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Banerjee T, Nayak A. Why trash don't pass? pharmaceutical licensing and safety performance of drugs. Eur J Health Econ 2017; 18:59-71. [PMID: 26781296 DOI: 10.1007/s10198-015-0758-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 12/14/2015] [Indexed: 06/05/2023]
Abstract
This paper examines how asymmetric information in pharmaceutical licensing affects the safety standards of licensed drugs. Pharmaceutical companies often license potential drug molecules at different stages of drug development from other pharmaceutical or biotechnology companies and complete the remaining of research stages before submitting the new drug application(NDA) to the food and drug administration. The asymmetric information associated with the quality of licensed molecules might result in the molecules which are less likely to succeed to be licensed out, while those with greater potential of success being held internally for development. We identify the NDAs submitted between 1993 and 2004 where new molecular entities were acquired through licensing. Controlling for other drug area specific and applicant firm specific factors, we investigate whether drugs developed with licensed molecules face higher probability of safety based recall and ultimate withdrawal from the market than drugs developed internally. Results suggest the opposite of Akerlof's (Q J Econ 84:488-500, 1970) lemons problem. Licensed molecules rather have less probability of facing safety based recalls and ultimate withdrawal from the market comparing to internally developed drug molecules. This suggests that biotechnology and small pharmaceutical firms specializing in pharmaceutical research are more efficient in developing good potential molecules because of their concentrated research. Biotechnology firms license out good potential molecules because it increases their market value and reputation. In addition, results suggest that both the number of previous approved drugs in the disease area, and also the applicant firms' total number of previous approvals in all disease areas reduce the probability that an additional approved drug in the same drug area will potentially be harmful.
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Affiliation(s)
| | - Arnab Nayak
- Stetson School of Business and Economics, Mercer University, Atlanta, GA, USA
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202
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Pashkov V, Kotvitska A, Noha P. Protecting the rights of producers original medicines. Wiad Lek 2017; 70:834-837. [PMID: 29064813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION the article analyzes the state of protection of intellectual property rights of original medicine producers, its accordance with international standards. Attention is focused on the importance of exclusivity of medicine market. AIM the analysis of protection of intellectual property rights of medicine producers in Ukraine and determination of its conformity or non-conformity to the international standards. MATERIAL AND METHODS the experience of certain countries is analyzed in the research. Additionally, we used statistical data of international organizations, conclusions of experts. RESULTS there are numerous cases of state registration of generic medicinal products using the registration information of original medicinal products and delict of the rights of patent holders. CONCLUSIONS an effective mechanism of judicial protection of the original medicine producers` intellectual property rights from disorders that affect the profit was elaborated in Ukraine.
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Affiliation(s)
- Vitalii Pashkov
- Poltava Law Institute Of Yaroslav Mudryi National Law University, Poltava, Ukraine
| | | | - Petro Noha
- Poltava Law Institute Of Yaroslav Mudryi National Law University, Poltava, Ukraine
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203
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Steiner DJ. Pharmaceuticals and Medical Devices: Business Practices. Issue Brief Health Policy Track Serv 2016; 2016:1-38. [PMID: 28252886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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204
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White RS. Pharmaceuticals and Medical Devices: FDA Oversight. Issue Brief Health Policy Track Serv 2016; 2016:1-74. [PMID: 28252887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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205
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Paumgartten FJR. Pharmaceutical lobbying in Brazil: a missing topic in the public health research agenda. Rev Saude Publica 2016; 50:70. [PMID: 28099661 PMCID: PMC5152825 DOI: 10.1590/s1518-8787.2016050006508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 10/15/2015] [Indexed: 11/21/2022] Open
Abstract
In the US, where registration of lobbyists is mandatory, the pharmaceutical industry and private health-care providers spend huge amounts of money seeking to influence health policies and government decisions. In Brazil, where lobbying lacks transparency, there is virtually no data on drug industry expenditure to persuade legislators and government officials of their viewpoints and to influence decision-making according to commercial interests. Since 1990, however, the Associação da Indústria Farmacêutica de Pesquisa (Interfarma - Pharmaceutical Research Industry Association), Brazilian counterpart of the Pharmaceutical Research and Manufacturers of America (PhRMA), main lobbying organization of the US pharmaceutical industry, has played a major role in the advocacy of interests of major drug companies. The main goals of Interfarma lobbying activities are: shortening the average time taken by the Brazilian regulatory agency (ANVISA) to approve marketing authorization for a new drug; making the criteria for incorporation of new drugs into SUS (Brazilian Unified Health System) more flexible and speeding up technology incorporation; changing the Country's ethical clearance system and the ethical requirements for clinical trials to meet the need of the innovative drug industry, and establishing a National Policy for Rare Diseases that allows a prompt incorporation of orphan drugs into SUS. Although lobbying affects community health and well-being, this topic is not in the public health research agenda. The impacts of pharmaceutical lobbying on health policies and health-care costs are of great importance for SUS and deserve to be investigated.
