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Wu R, Wang X, Cui P, Chen W, Yang W, Lai Y. Efficacy and safety of generic cefoperazone/sulbactam versus branded cefoperazone/sulbactam in the treatment of bacterial infections: a systematic review and meta-analysis. J Chemother 2024:1-11. [PMID: 38644652 DOI: 10.1080/1120009x.2024.2343961] [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: 11/28/2023] [Accepted: 04/12/2024] [Indexed: 04/23/2024]
Abstract
This study aim to assess the clinical efficacy and safety of generic cefoperazone/sulbactam compared to the branded cefoperazone/sulbactam (Sulperazon) in treating bacterial infections through a meta-analysis. Searches were conducted across PubMed, Embase, Cochrane Library, CNKI, WanFang, VIP databases, and Clinical Trials database, resulting in the inclusion of 11 studies comprising 7 randomized controlled trials (RCTs) and 4 retrospective cohort studies (RCSs). Meta-analysis of the RCTs indicated no statistical differences in clinical success rates, clinical cure rates, microbiological eradication rates, and incidence of adverse reactions between the generic cefoperazone/sulbactam and the branded version. Findings from the RCSs aligned with those from the RCTs, demonstrating that generic versions of cefoperazone/sulbactam are equivalent in efficacy and safety to their branded counterparts in treating bacterial infections.
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Affiliation(s)
- Rui Wu
- Yunnan Provincial Key Laboratory of Entomological Biopharmaceutical R&D, Dali University, Dali, Yunnan Province, China
| | - Xuechang Wang
- Department of Pharmacy, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology, Kunming, China
| | - Pumei Cui
- Department of Pharmacy, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology, Kunming, China
| | - Wei Chen
- College of Pharmacy, Dali University, Dali, Yunnan Province, China
| | - Wanqi Yang
- Yunnan Provincial Key Laboratory of Entomological Biopharmaceutical R&D, Dali University, Dali, Yunnan Province, China
- College of Pharmacy, Dali University, Dali, Yunnan Province, China
- National-Local Joint Engineering Research Center of Entomoceutics, Dali University, Dali, Yunnan Province, China
| | - Yong Lai
- Yunnan Provincial Key Laboratory of Entomological Biopharmaceutical R&D, Dali University, Dali, Yunnan Province, China
- College of Pharmacy, Dali University, Dali, Yunnan Province, China
- National-Local Joint Engineering Research Center of Entomoceutics, Dali University, Dali, Yunnan Province, China
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Merchant HA, Babar ZUD, Hussain IM. A leap towards enforcing medicines prescribing by generic names in low- and middle-income countries (LMICs): pitfalls, limitations, and recommendations for local drug regulatory agencies. J Pharm Policy Pract 2022; 15:104. [PMID: 36550588 PMCID: PMC9773520 DOI: 10.1186/s40545-022-00501-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The Drug Regulatory Authority of Pakistan (DRAP) in response to the public outcry on increasing medicines prices in the country issued notifications to direct healthcare professionals to prescribe medicines with their generic names. Like DRAP, many regulators in the low- and middle-income countries (LMICs) are also inspiring from the west to legally enforce generic prescribing in a bid to reduce the out-of-pocket public expenditures. However, there are pitfalls in the LMICs drug regulatory framework, which if left unaddressed can severely jeopardise the foreseen benefits of medicines prescribing by generic names. This article critically appraises the impact of prescribing by generic names regulations in LMICs and highlights the key considerations that are vital to address before legally enforcing generic prescribing. The ethics, regulatory compliance, and good governance are the key to success; better generics for a better tomorrow.
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Affiliation(s)
- Hamid A. Merchant
- grid.15751.370000 0001 0719 6059Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH UK ,grid.413930.c0000 0004 0606 8575Health Services Academy, Park Road, Chak Shahzad, Islamabad, 44000 Pakistan
| | - Zaheer-Ud-Din Babar
- grid.15751.370000 0001 0719 6059Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH UK
| | - Izhar M. Hussain
- grid.412080.f0000 0000 9363 9292Institute of Business and Health Management (IBHM), Dow University of Health Sciences (DUHS), SUPARCO Road, Karachi, 74200 Pakistan
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Li WJ, Xia MJ, Gong SW, Ding YF. Perceptions of Generic Drugs in the Pharmacists of Public Hospitals: A Cross-sectional Survey in Hubei Province of China. Curr Med Sci 2021; 41:987-995. [PMID: 34476663 DOI: 10.1007/s11596-021-2412-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 02/16/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Generic drugs provide an opportunity for savings in drug expenditure since they are available at a lower cost and do not affect patients' health. A better understanding of pharmacists' knowledge, attitudes, and perception can promote the quality use of generic drugs. The objective of this study was to investigate the knowledge, attitudes, and perception of pharmacists from tertiary hospitals in China regarding generic drugs. METHODS A cross-sectional survey using a postal questionnaire was conducted, which was sent to 200 hospital pharmacists randomly selected from tertiary hospitals in Hubei Province. A total of 125 questionnaires out of 200 were received. Of the respondents, 80 were female and 45 were male. RESULTS The majority of respondents (87.2%) could clearly distinguish between original and generic drugs. Pharmacists agreed that generic drugs were less effective (52.8%) and produced more side effects (52%). Fortynine respondents thought that generic drug products were not adequately tested. Approximately 78% and 60% of the pharmacists indicated that generic substitution was not feasible for drugs with narrow therapeutic windows and drugs for critical diseases, respectively. Most of them supported the recommendation of generic drugs based on professional judgment. CONCLUSION Our study showed that a considerable portion of Chinese hospital pharmacists hold negative perceptions of generic drugs. Interventions to improve pharmacists' knowledge of generic drugs are needed.
