MyMedR

Development and validation of a multilateral index to determine economic status in developing countries: the Patient Financial Eligibility Tool (PFET)

Saba J, Audureau E, Bizé M, Koloshuk B, Ladner J

Popul Health Manag, 2013 Apr;16(2):82-9.

PMID: 23276290 DOI: 10.1089/pop.2012.0049

The objective was to develop and validate a multilateral index to determine patient ability to pay for medication in low- and middle-income countries. Primary data were collected in 2009 from 117 cancer patients in China, India, Thailand, and Malaysia. The initial tool included income, expenditures, and assets-based items using ad hoc determined brackets. Principal components analysis was performed to determine final weights. Agreement (Kappa) was measured between results from the final tool and from an Impact Survey (IS) conducted after beginning drug therapy to quantify a patient's actual ability to pay in terms of number of drug cycles per year. The authors present the step-by-step methodology employed to develop the tool on a country-by-country basis. Overall Cronbach value was 0.84. Agreement between the Patient Financial Eligibility Tool (PFET) and IS was perfect (equal number of drug cycles) for 58.1% of patients, fair (1 cycle difference) for 29.1%, and poor (>1 cycle) for 12.8%. Overall Kappa was 0.76 (P<0.0001). The PFET is an effective tool for determining an individual's ability to pay for medication. Combined with tiered models for patient participation in the cost of medication, it could help to increase access to high-priced products in developing countries.

Matched MeSH terms: Pharmaceutical Preparations/economics

Systematic review of factors affecting pharmaceutical expenditures

Mousnad MA, Shafie AA, Ibrahim MI

Health Policy, 2014 Jun;116(2-3):137-46.

PMID: 24726509 DOI: 10.1016/j.healthpol.2014.03.010

To systematically identify the main factors contributing to the increase in pharmaceutical expenditures.

Matched MeSH terms: Pharmaceutical Preparations/economics*

Achieving cost-efficient management of drug supply via economic order quantity and minimum-maximum stock level

Dewi EK, Dahlui M, Chalidyanto D, Rochmah TN

Expert Rev Pharmacoecon Outcomes Res, 2020 Jun;20(3):289-294.

PMID: 31203686 DOI: 10.1080/14737167.2019.1633308

BACKGROUND: A good drug inventory planning system is important for an efficient budgeting, procurement, and cost control of drugs. When stagnant drugs in the inventory are too much, wastage due to expired and spoiled drugs could occur. These will not only cause loss of income but could also jeopardize healthcare service delivery.

RESEARCH DESIGN AND METHODS: This study aimed to determine the most efficient and effective management of stagnant and shortage drugs by comparing three pharmacy logistic methods; the economic order quantity (EOQ), minimum-maximum stock level (MMSL), and the traditional consumption of drug inventory, at RA Basoeni Hospital, Mojokerto. Drug inventory was analyzed to calculate the opportunity loss, opportunity cost, and proportions of both stagnant and shortage drugs.

RESULTS: We found that EOQ and MMSL performed best for control of stagnant drugs and shortage drugs, respectively. Both methods had proved as effective pharmacy logistic planning. In addition, EOQ produced the lowest opportunity cost for stagnant drugs besides the lowest opportunity loss for shortage drugs.

CONCLUSION: The study concluded that EOQ is the most effective and efficient method to manage stagnant and shortage drugs at hospital pharmacy.

Matched MeSH terms: Pharmaceutical Preparations/economics

Pharmaceutical Policy Reforms to Regulate Drug Prices in the Asia Pacific Region: The Case of Australia, China, India, Malaysia, New Zealand, and South Korea

Hasan SS, Kow CS, Dawoud D, Mohamed O, Baines D, Babar ZU

Value Health Reg Issues, 2019 May;18:18-23.

PMID: 30414506 DOI: 10.1016/j.vhri.2018.08.007

Medicine price directly affects affordability and access to medicines particularly in countries where a major portion of pharmaceutical spending is through out-of-pocket payment, such as in the Asia Pacific region. We have undertaken a detailed appraisal of the pharmaceutical policy reforms to regulate drug prices in 3 developed (Australia, New Zealand, and South Korea) and 3 emerging (China, India, and Malaysia) economies of the Asia Pacific region. Despite continuous efforts by the authorities in adopting a wide range of reformatory pharmaceutical pricing policies to ensure affordability of medicines, these policies may not be optimal where drug prices were not lowered as expected (eg, in Korea). On the contrary, considerable price reductions of various pharmaceuticals have been observed in New Zealand and India because of the reform in pharmaceutical pricing policy. This review of pharmaceutical pricing reforms reinforces the need for constant monitoring by policy makers in Asia Pacific countries to regulate drug prices and to undertake reform in pharmaceutical pricing policies when necessary to ensure affordability and access to medicines.

Matched MeSH terms: Pharmaceutical Preparations/economics*

TPPA should not be adopted without a full, independent health assessment

Keating G, Freeman J, Macmillan A, Neuwelt P, Monasterio E

N Z Med J, 2016 Feb 19;129(1430):7-13.

PMID: 26914417

Matched MeSH terms: Pharmaceutical Preparations/economics

Trade, TRIPS, and pharmaceuticals

Smith RD, Correa C, Oh C

Lancet, 2009 Feb 21;373(9664):684-91.

PMID: 19167054 DOI: 10.1016/S0140-6736(08)61779-1

The World Trade Organization's Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) set global minimum standards for the protection of intellectual property, substantially increasing and expanding intellectual-property rights, and generated clear gains for the pharmaceutical industry and the developed world. The question of whether TRIPS generates gains for developing countries, in the form of increased exports, is addressed in this paper through consideration of the importance of pharmaceuticals in health-care trade, outlining the essential requirements, implications, and issues related to TRIPS, and TRIPS-plus, in which increased restrictions are imposed as part of bilateral free-trade agreements. TRIPS has not generated substantial gains for developing countries, but has further increased pharmaceutical trade in developed countries. The unequal trade between developed and developing countries (ie, exporting and importing high-value patented drugs, respectively) raises the issue of access to medicines, which is exacerbated by TRIPS-plus provisions, although many countries have not even enacted provision for TRIPS flexibilities. Therefore this paper focuses on options that are available to the health community for negotiation to their advantage under TRIPS, and within the presence of TRIPS-plus.

Matched MeSH terms: Pharmaceutical Preparations/economics

Fulltext Trans-Pacific Partnership Provisions in Intellectual Property, Transparency, and Investment Chapters Threaten Access to Medicines in the US and Elsewhere

Baker BK

PLoS Med, 2016 Mar;13(3):e1001970.

PMID: 26954325 DOI: 10.1371/journal.pmed.1001970

Brook Baker describes the potential harms to global health from the Trans Pacific Partnership Agreement and its failure to balance the interests of patients and the public with those of industry.

Matched MeSH terms: Pharmaceutical Preparations/economics

Impact of a renal drug dosing service on dose adjustment in hospitalized patients with chronic kidney disease

Hassan Y, Al-Ramahi RJ, Aziz NA, Ghazali R

Ann Pharmacother, 2009 Oct;43(10):1598-605.

PMID: 19776297 DOI: 10.1345/aph.1M187

Appropriate drug selection and dosing for patients with chronic kidney disease (CKD) is important to avoid unwanted drug effects and ensure optimal patient outcomes.

Matched MeSH terms: Pharmaceutical Preparations/economics

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