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207
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Hawkes N. Competition watchdog finds new target: overpriced generics. BMJ 2016; 355:i6712. [PMID: 27974337 DOI: 10.1136/bmj.i6712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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208
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Hawkes N. Pfizer is fined £84m for "exploiting opportunity" to hike price of phenytoin. BMJ 2016; 355:i6628. [PMID: 27932377 DOI: 10.1136/bmj.i6628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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209
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Abstract
Drug importation from Canada has been holly debated for nearly a decade. Many believe that drug importation will bring needed competition and lower US drug prices. Opposition argues that the costs of ensuring product quality and safety, as well as added healthcare costs, will offset savings attained from imported pharmaceuticals. The US needs to become innovative and seek solutions that will provide effective, safe, and economical pharmaceuticals without placing a burden on other countries and without damaging the pharmaceutical research.
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Affiliation(s)
- Marv Shepherd
- Center for Pharmacoeconomic Studies, College of Pharmacy, University of Texas, Austin, TX 78712, USA.
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210
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Affiliation(s)
- Laura N Vandenberg
- Department of Environmental Health Sciences, University of Massachusetts Amherst School of Public Health and Health Sciences, Amherst, Massachusetts 01003
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211
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Ravinetto R, De Weggheleire A, Dorlo TP, Francque S, Sokkab A, Pouget C, Meessen B, Tabernero P, Newton PN, Lynen L. Predictable threats to public health through delaying universal access to innovative medicines for hepatitis C: a pharmaceutical standpoint. Trop Med Int Health 2016; 21:1490-1495. [PMID: 27671365 PMCID: PMC5244681 DOI: 10.1111/tmi.12784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Raffaella Ravinetto
- Clinical Sciences DepartmentInstitute of Tropical MedicineAntwerpBelgium
- Clinical Pharmacology and PharmacotherapyKU LeuvenLeuvenBelgium
| | | | - Thomas P.C. Dorlo
- Department Pharmaceutical BiosciencesUppsala UniversityUppsalaSweden
- Division of Pharmacoepidemiology & Clinical PharmacologyUtrecht UniversityUtrechtThe Netherlands
| | | | - An Sokkab
- Sihanouk Hospital Centre of HopePhnom PenhCambodia
| | | | - Bruno Meessen
- Public Health DepartmentInstitute of Tropical MedicineAntwerpBelgium
| | | | - Paul N. Newton
- Lao‐Oxford‐Mahosot Hospital‐Wellcome Trust Research UnitMahosot HospitalVientianeLao PDR
- Centre for Tropical Medicine & Global HealthNuffield Department of MedicineOxford UniversityOxfordUK
- Worldwide Antimalarial Resistance NetworkChurchill HospitalOxford UniversityOxfordUK
- London School of Hygiene and Tropical MedicineLondonUK
| | - Lut Lynen
- Clinical Sciences DepartmentInstitute of Tropical MedicineAntwerpBelgium
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212
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Reinke T. Patent litigation could make 2017 no 'dancing' matter. Manag Care 2016; 25:23-28. [PMID: 28121555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
No matter how you slice it, 2016 was a banner year for biosimilars. Still, the high-stakes marketing, regulatory, and legal combat between originators and biosimilars is a long way from over. So far, the originators have been able to hold their ground and thwart the launch of biosimilars with patent lawsuits.