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Affiliation(s)
- Wei-Jie Li
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Mei-Jun Xia
- Department of Pharmacy Business and Administration, School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Shi-Wei Gong
- Department of Pharmacy Business and Administration, School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Yu-Feng Ding
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Mostafa S, Mohammad MA, Ebrahim J. Policies and Practices Catalyzing the Use of Generic Medicines: A Systematic Search and Review. Ethiop J Health Sci 2021; 31:167-178. [PMID: 34158764 PMCID: PMC8188110 DOI: 10.4314/ejhs.v31i1.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background The use of generic medicines instead of branded, is one of the main policies to decrease the expenditures and provide access to affordable and essential medicines in low and middle-income countries. The present study aims to systematically create a comprehensive synthesis of demand-side policies, encouraging the use of generic medicines. Methods The study systematically searched and reviewed the articles in Medline, Scopus, Web of Science, and Embase from 1.1.2000 to 12.5.2019. A total of 6435 records were identified during this period of time (Medline (n=315), Scopus (n=4323), Web of Science (n=71) and Embase (n=1726)). All stages are conducted according to the Preferred Reporting Item for Systematic Reviews and Meta-Analyzed (PRISMA). Results The encouraging policies and practices were classified into four categories from 44 articles analyzed, including; Prescribing, Dispensing, Patients/consumers, and healthcare organizations. Subthemes were also explored in relation to each category as; education, financial incentives, generic substitution, advertising approaches, and enforcement. Conclusion Various policies should be taken into consideration to encourage successful generic medication prescribing, dispensing, and consumption in both supply and demand-side. Economic, political, socio-cultural, technological, legal, and structural factors could as such accelerate the policies' effect. Studying the experience of successful countries can be helpful for policymakers.
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Affiliation(s)
- Shahmoradi Mostafa
- Ph.D. Candidate, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mosadeghrad Ali Mohammad
- Associate Professor, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Jaafaripooyan Ebrahim
- Associate Professor, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Saleem Z, Saeed H, Akbar Z, Saeed A, Khalid S, Farrukh L, Irfan A, Anam A, Hassali MA, Rasheed H, Babar ZUD. WHO key access antibiotics price, availability and affordability in private sector pharmacies in Pakistan. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2021; 19:10. [PMID: 33593366 PMCID: PMC7885400 DOI: 10.1186/s12962-021-00263-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 02/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Poor availability and unaffordability of key access antibiotics may increase antimicrobial resistance in the community by promoting inappropriate antibiotic selection and abridged therapy compliance. OBJECTIVE To check the prices, availability, and affordability of the World Health Organization (WHO) key access antibiotics in private sector pharmacies of Lahore, Pakistan. METHODOLOGY A survey of WHO key access antibiotics from WHO essential medicine list 2017 was conducted in private sector pharmacies of 4 different regions of Lahore employing adapted WHO/HAI methodology. The comparison of prices and availability between originator brands (OB) and lowest price generics (LPG) were conducted followed by the effect of medicine price differences on patient's affordability. The data were analyzed using a preprogrammed WHO Microsoft excel workbook. RESULTS The mean availability of OB products was 45.20% and the availability of LPGs was 40.40%. The OBs of co-amoxiclav, clarithromycin and metronidazole and LPGs of azithromycin and ciprofloxacin were easily available (100%) in all private sector pharmacies. Whereas, antibiotics like chloramphenicol, cloxacillin, nitrofurantoin, spectinomycin, and cefazolin were totally unavailable in all the surveyed pharmacies. The OBs and LPGs with high MPRs were ceftriaxone (OB; 15.31, LPG; 6.38) and ciprofloxacin (OB; 12.42, LPG; 5.77). The median of brand premium obtained was 38.7%, which varied between the lowest brand premium of 3.97% for metronidazole and highest for ceftriaxone i.e. 140%. The cost of standard treatment was 0.5 day's wage (median) if using OB and 0.4 day's wage (median) for LPG, for a lowest paid unskilled government worker. Treatment with OB and LPG was unaffordable for ciprofloxacin (OB; 2.4, LPG; 1.1) & cefotaxime (OB; 12.7, LPG; 8.1). CONCLUSION There is dire need to properly implement price control policies to better regulate fragile antibiotic supply system so that the availability of both OB and LPG of key access antibiotics should be increased. The prices could be reduced by improving purchasing efficiency, excluding taxes and regulating mark-ups. This could increase the affordability of patients to complete their antibiotic therapy with subsequent reduction in antimicrobial resistance.
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Affiliation(s)
- Zikria Saleem
- Department of Pharmacy Practice, Faculty of Pharmacy, The University of Lahore, Lahore, Pakistan
| | - Hamid Saeed
- University College of Pharmacy, University of the Punjab, Allama Iqbal Campus, Lahore, Pakistan
| | - Zunaira Akbar
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore, Pakistan.
