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1 – 10 of over 16000Patrice 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 actions…
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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The purpose of this study was to examine consumer data acquired by branded prescription drug websites and the ethics of privacy related to the interconnected web of personal…
Abstract
Purpose
The purpose of this study was to examine consumer data acquired by branded prescription drug websites and the ethics of privacy related to the interconnected web of personal information accessed, packaged and resold by tracker technologies.
Design/methodology/approach
The research used the DMI Tracker Tool to collect data on the top 17 branded prescription drug websites, with a specific interest in the tracker technologies embedded in those websites. That data was analyzed using Gephi, an open-source data visualization tool, to map the network of trackers embedded in those branded prescription drug websites.
Findings
Findings visualize the interconnections between tracker technologies and prescription drug websites that undergird a system of personal data acquisition and programmatic advertising vehicles that serve the interests of prescription drug marketers and Big Tech. Based on the theory of platform ethics, the study demonstrated the presence of a technostructural ecosystem dominated by Big Tech, a system that goes unseen by consumers and serves the interests of advertisers and resellers of consumer data.
Research limitations/implications
The 17 websites used in this study were limited to the top-selling prescription drugs or those with the highest ad expenditures. As such this study is not based on a random sampling of branded prescription drug websites. The popularity of these prescription drugs or the expanse of advertising associated with the drugs makes them appropriate to study the presence of tracking devices that collect data from consumers and serve advertising to them. It is also noted that websites are dynamic spaces, and some trackers within their infrastructures are apt to change over time.
Practical implications
Branded prescription drug information has over the past three decades become part of consumers’ routine search for information regarding what ails them. As drug promotion moved from print to TV and the Web, searching for drug information has become a part of everyday life. The implications of embedded trackers on branded prescription drug websites are the subject of this research.
Social implications
This study has significant social implications as consumers who are searching for information regarding prescription medications may not want drug companies tracking them in a way that many perceive to be an invasion of privacy. Yet, as the Web is dominated by Big Tech, web developers have little choice but to remain a part of this technostructural ecosystem.
Originality/value
This study sheds light on branded prescription drug websites, exploring the imbalance between the websites under study, Big Tech and consumers who lack awareness of the system that operates backstage.
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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 and to…
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 grow…
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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- 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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Xiaomei Jiang, Shuo Wang, Wenjian Liu and Yun Yang
Traditional Chinese medicine (TCM) prescriptions have always relied on the experience of TCM doctors, and machine learning(ML) provides a technical means for learning these…
Abstract
Purpose
Traditional Chinese medicine (TCM) prescriptions have always relied on the experience of TCM doctors, and machine learning(ML) provides a technical means for learning these experiences and intelligently assists in prescribing. However, in TCM prescription, there are the main (Jun) herb and the auxiliary (Chen, Zuo and Shi) herb collocations. In a prescription, the types of auxiliary herbs are often more than the main herb and the auxiliary herbs often appear in other prescriptions. This leads to different frequencies of different herbs in prescriptions, namely, imbalanced labels (herbs). As a result, the existing ML algorithms are biased, and it is difficult to predict the main herb with less frequency in the actual prediction and poor performance. In order to solve the impact of this problem, this paper proposes a framework for multi-label traditional Chinese medicine (ML-TCM) based on multi-label resampling.
Design/methodology/approach
In this work, a multi-label learning framework is proposed that adopts and compares the multi-label random resampling (MLROS), multi-label synthesized resampling (MLSMOTE) and multi-label synthesized resampling based on local label imbalance (MLSOL), three multi-label oversampling techniques to rebalance the TCM data.
Findings
The experimental results show that after resampling, the less frequent but important herbs can be predicted more accurately. The MLSOL method is shown to be the best with over 10% improvements on average because it balances the data by considering both features and labels when resampling.
Originality/value
The authors first systematically analyzed the label imbalance problem of different sampling methods in the field of TCM and provide a solution. And through the experimental results analysis, the authors proved the feasibility of this method, which can improve the performance by 10%−30% compared with the state-of-the-art methods.
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Smart E. Otu, Macpherson Uchenna Nnam, Mary Juachi Eteng, Ijeoma Mercy Amugo and Babatunde Michel Idowu
The purpose of this study is to examine the politics, political economy, and fallout of hawkish regulatory policy on prescription drugs in Nigeria. Hawkish regulatory policy on…
Abstract
Purpose
The purpose of this study is to examine the politics, political economy, and fallout of hawkish regulatory policy on prescription drugs in Nigeria. Hawkish regulatory policy on prescription drug in Nigeria, such as opioid analgesics, is a very complex and multifaceted one, which usually involves the interplay of many factors and parties.
Design/methodology/approach
Policy manuals, official government gazettes (legislations, regulations, Acts and decrees), academic literature and a direct ethnographic observation of events surrounding the regulation of prescription drugs were reviewed and engaged.
Findings
The results revealed that Nigerian and global political economy and politics interface to define the direction of the new restrictive opioid policy, with resultant friction between prohibition and consumption. The reviews showed that the overarching “get-tough” and “repressive” policy are not necessarily founded on empirical evidence of an increase in prescription drug sales or use, but more as a product of the interplay of both internal and external politics and the prevailing socioeconomic order.
Practical implications
Instead of borrowing extensively from or being influenced by repressive Western drug laws and perspectives, Nigerian policymakers on prescription opioids should take control of the process by drawing up a home-grown policy that is less intrusive and punitive in nature for better outcomes. A mental sea change is required to understand the intrigues of Western power in Nigeria’s politics and political economy to avoid the continuous symptomatic failure of drug policy.
Originality/value
The politics and economic influence of the United Nations, USA and Western powers, as well as the axiom of moral panic of prescription drugs scares within the Nigerian environment, are particularly significant in the making of the emerging hawkish policy on prescription drugs in Nigeria.
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Girish Ramesh Kulkarni, Suraj Agrahari and Sankar Sen
Launching a new product successfully in a multi-brand portfolio is one of the major challenges a pharmaceutical marketer faces. This study aims to examine the role of detailing of…
Abstract
Purpose
Launching a new product successfully in a multi-brand portfolio is one of the major challenges a pharmaceutical marketer faces. This study aims to examine the role of detailing of new brands on physicians’ prescription behaviour as compared to established brands. Further, the study explores mediating role of detailing priority and detailing time on the relationship between detailing of new versus established brands and physician’s prescription behaviour.
Design/methodology/approach
This study was conducted as a real-world observational study involving field research. In total, 338 physicians, 90 PSRs and 44 field managers participated in this study. A serial mediation model (Hayes, Model 6) was used to examine the relationship. Regression analysis with bootstrapping was used to test the hypotheses.
Findings
Detailing of new versus established brands has a differential effect on physicians’ prescription behaviour. In addition, this relationship is serially mediated by detailing priority and detailing time.
Research limitations/implications
Results suggest that detailing priority and detailing time positively and significantly alter the relationship between the detailing of new brands and physicians’ prescription behaviour as compared to established brands. While, in the absence of mediators, established brands generate higher prescriptions than new brands, the serial mediating effect helps new brands to generate more prescriptions as compared to established brands.
Practical implications
This research highlights the importance of detailing priority and detailing time for the successful launch of the new products. It presents compelling evidence for practicing managers to effectively use a “predetermined detailing plan” vis-à-vis “individualized detailing strategy” during the launch of a new brand.
Originality/value
To the best of the authors’ knowledge, this is the first study to evaluate the role of detailing priority and detailing time as mediators between the relationship of detailing and physicians’ prescription behaviour. This is also one of the rare studies to use real-world observational study methodology for conducting research.
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