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213
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Hawkes N. Pfizer could face large fine over pricing of generic phenytoin. BMJ 2016; 355:i6401. [PMID: 27895057 DOI: 10.1136/bmj.i6401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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214
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Affiliation(s)
- Jason L Schwartz
- From the Department of Health Policy and Management, Yale School of Public Health, and the Section of the History of Medicine, Yale School of Medicine, New Haven, CT
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215
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Abstract
The Medicare Modernization Act (MMA) prohibited the government from negotiating drug prices, a feature that the act's critics characterize as a giveaway to the drug industry. Instead of the government negotiating to keep prices down, the act relies on competition among drug companies to obtain business from private insurers; yet, competition cannot be effective when there are no close clinical substitutes. In the past few years, the rate of introduction of first-in-class drugs has been low; if this continues, the prohibition on negotiation may be only a minor problem. However, if the prior rate of introduction resumes, the government may find itself with unacceptable expenditure levels.
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Affiliation(s)
- Joseph P Newhouse
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave., Boston, MA 02115, USA.
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216
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Thompson JC, Volpe KA, Bridgewater LK, Qeadan F, Dunivan GC, Komesu YM, Cichowski SB, Jeppson PC, Rogers RG. Sunshine Act: shedding light on inaccurate disclosures at a gynecologic annual meeting. Am J Obstet Gynecol 2016; 215:661.e1-661.e7. [PMID: 27319366 DOI: 10.1016/j.ajog.2016.06.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 05/27/2016] [Accepted: 06/07/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Physicians and hospital systems often have relationships with biomedical manufacturers to develop new ideas, products, and further education. Because this relationship can influence medical research and practice, reporting disclosures are necessary to reveal any potential bias and inform consumers. The Sunshine Act was created to develop a new reporting system of these financial relationships called the Open Payments database. Currently all disclosures submitted with research to scientific meetings are at the discretion of the physician. We hypothesized that financial relationships between authors and the medical industry are underreported. OBJECTIVES We aimed to describe concordance between physicians' financial disclosures listed in the abstract book from the 41st annual scientific meeting of the Society of Gynecologic Surgeons to physician payments reported to the Center for Medicaid and Medicare Services Open Payments database for the same year. STUDY DESIGN Authors and scientific committee members responsible for the content of the 41st annual scientific meeting of the Society of Gynecologic Surgeons were identified from the published abstract book; each abstract listed disclosures for each author. Abstract disclosures were compared with the transactions recorded on the Center for Medicaid and Medicare Services Open Payments database for concordance. Two authors reviewed each nondisclosed Center for Medicaid and Medicare Services listing to determine the relatedness between the company listed on the Center for Medicaid and Medicare Services and abstract content. RESULTS Abstracts and disclosures of 335 physicians meeting inclusion criteria were reviewed. A total of 209 of 335 physicians (62%) had transactions reported in the Center for Medicaid and Medicare Services, which totaled $1.99 million. Twenty-four of 335 physicians (7%) listed companies with their abstracts; 5 of those 24 physicians were concordant with the Center for Medicaid and Medicare Services. The total amount of all nondisclosed transactions was $1.3 million. Transactions reported in the Center for Medicaid and Medicare Services associated with a single physician ranged from $11.72 to $405,903.36. Of the 209 physicians with Center for Medicaid and Medicare Services transactions that were not disclosed, the majority (68%) had at least 1 company listed in the Center for Medicaid and Medicare Services that was determined after review to be related to the subject of their abstract. CONCLUSION Voluntary disclosure of financial relationships was poor, and the majority of unlisted disclosures in the abstract book were companies related to the scientific content of the abstract. Better transparency is needed by physicians responsible for the content presented at gynecological scientific meetings.