| | - Amna Saeed
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Jiaotong University, Xi'an, Shaanxi, China.,Center for Drug Safety and Policy Research, Xian Jiaotong University, Xi'an, Shaanxi, China.,The Global Health Institute, Xi'an Jiaotong University, Xi'an, Shaanxi, China.,Shaanxi Centre for Health Reform and Development Research, Xi'an, China
| | - Saleha Khalid
- University College of Pharmacy, University of the Punjab, Allama Iqbal Campus, Lahore, Pakistan
| | - Laiba Farrukh
- University College of Pharmacy, University of the Punjab, Allama Iqbal Campus, Lahore, Pakistan
| | - Aleena Irfan
- University College of Pharmacy, University of the Punjab, Allama Iqbal Campus, Lahore, Pakistan
| | - Azka Anam
- University College of Pharmacy, University of the Punjab, Allama Iqbal Campus, Lahore, Pakistan
| | - Mohamed Azmi Hassali
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, George Town, Malaysia
| | - Huma Rasheed
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Zaheer-Ud-Din Babar
- Department of Pharmacy, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK
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Babar ZUD. Ten recommendations to improve pharmacy practice in low and middle-income countries (LMICs). J Pharm Policy Pract 2021; 14:6. [PMID: 33407945 PMCID: PMC7788796 DOI: 10.1186/s40545-020-00288-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Medicines are important health interventions and their appropriate use could improve health outcomes. Throughout the globe, pharmacists play a very important role to improve the use of medicines. Though high-income countries are debating on futuristic approaches, independent prescribing of pharmacists, clinical skills, and to expand pharmacy services; a large majority of low and middle-income countries still lag behind to strengthen pharmacy practice. This paper presents a key set of recommendations that can improve pharmacy practice in low and middle-income countries (LMICs). The ten recommendations include (1) Mandatory presence of graduate-level pharmacists at community pharmacies (2) Clear demarcation of the roles and responsibilities of different categories of pharmacists (3) Effective categorization and implementation of medicines into (a) prescription medicines (b) pharmacists only medicines (c) over the counter medicines (4) Enforcement of laws and regulations for the sale of medicines (5) Prohibiting doctors from dispensing medicines (the dispensing separation between pharmacists and doctors). (6) Involving pharmacies and pharmacists in Universal Health Coverage Schemes to improve the affordability of medicines (7) Strengthening national medicines regulatory authorities to improve the quality, safety, and effectiveness of medicines (8) Training of pharmacists in clinical skills, vaccination, and minor ailment schemes (9) Promoting independent medicines information for consumers and healthcare professionals by developing national medicines information strategy (10) Mandatory Continuing Professional Development (CPD) programs for the Pharmacists.
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Affiliation(s)
- Zaheer-Ud-Din Babar
- Department of Pharmacy, Centre for Pharmaceutical Policy and Practice Research, University of Huddersfield, Queensgate, HD1 3DH, Huddersfield, UK.
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7
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Lin L, Alam P, Fearon E, Hargreaves JR. Public target interventions to reduce the inappropriate use of medicines or medical procedures: a systematic review. Implement Sci 2020; 15:90. [PMID: 33081791 PMCID: PMC7574316 DOI: 10.1186/s13012-020-01018-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 07/06/2020] [Indexed: 01/08/2023] Open
Abstract
Background An epidemic of health disorders can be triggered by a collective manifestation of inappropriate behaviors, usually systematically fueled by non-medical factors at the individual and/or societal levels. This study aimed to (1) landscape and assess the evidence on interventions that reduce inappropriate demand of medical resources (medicines or procedures) by triggering behavioral change among healthcare consumers, (2) map out intervention components that have been tried and tested, and (3) identify the “active ingredients” of behavior change interventions that were proven to be effective in containing epidemics of inappropriate use of medical resources. Methods For this systematic review, we searched MEDLINE, EMBASE, the Cochrane Library, and PsychINFO from the databases’ inceptions to May 2019, without language restrictions, for behavioral intervention studies. Interventions had to be empirically evaluated with a control group that demonstrated whether the effects of the campaign extended beyond trends occurring in the absence of the intervention. Outcomes of interest were reductions in inappropriate or non-essential use of medicines and/or medical procedures for clinical conditions that do not require them. Two reviewers independently screened titles, abstracts, and full text for inclusion and extracted data on study characteristics (e.g., study design), intervention development, implementation strategies, and effect size. Data extraction sheets were based on the checklist from the Cochrane Handbook for Systematic Reviews. Results Forty-three studies were included. The behavior change technique taxonomy v1 (BCTTv1), which contains 93 behavioral change techniques (BCTs), was used to characterize components of the interventions reported in the included studies. Of the 93 BCTs, 15 (16%) were identified within the descriptions of the selected studies targeting healthcare consumers. Interventions consisting of education messages, recommended behavior alternatives, and a supporting environment that incentivizes or encourages the adoption of a new behavior were more likely to be successful. Conclusions There is a continued tendency in research reporting that mainly stresses the effectiveness of interventions rather than the process of identifying and developing key components and the parameters within which they operate. Reporting “negative results” is likely as critical as reporting “active ingredients” and positive findings for implementation science. This review calls for a standardized approach to report intervention studies. Trial registration PROSPERO registration number CRD42019139537
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Affiliation(s)
- Leesa Lin
- London School of Hygiene & Tropical Medicine, London, UK.
