-sharing for maintenance medications…
Abstract
Purpose – The purpose of this study is to estimate the own- and cross-price elasticity of brand-name outpatient prescription drug cost-sharing for maintenance medications and to estimate the effects of changes in the price differential between generic and brand-name prescription drugs.
Methodology/approach – We first review the literature on the effects of an increase in brand-name drug patient cost-sharing. In addition, we analyze two examples of utilization patterns in filling behavior associated with an increase in brand-name cost-sharing for patients in employer-sponsored health plans with chronic illness.
Findings – We found that the own-price elasticity of demand for brand-name prescription drugs was inelastic. However, the cross-price elasticity was not consistent in sign, and utilization patterns for generic prescription fills did not always increase after a rise in brand-name cost-sharing.
Research limitations – The empirical examples are limited to the experience of patients with employer-sponsored health insurance.
Practical implications – The common practice of increasing brand-name prescription drug patient cost-sharing to increase consumption of generic drugs may not always result in higher generic medication use. Higher brand-name drug cost-sharing levels may result in discontinuation of chronic therapies, instead of therapeutic switching.
Originality/value of chapter – The value of this chapter is its singular focus on the effects of higher brand-name drug cost-sharing through a synthesis of the literature examining the own- and cross-price elasticity of demand for brand-name medications and two empirical examples of the effects of changes in brand-name cost-sharing.
With expenditures totaling $227 billion in 2007, prescription drug purchases are a growing portion of the total medical expenditure, and as this industry continues to…
Abstract
With expenditures totaling $227 billion in 2007, prescription drug purchases are a growing portion of the total medical expenditure, and as this industry continues to grow, prescription drugs will continue to be a critical part of the larger health care industry. This chapter presents a survey on the economics of the US pharmaceutical industry, with a focus on the role of R&D and marketing, the determinants (and complications) of prescription drug pricing, and various aspects of consumer behavior specific to this industry, such as prescription drug regulation, the patient's interaction with the physician, and insurance coverage. This chapter also provides background in areas not often considered in the economics literature, such as the role of pharmacy benefit managers in prescription drug prices and the differentiation between alternative measures of prescription drug prices.
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Keywords
- Abbreviated New Drug Application (ANDA)
- Average Manufacturer Price (AMP)
- Average Wholesale Price (AWP)
- Bayh-Dole Act
- Bioequivalence
- Brand name drug
- Center for Medicare and Medicaid Services (CMS)
- Chain pharmacy
- Clinical trials
- Closed formulary
- Coinsurance
- Compliance
- Co-payment
- Cost controls
- Cost sharing
- Detailing
- Direct-to-consumer Advertising (DTC Advertising)
- Disease management
- Drug manufacturers
- Drug prices
- Drug–product substitution
- Experience goods
- Fee-for-service (FFS)
- First-mover advantage
- Food and Drug Administration (FDA)
- Formulary
- Generic drug
- Good Manufacturing Processes (GMP)
- Hatch-Waxman Act
- Health plan
- Insurance
- Investigational New Drug Application (IND)
- Mail-order pharmacy
- Mail-order prescription drugs
- Medicaid
- Medicare
- Medicare+Choice (M+C)
- Medicare Advantage
- Medicare Modernization Act (MMA)
- Medicare Part D
- Moral hazard
- Negative goods
- New Drug Application (NDA)
- Non-retail pharmacy
- Original Medicare
- Out-of-pocket
- Paid search advertising
- Patent
- Patient
- Pharmaceutical
- Pharmacy
- Pharmacy benefit manager (PBM)
- Physician
- Prescription drugs
- Product differentiation
- Rebate
- Reimbursement
- Research and development (R&D)
- Retail pharmacy
- Search costs
- Switching costs
- Therapeutic class
- Third-party insurance
- Tiered formulary
- Wholesale Acquisition Price (WAC)
- Wholesaler
Janet Currie, Jonas Jin and Molly Schnell
This chapter uses quarterly county-level data from 2006 to 2014 to examine the direction of causality in the relationship between per capita opioid prescription rates and…
Abstract
This chapter uses quarterly county-level data from 2006 to 2014 to examine the direction of causality in the relationship between per capita opioid prescription rates and employment-to-population ratios. We first estimate models of the effect of per capita opioid prescription rates on employment-to-population ratios, instrumenting opioid prescriptions for younger ages using opioid prescriptions to the elderly. We find that the estimated effect of opioids on employment-to-population ratios is positive but small for women, while there is no relationship for men. We then estimate models of the effect of employment-to-population ratios on opioid prescription rates using a shift-share instrument and find ambiguous results. Overall, our findings suggest that there is no simple causal relationship between economic conditions and the abuse of opioids. Therefore, while improving economic conditions in depressed areas is desirable for many reasons, it is unlikely on its own to curb the opioid epidemic.