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Affiliation(s)
- Jennifer C Thompson
- Department of Obstetrics and Gynecology, Division of Urogynecology, University of New Mexico, Albuquerque, NM
| | - Katherine A Volpe
- Department of Obstetrics and Gynecology, Division of Urogynecology, University of New Mexico, Albuquerque, NM
| | - Lindsay K Bridgewater
- Department of Obstetrics and Gynecology, Division of Urogynecology, University of New Mexico, Albuquerque, NM
| | - Fares Qeadan
- Clinical and Translational Science Center, University of New Mexico, Albuquerque, NM
| | - Gena C Dunivan
- Department of Obstetrics and Gynecology, Division of Urogynecology, University of New Mexico, Albuquerque, NM
| | - Yuko M Komesu
- Department of Obstetrics and Gynecology, Division of Urogynecology, University of New Mexico, Albuquerque, NM
| | - Sara B Cichowski
- Department of Obstetrics and Gynecology, Division of Urogynecology, University of New Mexico, Albuquerque, NM
| | - Peter C Jeppson
- Department of Obstetrics and Gynecology, Division of Urogynecology, University of New Mexico, Albuquerque, NM
| | - Rebecca G Rogers
- Department of Obstetrics and Gynecology, Division of Urogynecology, University of New Mexico, Albuquerque, NM.
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217
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Hawkes N. Pfizer loses appeal over use of branded painkiller pregabalin. BMJ 2016; 355:i5578. [PMID: 27754840 DOI: 10.1136/bmj.i5578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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218
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Abstract
In overturning Latham J's judgment in R v Department of Health, Ex Parte Source Informatics Ltd. that anonymisation does not obviate breaching a personal confidence, the Court of Appeal holds that where the duty of confidence arises in equity it does not prohibit the confidant using the confided information without the consent of the confider if this does not treat the confider unfairly (relative to the Court's view of the confider's legitimate interests). We argue that this principle – by bringing fairness to bear on the scope of the duty of confidence rather than on whether a breach of it may be lawful – has no authority in usable precedents; that the Court's interpretation of fairness in applying this principle is, in any event, incompatible with the Data Protection Act 1998 (in part because the Court has too narrow a conception of privacy); that the Court errs in holding that neither anonymisation of personal data nor use of anonymous data falls under the Data Protection Act; and that the Court's insensitivity to the vulnerability that leads patients to disclose information about themselves to health professionals for their treatment, leads it to misidentify the basis of the duty of confidence in such disclosures. The Court of Appeal's reasoning does not clarify the duty of confidence, but virtually abolishes it in the face of competing commercial and research interests.
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Affiliation(s)
- D Beyleveld
- Sheffield Institute of Biotechnological Law and Ethics, University of Sheffield, UK
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220
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Guennif S. Evaluating the Usefulness of Compulsory Licensing in Developing Countries: A Comparative Study of Thai and Brazilian Experiences Regarding Access to Aids Treatments. Dev World Bioeth 2016; 17:90-99. [PMID: 27699996 DOI: 10.1111/dewb.12124] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
While compulsory licensing (CL) is described in the TRIPS agreement as flexibility to protect public health by improving access to medicines in developing countries, a recent literature contends adversely that CL may harm public health. Therefore, this article intends to evaluate the usefulness of CL in the South through the prism of obligations and goals entrusted to patent holders (the effective and non-abusive exploitation of patents in order to achieve industrial and health developments) and in light of experiences in Thailand and Brazil regarding access to antiretroviral drugs. In this way, it shows that the obligations assigned to patent holders were better served by the recipients of CL and brought significant health and industrial benefits in the two high middle-income countries. In particular, CL allowed the scaling-up of free and universal access to antiretroviral drugs by assuring the financial sustainability of these public health programs endangered by monopolistic practices from patent holders.
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221
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Berger J, Dunn JD, Johnson MM, Karst KR, Shear WC. How drug life-cycle management patent strategies may impact formulary management. Am J Manag Care 2016; 22:S487-S495. [PMID: 28719222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Drug manufacturers may employ various life-cycle management patent strategies, which may impact managed care decision making regarding formulary planning and management strategies when single-source, branded oral pharmaceutical products move to generic status. Passage of the Hatch-Waxman Act enabled more rapid access to generic medications through the abbreviated new drug application process. Patent expirations of small-molecule medications and approvals of generic versions have led to substantial cost savings for health plans, government programs, insurers, pharmacy benefits managers, and their customers. However, considering that the cost of developing a single medication is estimated at $2.6 billion (2013 dollars), pharmaceutical patent protection enables companies to recoup investments, creating an incentive for innovation. Under current law, patent protection holds for 20 years from time of patent filing, although much of this time is spent in product development and regulatory review, leaving an effective remaining patent life of 7 to 10 years at the time of approval. To extend the product life cycle, drug manufacturers may develop variations of originator products and file for patents on isomers, metabolites, prodrugs, new drug formulations (eg, extended-release versions), and fixed-dose combinations. These additional patents and the complexities surrounding the timing of generic availability create challenges for managed care stakeholders attempting to gauge when generics may enter the market. An understanding of pharmaceutical patents and how intellectual property protection may be extended would benefit managed care stakeholders and help inform decisions regarding benefit management.