| | - Prima Alam
- London School of Hygiene & Tropical Medicine, London, UK
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Gasteiger C, Lobo M, Dalbeth N, Petrie KJ. Patients' beliefs and behaviours are associated with perceptions of safety and concerns in a hypothetical biosimilar switch. Rheumatol Int 2020; 41:163-171. [PMID: 32300866 DOI: 10.1007/s00296-020-04576-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 04/02/2020] [Indexed: 01/23/2023]
Abstract
Although patient acceptance is important for biosimilar adoption and reducing healthcare costs, many patients perceive biosimilars to be unsafe and have concerns about switching. Studies show that patients' characteristics influence negative perceptions toward generic drugs, but little research has explored biosimilar acceptance. This study examines which demographic and psychological characteristics are associated with patients' safety perceptions and concerns about switching to biosimilars. Ninety-six patients taking bio-originators for rheumatic conditions (65% for rheumatoid arthritis) completed the Brief Illness Perceptions Questionnaire, Beliefs about Medicines Questionnaire and Perceived Sensitivity to Medicines Scale. Demographic factors, information seeking, concerns about switching and safety perceptions were also assessed. Pearson's correlations and hierarchical linear regressions were conducted to explore whether patient characteristics are associated with perceptions of biosimilars. Negative safety perceptions were associated with being female, short-term bio-originator use, illness beliefs, seeking health information online, high perceived sensitivity to medicines and negative beliefs about medicines. Only being female (β = 0.24, P = 0.02) was independently associated. More concerns about switching were associated with being female, illness beliefs, high perceived sensitivity to medicines, information-seeking behaviours and preferring innovator drugs. Seeking health information online (β = 0.20, P = 0.04), preferring innovator drugs (β = 0.29, P = 0.004) and stronger emotional responses (β = 0.26, P = 0.01) were independently associated. Perceived bio-originator effectiveness was inversely associated with preferring biosimilars (rs= - 0.33, P < 0.001). Patients who have stronger emotional responses to their condition, are females, seek health information online and prefer innovator drugs that have more negative perceptions about biosimilars. Experiences with bio-originators influence attitudes towards switching.
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Affiliation(s)
- Chiara Gasteiger
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
| | - Maria Lobo
- Department of Rheumatology, Auckland District Health Board, Auckland, New Zealand
| | - Nicola Dalbeth
- Department of Rheumatology, Auckland District Health Board, Auckland, New Zealand
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Keith J Petrie
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
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Hohmann NS, Garza KB, Surry D, Hansen RA, Harris I, Kiptanui Z, Oguntimein O, Frost MM, Qian J. Healthcare provider opinions about a generic drug educational newsletter. Res Social Adm Pharm 2019; 16:1228-1236. [PMID: 31838057 DOI: 10.1016/j.sapharm.2019.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 10/05/2019] [Accepted: 12/01/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Increasing the prescribing and dispensing of generic drugs, compared to branded drugs, may increase patient access to affordable drug treatments. Healthcare providers have information needs regarding generic drugs, but available, tailored education materials designed for provider use are lacking. OBJECTIVES To examine healthcare provider opinions and receptivity regarding generic drug educational materials in content, format and design, delivery channel, and level of satisfaction. METHODS A national online survey was conducted in summer 2018 to gather practicing healthcare prescribers' (i.e., physicians, nurse practitioners, physician assistants) and pharmacists' opinions on an educational newsletter developed through a collaboration between the investigators and the U.S. Food and Drug Administration (FDA). Survey data were analyzed using descriptive statistics. Quantitative analyses were performed using SPSS version 24 (IBM, Armonk, NY), while responses to open-ended questions were assessed using qualitative content analysis in Excel. RESULTS A total of 208 surveys were completed. Overall, participants expressed positive opinions about the newsletter's content and format/design. About 69% of prescribers and 60% of pharmacists stated the newsletter gave information that will help them better serve patients. While 15% of surveyed pharmacists stated that they did not have resources to help them get information on generic drug availability and cost, more prescribers (37%) responded similarly. Both prescribers and pharmacists preferred to receive this newsletter via email from the FDA or a professional association. CONCLUSIONS Findings indicate the feasibility of educational outreach programs about generic drugs targeted towards healthcare providers. There is room for improvement in making prescribers and pharmacists aware of resources for learning about generic drug availability and cost. Future studies may test alternate versions of the newsletter that have been tailored to the needs of specific provider specialties or provider practices serving specific patient sub-groups, as well as preferred dissemination frequency.
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Affiliation(s)
- Natalie S Hohmann
- Department of Pharmacy Practice, Auburn University Harrison School of Pharmacy, Auburn University, 4201 Walker Building, Auburn, AL, 36849, USA.
| | - Kimberly B Garza
- Department of Health Outcomes Research and Policy, Auburn University Harrison School of Pharmacy, Auburn University, 4306 Walker Building, Auburn, AL, 36849, USA.
| | - Daniel Surry
- Department of Health Outcomes Research and Policy, Auburn University Harrison School of Pharmacy, Auburn University, 4306 Walker Building, Auburn, AL, 36849, USA.
| | - Richard A Hansen
- Department of Health Outcomes Research and Policy, Auburn University Harrison School of Pharmacy, Auburn University, 4306 Walker Building, Auburn, AL, 36849, USA.
| | - Ilene Harris
- IMPAQ International LLC, IMPAQ Int., Columbia, MD, 21044, USA.
| | | | - Oluwamurewa Oguntimein
- U.S. Food and Drug Administration (FDA), Office of Generic Drugs (OGD), 10903 New Hampshire Avenue Bldg. 75, Silver Spring, MD, 20993-0002, USA.
| | - Mitchell M Frost
- U.S. Food and Drug Administration (FDA), Office of Generic Drugs (OGD), 10903 New Hampshire Avenue Bldg. 75, Silver Spring, MD, 20993-0002, USA.
| | - Jingjing Qian
- Department of Health Outcomes Research and Policy, Auburn University Harrison School of Pharmacy, Auburn University, 4306 Walker Building, Auburn, AL, 36849, USA.
