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Rockers PC, Kiragu ZW, Onyango MA, Laing RO, Wirtz VJ. Willingness to pay brand premiums for generic medicines in Kenya: A bidding game experiment. Int J Health Plann Manage 2023; 38:1453-1463. [PMID: 37337315 DOI: 10.1002/hpm.3670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 09/25/2022] [Accepted: 06/04/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Recent growth in the market share of higher priced branded generic medicines in low- and middle-income countries (LMICs) has raised concerns around affordability and access. We examined consumer willingness to pay (WTP) for branded versus unbranded generic non-communicable disease (NCD) medicines in Kenya. METHODS We randomly assigned NCD patients to receive a hypothetical offer for either a Novartis Access-branded medicine or for an unbranded generic equivalent. We then analysed WTP data captured using a bidding game methodology. RESULTS We found that WTP for Novartis Access medicines was on average 23% higher than for unbranded generic equivalents (p = 0.009). The WTP brand premium was driven almost entirely by wealthier patients. CONCLUSIONS Our findings suggest that the dominance of branded generics in LMICs like Kenya reflect in part consumer preferences for these medicines. Governments and other health sector actors may be justified in intervening to improve access to these medicines and equivalent non-branded generics, particularly for the poorest patients who appear to have no preference for branded medicines.
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Affiliation(s)
- Peter C Rockers
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Zana Wangari Kiragu
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Monica A Onyango
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Richard O Laing
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
- School of Public Health, University of Western Cape, Bellville, South Africa
| | - Veronika J Wirtz
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
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Yu M, Li X, Jin H, Chen L, Wang N, Wang H, Cao Y, Sui X, Gao X, Yang H, Wang W. Bioequivalence of a Generic Nateglinide Formulation in Healthy Chinese Volunteers under Fasting and Fed Conditions: A Randomized, Open-Label, Double-Cycle, Double-Crossover Study. Pharmacology 2021; 106:418-425. [PMID: 33866315 DOI: 10.1159/000512851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 11/03/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Nateglinide or N-(trans-4-isopropylcyclohexyl-1-carbonyl)-D-phenylalanine is a drug with a rapid hypoglycemic effect that is mainly used in the treatment of type 2 diabetes. Very few studies have assessed bioequivalence based on feeding status. This study aimed to assess the pharmacokinetic bioequivalence and safety of nateglinide-containing tablets (0.12 g) in healthy Chinese volunteers under fasting and fed conditions. METHODS The studies were performed in 2017-2018 in the Phase I Clinical Trial Ward of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, China. Eligible Chinese volunteers received a single 0.12-g dose of the test or reference formulation, followed by a 7-day washout period and administration of the alternate formulation. Blood samples were collected at various time intervals, and plasma nateglinide concentrations were analyzed by liquid chromatography-tandem mass spectrometry. Then, the adverse events, laboratory test results, vital signs, and physical exam findings were compared between the 2 groups. RESULTS The ratios of the geometric means of Cmax, AUC0-t, and AUC0-inf of the tested to reference preparations under fasting conditions were 105.03% (90% confidence interval [CI]: 99.53-110.83%), 104.02% (90% CI: 101.37-106.74%), and 104.04% (90% CI: 101.38-106.77%), respectively. The same ratios under fed conditions were 96.55% (90% CI: 85.80-108.65%), 103.08% (90% CI: 100.07-106.18%), and 103.07% (90% CI: 100.21-106.01%), respectively. The 90% CI values for Cmax, AUC0-t, and AUC0-inf fell within the accepted range of bioequivalence (80.00-125.0%). Common adverse events included hypoglycemia, heart rate increase, palpitation, sweating, dizziness, and diarrhea. CONCLUSIONS The test formulation (0.12 g) met the CFDA's regulatory definition for bioequivalence to the reference formulation. Both formulations were well tolerated by healthy Chinese subjects. TRIAL REGISTRATION This trial has been registered in the Chinese Clinical trial registry (ChiCTR2000030694), March 10, 2020.