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222
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Coustasse A, Kimble CA, Stanton RB, Naylor M. Could the Pharmaceutical Industry Benefit from Full-Scale Adoption of Radio-Frequency Identification (RFID) Technology with New Regulations? Perspect Health Inf Manag 2016; 13:1b. [PMID: 27843419 PMCID: PMC5075230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Healthcare regulators are directing attention to the pharmaceutical supply chain with the passage of the Drug Quality and Security Act (DQSA) and the Drug Supply Chain Security Act (DSCSA). Adoption of Radio-Frequency Identification (RFID) technology has the ability to improve compliance, reduce costs, and improve safety in the supply chain but its implementation has been limited; primarily because of hardware and tag costs. The purpose of this research study was to analyze the benefits to the pharmaceutical industry and healthcare system of the adoption of RFID technology as a result of newly implemented supply chain regulations. The methodology was a review following the steps of a systematic review with a total of 96 sources used. With the DSCSA, pharmaceutical companies must track and trace prescription drugs across the supply chain, and RFID can resolve many track-and-trace issues with manufacturer control of data. The practical implication of this study is that pharmaceutical companies must continue to have the potential to increase revenues, decrease associated costs, and increase compliance with new FDA regulations with RFID. Still, challenges related to regulatory statute wording, implementation of two-dimensional barcode technology, and the variety of interfaces within the pharmaceutical supply chain have delayed adoption and its full implementation.
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Affiliation(s)
- Alberto Coustasse
- Healthcare administration at Marshall University in South Charleston, WV
| | - Craig A Kimble
- Pharmacy practice at Marshall University School of Pharmacy in Huntington, WV
| | | | - Mariah Naylor
- Healthcare administration program at Marshall University in South Charleston, WV
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223
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Hawkes N. European drug agency to appeal ruling that it stop releasing trial data. BMJ 2016; 354:i5331. [PMID: 27694255 DOI: 10.1136/bmj.i5331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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224
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Dalzell MD. AMCP Seeks an End to 20 Years Of Confusion Over FDAMA Section 114. Manag Care 2016; 25:43-45. [PMID: 28121576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The FDA never issued regulations to clarify the boundaries of promotion of pharmacoeconomic data, something it's been dragging its feet on for nearly 20 years. In turn, pharma companies, fearful of being penalized for off-lable promotion, have erred on the side of caution, hesitating to take advantage of Section 114.
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Abstract
OBJECTIVE To provide updated evidence on US trends in: market exclusivity periods (MEPs, time between brand-name drug launch and first generic competitors) for new molecular entities (NMEs); likelihood, timing and number of Hatch-Waxman Act Paragraph IV patent challenges; and generic drug penetration. METHODS This study used IMS Health National Sales Perspectives(TM) US data to calculate MEPs for the 288 NMEs experiencing initial generic entry between January 1995 and December 2014, the number of generic competitors for 12 months afterward (by level of annual sales prior to generic entry), and generic penetration rates. The likelihood, timing and number of Paragraph IV challengers were calculated using data from Abbreviated New Drug Approval (ANDA) letters, the FDA website, public information searches, and ParagraphFour.com. RESULTS For drugs experiencing initial generic entry in 2013-2014, the MEP was 12.5 years for drugs with sales greater than $250 million (in 2008 dollars) in the year prior to generic entry ($250 million + NMEs), 13.6 years overall. After generic entry, brands rapidly lost sales, with their average unit share being 7% at 1 year for $250 million + NMEs, 12% overall. Ninety-four percent of $250 million + NMEs experiencing initial generic entry in 2013-2014 had faced at least one Paragraph IV challenge, an average of 5.2 years after brand launch (76% and 5.9 years for all NMEs). NMEs faced an average of 5.1 and 6.2 Paragraph IV challenges per NME, for all and $250 million + NMEs, respectively. LIMITATIONS Analyses, including Paragraph IV calculations, were restricted to NMEs where generic entry had occurred. CONCLUSION The average 2013-2014 MEP of 12.5 years for $250 million + NMEs, 13.6 overall remains consistent with prior research. MEPs are lower, and Paragraph IV challenges are more frequent and occur earlier for $250 million + drugs. Generic share erosion is also greater, and continues to intensify for both NME types.