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Hohmann NS, Garza KB, Surry D, Hansen RA, Harris I, Kiptanui Z, Oguntimein O, Frost MM, Qian J. Communicating benefits and risks of generic drugs to consumers: Patient and caregiver opinions of two FDA-developed educational materials. Res Social Adm Pharm 2019; 15:1489-1493. [DOI: 10.1016/j.sapharm.2019.01.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 01/22/2019] [Indexed: 10/27/2022]
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Domeyer PJ, Katsari V, Sarafis P, Aletras V, Niakas D. Greek students' attitudes, perception and knowledge regarding generic medicines in times of economic crisis: a cross-sectional study. BMC MEDICAL EDUCATION 2018; 18:262. [PMID: 30442145 PMCID: PMC6238271 DOI: 10.1186/s12909-018-1379-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 11/02/2018] [Indexed: 05/09/2023]
Abstract
BACKGROUND The penetration of generic medicines in the pharmaceutical market is influenced, among others, by the consumer's attitude upon them. The attitude of students in health management and recent alumni is particularly important, as they constitute tomorrow's policymakers. The aim of our study was to assess their attitude, perception and knowledge towards generic medicines. METHODS A cross-sectional study was undertaken, involving students in Health Management and recent alumni. The ATtitude TOwards GENerics (ATTOGEN) validated questionnaire was used, which consists of 18 items, yielding 6 scales (trust, state audit, knowledge, drug quality, drug substitution and fiscal impact), with all item responses expressed on a 5-point Likert scale and higher scores denoting greater disagreement. Correlation coefficients were computed and independent sample tests were performed using non-parametrical statistical methods. RESULTS A total of 1402 students were interviewed, with a female predominance (62.88%). The mean (SD) scores for the six scales of the ATTOGEN questionnaire were: Trust: 2.877 (0.940), State audit: 3.251 (0.967), Knowledge: 1.537 (0.688), Drug quality: 2.708 (0.971), Drug substitution: 3.828 (1.127) and Fiscal impact: 2.299 (0.860). Trust over generics was statistically significantly associated with all ATTOGEN scales (all p < 0.001). In addition, the increased level of knowledge about generics was associated with recognition of the generic medicines' quality equivalence (p < 0.001) and positive fiscal impact (p = 0.018). Pharmacists declared having a superior knowledge of generic medicines, being more satisfied with the information they receive about them and strongly believing in drug substitution (p < 0.001). Comparatively to other professionals, pharmacists also indicated substantial differences between branded and generic medicines more often (p < 0.001). They also argued to a greater extent that generic medicines were invented and promoted to resolve the financial crisis of social security institutions at the expense of citizens (p < 0.001). CONCLUSIONS This study demonstrated a mixed attitude of students regarding generic medicines. Trust and knowledge emerged as key factors shaping the students' attitude towards generics. Among students, pharmacists exhibited a distinct response pattern. This study underlines the importance of addressing and correcting health management students' misbeliefs about generics' quality and utility.
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Affiliation(s)
| | - Vasiliki Katsari
- School of Social Sciences, Hellenic Open University, Patras, Greece
| | - Pavlos Sarafis
- Nursing Department, Cyprus University of Technology, Limassol, Cyprus
| | - Vassilis Aletras
- Department of Business Administration, University of Macedonia, Thessaloniki, Greece
| | - Dimitris Niakas
- School of Social Sciences, Hellenic Open University, Patras, Greece
- Μedical School, National and Kapodistrian University of Athens, Athens, Greece
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Hohmann N, Hansen R, Garza KB, Harris I, Kiptanui Z, Qian J. Association between Higher Generic Drug Use and Medicare Part D Star Ratings: An Observational Analysis. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2018; 21:1186-1191. [PMID: 30314619 DOI: 10.1016/j.jval.2018.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 02/22/2018] [Accepted: 03/10/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Increasing generic drug use, due to potential for cost savings and drug access, is a viable consideration for Medicare prescription drug plans to achieve high star ratings and improve quality of plan offerings for Medicare beneficiaries. OBJECTIVE To examine the association between contract-level proportion of generic drugs dispensed (pGDD) and Medicare Part D star ratings. METHODS This was a retrospective study of linked 2011 Medicare Part D star rating data with contract-level pGDD data. A total of 477 individual Medicare prescription contracts were included, representing 75% of total Prescription Drug Plans and more than 65% of total Medicare Advantage Prescription Drug Plans available by the end of 2010. Primary outcomes were Medicare Part D summary and domain star ratings (1-5 indicating lowest to highest performance), incorporating a range of quality measures for access, cost, beneficiary satisfaction, and health services outcomes and processes. Ordinal logistic regression models were used to examine associations between pGDD and Medicare Part D summary and domain star ratings, controlling for contract type and number of beneficiary enrollment. RESULTS Higher pGDD was associated with higher summary star ratings (adjusted odds ratio 1.08 with 95% confidence interval 1.04-1.12) and higher "member experience with drug plan" domain ratings (adjusted odds ratio 1.07 with 95% confidence interval 1.03-1.11). CONCLUSIONS Prescription formulary benefit design targeting increasing generic drug use appears to be associated with improved member experience and higher plan star ratings. Consideration may be given to incorporating pGDD into Medicare Part D star rating measures to improve quality of prescription plans.
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Affiliation(s)
- Natalie Hohmann
- Department of Health Outcomes Research and Policy, Auburn University Harrison School of Pharmacy, Auburn, AL, USA
| | - Richard Hansen
- Department of Health Outcomes Research and Policy, Auburn University Harrison School of Pharmacy, Auburn, AL, USA
| | - Kimberly B Garza
- Department of Health Outcomes Research and Policy, Auburn University Harrison School of Pharmacy, Auburn, AL, USA
| | | | | | - Jingjing Qian
- Department of Health Outcomes Research and Policy, Auburn University Harrison School of Pharmacy, Auburn, AL, USA.