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Jakob Demant, Silje Anderdal Bakken and Alexandra Hall
Internet use has changed the mechanics of drug dealing. Although this has spurred some initial academic interest in how markets and their users have been changing, the…
Abstract
Purpose
Internet use has changed the mechanics of drug dealing. Although this has spurred some initial academic interest in how markets and their users have been changing, the issue is still under-researched. The purpose of this paper is to understand how the organisation of the distribution of prescription drugs and other illegal drugs overlap in these online markets by analysing data gathered from observation of the Swedish Facebook drug market and its participants.
Design/methodology/approach
Data were gathered during three months of digital ethnography conducted among Swedish Facebook posters supplemented by 25 interviews with sellers (20) and buyers (5). Screenshots and interview data were coded by carrying out an NVivo-based content analysis. The analysis is based on descriptive statistics of drug types, co-occurrence with other drugs, group size and the demographic characteristics of sellers. Additionally, the interviewees’ descriptions of the marketplace and their drug dealing or buying activities were included in the analysis.
Findings
In total, 57 Swedish Facebook groups that sold illegal substances were located. The groups rarely specialised in specific drug types, but were convened around demographic factors, such as specific cities and locales. The sales of prescription drugs were part of the overall activity of groups selling other illegal drugs, but they were more often sold in separate Facebook posts, possibly by specialist sellers. Swedish Facebook sales primarily concerned alprazolam, tramadol, pregabalin and clonazepam, and were sold by both professional and amateur sellers.
Originality/value
This study reports findings from a Nordic comparative study on social media drug dealing, representing the first in-depth study of digitally mediated prescription drug dealing outside of cryptomarkets.
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Mirsada Serdarevic, Vicki Osborne, Amy Elliott, Catherine W Striley and Linda B Cottler
This study examined how youth would mitigate non-medical use of prescription medication among their peers.
Abstract
Purpose
This study examined how youth would mitigate non-medical use of prescription medication among their peers.
Design/methodology/approach
The National Monitoring of Adolescent Prescription Stimulants Study (N-MAPSS) was conducted as an interview comprising 11,048 youth of 10–18 years of age between 2008 and 2011 from entertainment venues of 10 US urban, suburban, and rural areas. Using a mixed-methods approach, participants completed a survey culminating in open-ended questions asking: (1) How should kids your age be informed about prescription drugs and their effects? (2) If you ran the world, how would you stop kids from taking other people’s prescription medicines? (3) Why do people use prescription stimulants without a prescription? Responses from a random sample of 900 children were analyzed using qualitative thematic analyses.
Findings
The random sample of 900 youth (52 percent female, 40 percent white, with a mean age of 15.1 years) believed they should be educated about prescription drugs and their negative effects at schools, at home by parents, through the media, and health professionals. Youth would stop kids from using other people’s prescription drugs through more stringent laws that restricted use, and providing education about negative consequences of use. Peer pressure was the most common reason the youth gave for using other’s pills, though some reported taking them out of curiosity.
Originality/value
The importance of considering youth’s opinions on non-medical use of prescription medications is often overlooked. This evidence, from a peer perspective, could end the illicit use of prescription drugs among today’s youth.
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Aleksey Anisimov, Anatoliy Ryzhenkov and Elena Menis
This study aims to clarify the scope of the legal procedure of the acquisitive prescription in Russia.
Abstract
Purpose
This study aims to clarify the scope of the legal procedure of the acquisitive prescription in Russia.
Design/methodology/approach
Dialectical method, historical method and system analysis method have been used.
Findings
The authors consistently prove the inadmissibility of applying acquisitive prescription to land plots in private, state or municipal ownership. One of the features of Russia as an emerging market economy is that, the major part of state lands is in so-called “non-delineated state ownership.” Plots included in such lands are not registered in the cadaster or transferred to particular public owners. That is why, the authors prove that the procedure of acquisitive prescription must be applied only in relation to land plots that are in non-delineated state ownership and have been occupied by citizens and legal entities for 15 years.
Originality/value
The authors propose new guarantees of the rights of private and public land owners. Clarification of the scope of the acquisitive prescription procedure will streamline the turnover of real estate in Russia.
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