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Affiliation(s)
| | - Genia Long
- b Analysis Group, Inc. , Boston , MA , USA
| | | | - Ani Boyo
- b Analysis Group, Inc. , Boston , MA , USA
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226
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Food and Drug Administration, HHS. Requirements for Foreign and Domestic Establishment Registration and Listing for Human Drugs, Including Drugs That Are Regulated Under a Biologics License Application, and Animal Drugs. Final rule. Fed Regist 2016; 81:60169-224. [PMID: 27580511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The Food and Drug Administration (FDA) is amending its regulations governing drug establishment registration and drug listing. These amendments reorganize, modify, and clarify current regulations concerning who must register establishments and list human drugs, human drugs that are also biological products, and animal drugs. The final rule requires electronic submission, unless waived in certain circumstances, of registration and listing information. This rulemaking pertains to finished drug products and to active pharmaceutical ingredients (APIs) alone or together with one or more other ingredients. The final rule describes how and when owners or operators of establishments at which drugs are manufactured or processed must register their establishments with FDA and list the drugs they manufacture or process. In addition, the rule makes certain changes to the National Drug Code (NDC) system. We are taking this action to improve management of drug establishment registration and drug listing requirements and make these processes more efficient and effective for industry and for us. This action also supports implementation of the electronic prescribing provisions of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and the availability of current drug labeling information through DailyMed, a computerized repository of drug information maintained by the National Library of Medicine.
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Affiliation(s)
- Joseph D Tucker
- University of North Carolina Chapel Hill Project-China, Guangzhou, China; University of North Carolina Chapel Hill, Institute of Global Health and Infectious Diseases, Chapel Hill, NC, USA.
| | - Bonnie Wong
- School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Jing-Bao Nie
- Division of Health Sciences, Bioethics Centre, University of Otago, Dunedin, New Zealand
| | - Arthur Kleinman
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
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Abstract
In preclinical studies, pioglitazone was associated with bladder cancer in male rats (but not in female rats, mice dogs or monkeys). Because of this association, the Federal Drug Administration requested a large 10year epidemiological study to evaluate whether there was an association between bladder cancer and exposure to pioglitazone in patients. A 5-year interim report published in 2011 showed no significant association between ever vs never exposure to the drug but a significant association in patients exposed to pioglitazone for >2years. Importantly, the final 10year report did not confirm the 5year interim report finding no association between bladder cancer and pioglitazone, even after >4years of exposure to the drug. However, as would be expected, following the 5-year interim report, many epidemiological studies were carried out and civil litigation lawsuits began to be filed. Of the 23 epidemiological studies that have been published to date, 18 showed no association between bladder cancer and pioglitazone (5 with a combination of rosiglitazone and pioglitazone). Of the five that did show a significant association with pioglitazone, three could not be confirmed in the same population and in one of them there were significantly more risk factors for bladder cancer in the patients exposed to pioglitazone. In the fourth one, a significant association became non-significant when patients >79years were included. In the fifth one, detection bias was a major flaw. Currently, >11,000 legal cases have been filed, many of which claim emotional distress due to the fear of bladder cancer. To limit their legal costs, the pharmaceutical company has established a 2.4 billion dollar settlement pool. So much for evidence-based medicine.
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Affiliation(s)
- Mayer B Davidson
- Department of Internal Medicine, Charles R. Drew University, Los Angeles, California.