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Guttier MC, Silveira MPT, Luiza VL, Bertoldi AD. Impact of interventions to promote the use of generic drugs: a systematic review. CIENCIA & SAUDE COLETIVA 2018; 22:2627-2644. [PMID: 28793078 DOI: 10.1590/1413-81232017228.05762017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 04/10/2017] [Indexed: 11/21/2022] Open
Abstract
The need to increase access to medicines, coupled with the limited acceptance of generics has sparked the search for effective interventions to promote it. This systematic review aimed to conduct a survey on interventions to promote the use of generic drugs and its impact. Randomized clinical trials, non-randomized controlled trials, controlled before-after studies and interrupted time series were included. The analysis of the impact of interventions and quality of evidence followed Cochrane's guidelines. Impact of interventions was rated from "very large" to "very small" and the quality of evidence was rated from "high" to "very low". Seventeen papers addressing prescribers, pharmacists and users were selected. There were educational, financial incentives and use of electronic prescription and managerial interventions. Interventions applied to prescribers had little to medium impact, with very low-to-low quality evidence. Interventions applied to pharmacists had small impact with very low quality evidence. Interventions applied to users had medium and large impact with very low-to-low quality evidence. Further studies with good quality addressing interventions are required.
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Affiliation(s)
- Marília Cruz Guttier
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas (UFPel). R. Marechal Deodoro 1160/313, Centro. 96020-220 Pelotas RS Brasil.
| | | | - Vera Lucia Luiza
- Escola Nacional de Saúde Pública Sérgio Arouca, Fiocruz. Rio de Janeiro RJ Brasil
| | - Andréa Dâmaso Bertoldi
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas (UFPel). R. Marechal Deodoro 1160/313, Centro. 96020-220 Pelotas RS Brasil.
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14
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Tachi T, Saito K, Esaki H, Kanematsu Y, Yoshida A, Sugita I, Noguchi Y, Makino T, Umeda M, Yasuda M, Mizui T, Goto C, Teramachi H. Medical and economic factors influencing generic drug use in the Japanese public health system: Influencing factors in different populations. Int J Health Plann Manage 2018; 33:489-501. [DOI: 10.1002/hpm.2489] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 10/06/2017] [Accepted: 12/19/2017] [Indexed: 12/13/2022] Open
Affiliation(s)
- Tomoya Tachi
- Laboratory of Clinical PharmacyGifu Pharmaceutical University Gifu Japan
- Department of PharmacyGifu Municipal Hospital Gifu Japan
| | - Kosuke Saito
- Laboratory of Clinical PharmacyGifu Pharmaceutical University Gifu Japan
| | - Hiroki Esaki
- Laboratory of Clinical PharmacyGifu Pharmaceutical University Gifu Japan
| | - Yuta Kanematsu
- Laboratory of Clinical PharmacyGifu Pharmaceutical University Gifu Japan
| | - Aki Yoshida
- Laboratory of Clinical PharmacyGifu Pharmaceutical University Gifu Japan
| | - Ikuto Sugita
- Laboratory of Clinical PharmacyGifu Pharmaceutical University Gifu Japan
| | - Yoshihiro Noguchi
- Laboratory of Clinical PharmacyGifu Pharmaceutical University Gifu Japan
| | - Teppei Makino
- Department of PharmacyGifu Municipal Hospital Gifu Japan
| | - Michi Umeda
- Department of PharmacyGifu Municipal Hospital Gifu Japan
| | | | - Takashi Mizui
- Department of PharmacyGifu Municipal Hospital Gifu Japan
| | - Chitoshi Goto
- Department of PharmacyGifu Municipal Hospital Gifu Japan
| | - Hitomi Teramachi
- Laboratory of Clinical PharmacyGifu Pharmaceutical University Gifu Japan
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15
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Guttier MC, Silveira MPT, Luiza VL, Bertoldi AD. Factors influencing the preference for purchasing generic drugs in a Southern Brazilian city. Rev Saude Publica 2017; 51:59. [PMID: 28678909 PMCID: PMC5477709 DOI: 10.1590/s1518-8787.2017051006786] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 07/01/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The objective of this study is to identify factors associated with the preference for purchasing generic drugs in a medium-sized municipality in Southern Brazil. METHODS We have analyzed data from a population-based cross-sectional study conducted in 2012 with a sample of 2,856 adults (≥ 20 years old). The preference for purchasing generic drugs was the main outcome. The explanatory variables were the demographic and socioeconomic variables. Statistical analyses included Poisson regressions. RESULTS The preference for purchasing generic drugs was 63.2% (95%CI 61.4–64.9). The variables correlated with this preference in the fully adjusted models were: male (prevalence ratio [PR] = 1.08; 95%CI 1.03–1.14), age of 20–39 years (PR = 1.10; 95%CI 1.02–1.20), low socioeconomic status (PR = 1.15; 95%CI 1.03–1.28), and good knowledge about generic drugs (PR= 4.66; 95%CI 2.89–7.52). Among those who preferred to purchase generic drugs, 55.1% have reported accepting to replace the prescribed drug (if not a generic) with the equivalent generic drug. Another correlate of the preference for purchasing generic drugs was because individuals consider their quality equivalent to reference medicines (PR = 2.15; 95%CI 1.93–2.41). CONCLUSIONS Knowledge about generic drugs was the main correlate of the preference for purchasing generic drugs. The greater the knowledge or positive perception about generic drugs, the greater is the preference to purchase them. Therefore, educational campaigns for healthcare professionals and consumers appear to be the best strategy for expanding the use of generic drugs in Brazil.
