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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.

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.

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.

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.

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.

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.

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.

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.

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.

This paper seeks to empirically identify the major factors that influence physician loyalty behavior in prescribing certain brands of drugs.

Testable hypotheses were developed with respect to physician loyalty behavior regarding drug prescription practices, and a survey questionnaire was designed to capture the data from 71 physicians, as a convenience sample. The hypotheses were tested by PLS path modeling.

The major finding is that tangible rewards to physicians by the pharmaceutical companies lead to prescription loyalty. The second major finding is that the professional values of pharmaceutical sales representatives (PSR) impact significantly on physician prescription loyalty. The hypotheses related to the impact of PSR personality, drug quality, corporate reputation and professional influence on prescription loyalty were not supported in the study.

The results should prove useful to pharmaceutical companies in developing physician loyalty to particular brands as well as enhancing the understanding of drug control authorities and governmental health policy makers, in controlling unethical medical practices by physicians.

This paper reports an original empirical study on physician loyalty behavior in the context of drug prescription.

Pharmaceutical marketers and manufactures create hype of demand among patients towards a specific brand of drug or disease through drug advertisements. It induces the patients to seek additional information of the brand and ask for its prescription generation by the physician. The paper aims to determine the attitude of the physicians towards direct to consumer advertising (DTCA) and to examine the extent of patients’ request for a specific brand which leads to actual prescription generation.

Quantitative study, data was collected from field setting general practicing Doctors/Physicians in the leading hospitals. Quantitative data was collected from physicians working in leading hospitals. Doctors were selected on judgmental basis with high patient turnover. Sample size consists of 250 doctors, and questionnaire were adopted from two authors. Attitude of physicians towards DTCA and information inquired by the patient are two independent variables, whereas prescription generation by the physicians is dependent variable. SPSS was tool for data analysis.

Physicians have positive attitude towards DTCA and information provision to patient and consider it supplementary in overall health-care system. Advertising induces patients to visit physician and seek appropriate treatment and get induced to ask for further information.

Time and resources were limited.

First, it contributes towards knowledge, second, it shows the importance of DTCA and its impact on prescription generation and, third, it will help in devising drug advertising policy.

Highlights the issue are of not only misuse of drugs but also malpractice of drug prescription.

First, it explores the impact of the attitude of physicians along with the patients’ request on prescription generation behaviour. Second, it examines the impact of inquiring additional information about specific brand from the physician that might lead to the prescription generation. Finally, there is no study from the developing countries like Pakistan.

Prescription drug requests and physician denial are important aspects of medical decision making, but little research has been done to identify factors linked to prescription drug request and physician denial. This paper aims to explore factors in relation to patient prescription drug request and provider denial.

The paper is based on a cross‐sectional study in a nationally representative database of 2,988 individuals. Descriptive and multivariate stepwise conditional logistic regression analyses were conducted.

Results of multivariate regression models reveal, after adjusting for personal factors, that heart disease, allergy, anxiety, minor chronic conditions, medical seeking behaviors and direct‐to‐consumer advertising (DTCA) were found to be related to prescription drug request. The denied were individuals with arthritis, less prevalent chronic conditions, the uninsured, and African Americans. It was also found that 27.4 percent of the sample requested a prescription drug and about 24 percent of those who segmented for prescriptions were physicians.

DTCA is positively associated with prescription drug requests but the analysis did not support any effect of DTCA on the refusal status. Patients' requests and physician decision making to refuse are somewhat complicated and vary with different medical conditions.

The paper, using nationally representative data, investigates the factors associated with prescription drug request and denial.

The paper's aim is to analyze the functional relationships between factors related to the prescription of medical drugs in Brazil.

A survey was conducted among 232 medical doctors in Brazil. Data were collected using a structured questionnaire. Five hypotheses on the factors impacting drug prescription were proposed, and the constructs were validated using a set of techniques pertaining to the calculation of structural equations.

The process of medical drug prescription in Brazil is positively correlated with all the presented constructs. However, the study found that the five proposed hypotheses demonstrated varying degrees of positive effect levels, ranging from strong to weak. Particularly, factors such as the characteristics of the drug and information available on a drug have the weakest effect, while the cost‐benefit ratio of a drug has a moderate effect. The drug's brand and its related advertising have the strongest effect.

The results demonstrate the success of specific applications of advertising tools and brand construction in pharmaceutical marketing strategies targeting Brazilian physicians.

The study provides a broad map to understand the influences on drug prescriptions. Despite a prior study that found the behavior of physicians to be impacted by a different set of factors, this new research clearly shows that, in the Brazilian context, branding and advertising remain the major influences.

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.

This study examined how youth would mitigate non-medical use of prescription medication among their peers.

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.

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.

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.

The purpose of this paper is to examine the effects of diabetes, patient age, and health insurance on the number of prescription and non‐prescription drugs mentioned (ordered or provided) per physician visit in the USA.

The National Center for Health Statistics annually conducts three surveys about ambulatory care physician visits: the National Ambulatory Medical Care Survey, the National Hospital Ambulatory Medical Care Survey – outpatient departments, and the National Hospital Ambulatory Medical Care Survey – emergency departments. For this study, the data collected in 2003 and 2004 by these surveys were analyzed with the SAS procedures SURVEYMEANS and SURVEYREG, which can take into account the multistage sample design of these surveys.

Regression analyses show significant effects of diabetes, patient age, and health insurance provider on the number of prescription drug mentions and non‐prescription drug mentions per physician visit. Among adults greater than 18 years old, and even for visits by persons greater than 75 years old, diabetes visits relative to non‐diabetes visits had significantly more prescription drug mentions per visit and significantly more non‐prescription drug mentions per visit physician visits, for both general purposes and diabetes, without insurance coverage had significantly fewer prescription drug mentions per visit than the corresponding visits covered by either private health insurance, Medicare, or Medicaid. Thus, the results show that physicians use more prescription drugs and non‐prescription drugs to manage diabetes visits than non‐diabetes visits and prescribe fewer medications when patients have no insurance than when they have Medicare, Medicaid, or private health insurance.

Results from a nationally representative sample of physician visits in the USA show that physicians order or provide substantially more drugs for diabetes visits. These results suggest that diabetes sharply increases drug consumption. Also, physicians are likely to prescribe more medications to patients who have health insurance relative to patients without health insurance.

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.