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232
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Dyer O. Former Johnson and Johnson executives are convicted over off label marketing. BMJ 2016; 354:i4179. [PMID: 27469393 DOI: 10.1136/bmj.i4179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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233
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Affiliation(s)
- Alain Braillon
- University Hospital, 80000 Amiens, France
- Georgetown, TX 78633, USA
- Women's Health Academic Centre, King's College, London, UK
| | - John H Noble
- University Hospital, 80000 Amiens, France
- Georgetown, TX 78633, USA
- Women's Health Academic Centre, King's College, London, UK
| | - Susan Bewley
- University Hospital, 80000 Amiens, France
- Georgetown, TX 78633, USA
- Women's Health Academic Centre, King's College, London, UK
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234
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Lenzer J. Robert Califf: controversial new head of the FDA. BMJ 2016; 354:i3656. [PMID: 27381843 DOI: 10.1136/bmj.i3656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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235
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Nissanholtz-Gannot R, Yankellevich A, Nirel N. [THE INFLUENCE OF THE ISRAELI LEGISLATION ON THE RELATIONSHIP BETWEEN PHYSICIANS AND PHARMACEUTICAL COMPANIES]. Harefuah 2016; 155:426-430. [PMID: 28514133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION The relationship between physicians and pharmaceutical-companies raises many dilemmas. There are two types of solutions to these dilemmas: self-regulation and government regulation. Our goal was to review in what way legislative intervention and self-regulation standardize and affect the relationship. In addition, we examined the positions of relevant stakeholders regarding: 1. The relationship between physicians and pharmaceutical companies; 2. Future measures we should take to address the ethical dilemmas inherent in this relationship. METHODS 1. In-depth interviews with 42 senior representatives of all the relevant stakeholders, with emphasis on their organizational identity, since their points of view are influenced and shaped by organizational and professional positioning. We analyzed the interviews using the Narralizer program. 2. Analysis of three databases: The Ministry of Health, The Israel Medical Association and Pharma-Israel, regarding donations made to various parties in the health system. RESULTS The influence of Israeli legislation on the relationship between physicians and pharmaceutical companies is almost imperceptible. However, in recent years, there have been changes in this relationship stemming from international self-regulation, which leads to: contractual relationships, decreases in hospitality and tighter internal control over this relationship. CONCLUSIONS Regulation in Israel is not achieving its goal satisfactorily. Solutions to reduce the influence of this relationship exist. However, the first step is for the regulator to decide to what extent, if any, he wants to deal with this issue. If the regulator chooses to take the lead on this issue, we will soon face additional legislation that might limit the amount of money that the pharmaceutical companies can donate to healthcare organizations.
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237
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Abstract
This report presents information on the state of the U.S. health system in the spring of 2006. It includes data on the uninsured and underinsured and their access to health care, on socioeconomic inequality in health care, and on the rising costs of the U.S. health system. It also presents information on the role of corporate money in health care, focusing on the pharmaceutical industry, Medicare HMOs, and corporate-government conflicts of interest. The author includes a survey of recent public opinion polls on health care and health system reform and an update on the U.S. national health insurance legislation. The article ends by reviewing recent data on international health systems and international system comparisons.
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Affiliation(s)
- Ida Hellander
- Physicians for a National Health Program, Chicago, IL 60602, USA.
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238
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Affiliation(s)
- Ameet Sarpatwari
- From the Program on Regulation, Therapeutics, and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston
| | - Jerry Avorn
- From the Program on Regulation, Therapeutics, and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston
| | - Aaron S Kesselheim
- From the Program on Regulation, Therapeutics, and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston
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239
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Dyer O. Drug companies settle claim of misleading doctors on cancer survival data. BMJ 2016; 353:i3361. [PMID: 27307418 DOI: 10.1136/bmj.i3361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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240
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241
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242
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Goldberg D. On Physician-Industry Relationships and Unreasonable Standards of Proof for Harm: A Population-Level Bioethics Approach. Kennedy Inst Ethics J 2016; 26:173-194. [PMID: 27477195 DOI: 10.1353/ken.2016.0022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The primary claim of this paper is that a widely used argument against obstructing, curtailing, or eliminating deep physician-industry relationships is deficient. The typical argument critiqued requires that proof that physician-industry relationships cause harm flows from randomized controlled trials. Chief among the deficiencies in this claim is the fact that this specific demand for proof of harm essentially guts the precautionary principle. In so doing, the typical argument neuters the basic justification for public health action. In place of this fallacious move, the paper argues that proof of harm can be demonstrated via evidentiary standards widely accepted within the knowledge communities of public health scientists and epidemiologists. The paper concludes by noting that while there may be good reasons to oppose curtailment of deep physician-industry relationships, the typical argument described here is not among them.