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Affiliation(s)
- Marília Cruz Guttier
- Curso de Farmácia. Centro de Ciências Químicas, Farmacêuticas e de Alimentos. Universidade Federal de Pelotas. Pelotas, RS, Brasil
| | | | - Vera Lucia Luiza
- Escola Nacional de Saúde Pública Sérgio Arouca. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
| | - Andréa Dâmaso Bertoldi
- Programa de Pós-Graduação em Epidemiologia. Faculdade de Medicina. Universidade Federal de Pelotas. Pelotas, RS, Brasil
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Boccia R, Jacobs I, Popovian R, de Lima Lopes G. Can biosimilars help achieve the goals of US health care reform? Cancer Manag Res 2017; 9:197-205. [PMID: 28615973 PMCID: PMC5459961 DOI: 10.2147/cmar.s133442] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The US Patient Protection and Affordable Care Act (ACA) aims to expand health care coverage, contain costs, and improve health care quality. Accessibility and affordability of innovative biopharmaceuticals are important to the success of the ACA. As it is substantially more difficult to manufacture them compared with small-molecule drugs, many of which have generic alternatives, biologics may increase drug costs. However, biologics offer demonstrated improvements in patient care that can reduce expensive interventions, thus lowering net health care costs. Biosimilars, which are highly similar to their reference biologics, cost less than the originators, potentially increasing access through reduced prescription drug costs while providing equivalent therapeutic results. This review evaluates 1) the progress made toward enacting health care reform since the passage of the ACA and 2) the role of biosimilars, including the potential impact of expanded biosimilar use on access, health care costs, patient management, and outcomes. Barriers to biosimilar adoption in the USA are noted, including low awareness and financial disincentives relating to reimbursement. The evaluated evidence suggests that the ACA has partly achieved some of its aims; however, the opportunity remains to transform health care to fully achieve reform. Although the future is uncertain, increased use of biosimilars in the US health care system could help achieve expanded access, control costs, and improve the quality of care.
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Affiliation(s)
- Ralph Boccia
- Center for Cancers and Blood Disorders, Bethesda, MD
| | - Ira Jacobs
- Global Medical Affairs, Pfizer Inc., New York, NY
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Fadlallah R, Nas H, Naamani D, El-Jardali F, Hammoura I, Al-Khaled L, Brax H, Kahale L, Akl EA. Knowledge, Beliefs and Attitudes of Patients and the General Public towards the Interactions of Physicians with the Pharmaceutical and the Device Industry: A Systematic Review. PLoS One 2016; 11:e0160540. [PMID: 27556929 PMCID: PMC4996522 DOI: 10.1371/journal.pone.0160540] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 07/21/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To systematically review the evidence on the knowledge, beliefs, and attitudes of patients and the general public towards the interactions of physicians with the pharmaceutical and the device industry. METHODS We included quantitative and qualitative studies addressing any type of interactions between physicians and the industry. We searched MEDLINE and EMBASE in August 2015. Two reviewers independently completed data selection, data extraction and assessment of methodological features. We summarized the findings narratively stratified by type of interaction, outcome and country. RESULTS Of the 11,902 identified citations, 20 studies met the eligibility criteria. Many studies failed to meet safeguards for protecting from bias. In studies focusing on physicians and the pharmaceutical industry, the percentages of participants reporting awareness was higher for office-use gifts relative to personal gifts. Also, participants were more accepting of educational and office-use gifts compared to personal gifts. The findings were heterogeneous for the perceived effects of physician-industry interactions on prescribing behavior, quality and cost of care. Generally, participants supported physicians' disclosure of interactions through easy-to-read printed documents and verbally. In studies focusing on surgeons and device manufacturers, the majority of patients felt their care would improve or not be affected if surgeons interacted with the device industry. Also, they felt surgeons would make the best choices for their health, regardless of financial relationship with the industry. Participants generally supported regulation of surgeon-industry interactions, preferably through professional rather than governmental bodies. CONCLUSION The awareness of participants was low for physicians' receipt of personal gifts. Participants also reported greater acceptability and fewer perceived influence for office-use gifts compared to personal gifts. Overall, there appears to be lower awareness, less concern and more acceptance of surgeon-device industry interactions relative to physician-pharmaceutical industry interactions. We discuss the implications of the findings at the patient, provider, organizational, and systems level.
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Affiliation(s)
- Racha Fadlallah
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Center for Systematic Reviews of Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
| | - Hala Nas
- Faculty of Medicine, University of Damascus, Damascus, Syria
| | - Dana Naamani
- Department of Biology, Faculty of Art and Science, American University of Beirut, Beirut, Lebanon
| | - Fadi El-Jardali
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Center for Systematic Reviews of Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - Ihsan Hammoura
- Department of Biology, Faculty of Art and Science, American University of Beirut, Beirut, Lebanon
| | - Lina Al-Khaled
- Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Hneine Brax
- Faculty of Medicine, Université Saint Joseph, Beirut, Lebanon
| | - Lara Kahale
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Elie A. Akl
- Center for Systematic Reviews of Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
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Wong ZY, Alrasheedy AA, Hassali MA, Saleem F. Generic medicines in the Malaysian health care system: Opportunities and challenges. Res Social Adm Pharm 2016; 12:807-10. [PMID: 27157864 DOI: 10.1016/j.sapharm.2016.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 04/07/2016] [Indexed: 11/25/2022]
Affiliation(s)
- Zhi Yen Wong
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia.