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Affiliation(s)
- Ming Yu
- Phase I clinical trial ward, GCP center, Affiliated Hospital of Liaoning, University of Traditional Chinese Medicine, Shenyang, China
| | - Xiaobin Li
- Phase I clinical trial ward, GCP center, Affiliated Hospital of Liaoning, University of Traditional Chinese Medicine, Shenyang, China
| | - Hao Jin
- Medical room, Jiangsu Deyuan Pharmaceutical Co., Ltd, Lianyungang, China
| | - Lu Chen
- Phase I clinical trial ward, GCP center, Affiliated Hospital of Liaoning, University of Traditional Chinese Medicine, Shenyang, China
| | - Nan Wang
- Phase I clinical trial ward, GCP center, Affiliated Hospital of Liaoning, University of Traditional Chinese Medicine, Shenyang, China
| | - Huawei Wang
- Phase I clinical trial ward, GCP center, Affiliated Hospital of Liaoning, University of Traditional Chinese Medicine, Shenyang, China
| | - Ying Cao
- Phase I clinical trial ward, GCP center, Affiliated Hospital of Liaoning, University of Traditional Chinese Medicine, Shenyang, China
| | - Xin Sui
- Phase I clinical trial ward, GCP center, Affiliated Hospital of Liaoning, University of Traditional Chinese Medicine, Shenyang, China
| | - Xue Gao
- Phase I clinical trial ward, GCP center, Affiliated Hospital of Liaoning, University of Traditional Chinese Medicine, Shenyang, China
| | - Hanyue Yang
- Jiangsu Deyuan Pharmaceutical Co., Ltd., Lianyungang, China
| | - Wenping Wang
- Phase I clinical trial ward, GCP center, Affiliated Hospital of Liaoning, University of Traditional Chinese Medicine, Shenyang, China
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AlRuthia Y, Aljohani B, Alsharif WR, Alrasheed HH, Alghamdi BM, Asiri S, Alarfaj M, Almuaythir GS, Almazrou S, Almazroo O, Alaofi A, Alenazi R. Prospects of Establishing a Saudi Version of the United States Food and Drug Administration Orange Book. HEALTH POLICY AND TECHNOLOGY 2021. [DOI: 10.1016/j.hlpt.2020.08.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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More GS, Thomas AB, Chitlange SS, Nanda RK, Gajbhiye RL. Nitrogen Mustards as Alkylating Agents: A Review on Chemistry, Mechanism of Action and Current USFDA Status of Drugs. Anticancer Agents Med Chem 2020; 19:1080-1102. [PMID: 30834842 DOI: 10.2174/1871520619666190305141458] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 12/20/2018] [Accepted: 02/16/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND & OBJECTIVE Nitrogen mustard derivatives form one of the major classes of anti-cancer agents in USFDA approved drugs list. These are polyfunctional alkylating agents which are distinguished by a unique mechanism of adduct formation with DNA involving cross-linking between guanine N-7 of one strand of DNA with the other. The generated cross-linking is irreversible and leads to cell apoptosis. Hence it is of great interest to explore this class of anticancer alkylating agents. METHODS An exhaustive list of reviews, research articles, patents, books, patient information leaflets, and orange book is presented and the contents related to nitrogen mustard anti-cancer agents have been reviewed. Attempts are made to present synthesis schemes in a simplified manner. The mechanism of action of the drugs and their side effects are also systematically elaborated. RESULTS This review provides a platform for understanding all aspects of such drugs right from synthesis to their mechanism of action and side effects, and lists USFDA approved ANDA players among alkylating anticancer agents in the current market. CONCLUSION Perusing this article, generic scientists will be able to access literature information in this domain easily to gain insight into the nitrogen mustard alkylating agents for further ANDA development. It will help the scientific and research community to continue their pursuit for the design of newer and novel heterocyclic alkylating agents of this class in the coming future.
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Affiliation(s)
- Ghansham S More
- Department of Pharmaceutical Chemistry, Dr. D.Y. Patil Institute of Pharmaceutical Sciences and Research, Savitribai Phule Pune University, Pune, India
| | - Asha B Thomas
- Department of Pharmaceutical Chemistry, Dr. D.Y. Patil Institute of Pharmaceutical Sciences and Research, Savitribai Phule Pune University, Pune, India
| | - Sohan S Chitlange
- Department of Pharmaceutical Chemistry, Dr. D.Y. Patil Institute of Pharmaceutical Sciences and Research, Savitribai Phule Pune University, Pune, India
| | - Rabindra K Nanda
- Department of Pharmaceutical Chemistry, Dr. D.Y. Patil Institute of Pharmaceutical Sciences and Research, Savitribai Phule Pune University, Pune, India
| | - Rahul L Gajbhiye
- Organic & Medicinal Chemistry Division, CSIR-Indian Institute of Chemical Biology, Kolkata 700 032, India
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