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243
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Kukla R. Editorial Note. Kennedy Inst Ethics J 2016; 26:vii-ix. [PMID: 27477198 DOI: 10.1353/ken.2016.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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244
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Affiliation(s)
- François Bocquet
- a Faculty of Pharmacy , Paris Descartes University, Sorbonne Paris Cité , Paris , France
- b Health Law Institute, Inserm, UMR S 1145, Paris Descartes University, Sorbonne Paris Cité , Paris , France
- c General Agency of Equipment and Health Products (AGEPS) , Assistance Publique-Hôpitaux de Paris (AP-HP) , Paris , France
| | - Pascal Paubel
- a Faculty of Pharmacy , Paris Descartes University, Sorbonne Paris Cité , Paris , France
- b Health Law Institute, Inserm, UMR S 1145, Paris Descartes University, Sorbonne Paris Cité , Paris , France
- c General Agency of Equipment and Health Products (AGEPS) , Assistance Publique-Hôpitaux de Paris (AP-HP) , Paris , France
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245
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Patten vs the AMA. 1916. WMJ 2016; 115:117. [PMID: 27443084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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246
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McCarthy M. US senators urge FDA to take action over wasted cancer drugs. BMJ 2016; 353:i3021. [PMID: 27229895 DOI: 10.1136/bmj.i3021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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247
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Holzgreve H. [Sponsoring: uncertainty despite transparency law]. MMW Fortschr Med 2016; 158:34. [PMID: 27155698 DOI: 10.1007/s15006-016-8197-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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248
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Siegel B. Guidance on 340B drug program delivers mismatch of policy and priorities from HHS. Mod Healthc 2016; 46:25. [PMID: 27483590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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249
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Abstract
The right to health as a basic human right- and access to medicine as a part of it- have been a matter of attention for several decades. Also the responsibilities of different parties- particularly pharmaceutical companies- in realization of this right has been emphasized by World Health Organization. This is while many companies find no incentive for research and development of medicines related to rare diseases. Also some legal structures such as "patent agreements" clearly cause huge difficulties for access to medicine in many countries. High prices of brand medicine and no legal production of generics can increase the catastrophic costs- as well as morbidity-mortality of medication in lower income countries. Here we evidently review the current challenges in access to medicine and critically assess its legal roots. How societies/governors can make the pharmaceutical companies responsible is also discussed to have a look on possible future and actions that policy makers- in local or global level- can take.
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Affiliation(s)
- Saeed Ahmadiani
- Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, 16Azar St, Tehran, Iran
| | - Shekoufeh Nikfar
- Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, 16Azar St, Tehran, Iran.
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250
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Brooks E, Geyer R. Whatever happened to the Norwegian Medical Need Clause? Lessons for current debates in EU pharmaceutical regulation. Sociol Health Illn 2016; 38:576-591. [PMID: 26564268 DOI: 10.1111/1467-9566.12379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Until 1994, pharmaceutical products seeking market authorisation in Norway were required to demonstrate a fulfilment of unmet medical need. This clause enabled the national regulator to dramatically limit the number of products on the market whilst encouraging price competition to keep drug expenditure low and was credited with encouraging the development of drugs with genuine added therapeutic value and reducing the incidence of antimicrobial resistance. Norway was forced to abandon its Medical Need Clause (MNC) when it joined the European Economic Area as it was incompatible with the acquis communautaire of the European Union. This article reviews Norway's experience with its MNC in light of contemporary debates in European health policy. It discusses the potential contribution of an MNC-style regulation to improving health, reducing illness, ensuring sustainable health systems and fostering pharmaceutical innovation. It concludes by asking how these findings can inform current European Union debates over the growing cost of prescription drugs and direction of pharmaceutical development.
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Affiliation(s)
- Eleanor Brooks
- Department of Politics, Philosophy and Religion, County South, Lancaster University, UK
| | - Robert Geyer
- Department of Politics, Philosophy and Religion, County South, Lancaster University, UK
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