| | | | - Mohamed Azmi Hassali
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
| | - Fahad Saleem
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
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Guttier MC, Silveira MPT, Luiza VL, Bertoldi AD. Percepção, conhecimento e uso de medicamentos genéricos no Sul do Brasil: o que mudou entre 2002 e 2012? CAD SAUDE PUBLICA 2016; 32:S0102-311X2016000705014. [DOI: 10.1590/0102-311x00070215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 02/22/2016] [Indexed: 11/22/2022] Open
Abstract
Resumo: Este estudo compara a percepção, conhecimento e uso de medicamentos genéricos em adultos de Pelotas, Rio Grande do Sul, Brasil, por meio de dois estudos transversais de base populacional realizados em 2002 e 2012. Os desfechos estudados foram: (a) prevalência de utilização de medicamentos genéricos; (b) proporção de uso de medicamentos genéricos entre os demais medicamentos; (c) percepção dos usuários sobre preço e qualidade dos medicamentos genéricos; (d) conhecimento dos usuários sobre medicamentos genéricos; e (e) estratégias de aquisição de medicamentos. A prevalência de uso de medicamentos genéricos aumentou de 3,6% (IC95%: 3,0-4,3) para 26,1% (IC95%: 24,5-27,7) no período de dez anos. A percepção sobre preço e qualidade dos medicamentos genéricos se manteve estável, a identificação das características que diferenciam os medicamentos genéricos dos demais medicamentos melhorou (p < 0,001) e o erro de classificação de medicamento diminuiu (p < 0,001). Houve um aumento significativo na estratégia de aquisição de medicamentos pela substituição do medicamento prescrito pelo medicamento genérico. Entre 2002 e 2012, aumentou o conhecimento e uso de medicamentos genéricos, enquanto a percepção quanto ao menor preço e qualidade equivalente mantiveram-se elevadas.
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Godman B, Malmström RE, Diogene E, Gray A, Jayathissa S, Timoney A, Acurcio F, Alkan A, Brzezinska A, Bucsics A, Campbell SM, Czeczot J, de Bruyn W, Eriksson I, Yusof FAM, Finlayson AE, Fürst J, Garuoliene K, Guerra Júnior A, Gulbinovič J, Jan S, Joppi R, Kalaba M, Magnisson E, McCullagh L, Miikkulainen K, Ofierska-Sujkowska G, Pedersen HB, Selke G, Sermet C, Spillane S, Supian A, Truter I, Vlahović-Palčevski V, Vien LE, Vural EH, Wale J, Władysiuk M, Zeng W, Gustafsson LL. Are new models needed to optimize the utilization of new medicines to sustain healthcare systems? Expert Rev Clin Pharmacol 2015; 8:77-94. [PMID: 25487078 DOI: 10.1586/17512433.2015.990380] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Medicines have made an appreciable contribution to improving health. However, even high-income countries are struggling to fund new premium-priced medicines. This will grow necessitating the development of new models to optimize their use. The objective is to review case histories among health authorities to improve the utilization and expenditure on new medicines. Subsequently, use these to develop exemplar models and outline their implications. A number of issues and challenges were identified from the case histories. These included the low number of new medicines seen as innovative alongside increasing requested prices for their reimbursement, especially for oncology, orphan diseases, diabetes and HCV. Proposed models center on the three pillars of pre-, peri- and post-launch including critical drug evaluation, as well as multi-criteria models for valuing medicines for orphan diseases alongside potentially capping pharmaceutical expenditure. In conclusion, the proposed models involving all key stakeholder groups are critical for the sustainability of healthcare systems or enhancing universal access. The models should help stimulate debate as well as restore trust between key stakeholder groups.
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Affiliation(s)
- Brian Godman
- Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
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Piguet V, D’Incau S, Besson M, Desmeules J, Cedraschi C. Prescribing Generic Medication in Chronic Musculoskeletal Pain Patients: An Issue of Representations, Trust, and Experience in a Swiss Cohort. PLoS One 2015; 10:e0134661. [PMID: 26237036 PMCID: PMC4523195 DOI: 10.1371/journal.pone.0134661] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 07/13/2015] [Indexed: 11/18/2022] Open
Abstract
Objective Parallel to an ever stronger advocacy for the use of generics, various sources of information report concerns regarding substitution. The literature indicates that information regarding substitution is not univocal. The aim of this qualitative study was to explore patients’ representations regarding generics in patients suffering from non-specific disabling chronic musculoskeletal pain, as these patients are confronted with the issue of the prescription and/or substitution of original formulations with generics. Methods Qualitative methods were selected because the aim was to access the range of patients' representations and to consider their conceptions. Standardized face-to-face semi-structured interviews were used, and transcripts were submitted to content analysis. Results Patients’ representations suggest that they might be confident in taking a generic medication: when he/she has an understanding of generics as resulting from a development process that has become part of the public domain; the generic medication is prescribed by the physician; each prescription is discussed, i.e., the patient is prescribed the generic version of a given medication and not a generic medication. Discussion Economic arguments are not sufficient to justify substitution, and may even raise issues calling upon cognitive dissonance. Even in non-life-threatening diseases, negative cues require attention and need be de-emphasized - in particular lower price as an indication of lower quality, and generic status as contradictory with advocating individualization of medication.
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Affiliation(s)
- Valérie Piguet
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Center, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
- * E-mail:
| | - Stéphanie D’Incau
- Division of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Marie Besson
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Center, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Jules Desmeules
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Center, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Christine Cedraschi
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Center, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
- Division of General Medical Rehabilitation, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
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Hassali MA, Wong ZY, Alrasheedy AA, Saleem F, Mohamad Yahaya AH, Aljadhey H. Does educational intervention improve doctors' knowledge and perceptions of generic medicines and their generic prescribing rate? A study from Malaysia. SAGE Open Med 2014; 2:2050312114555722. [PMID: 26770747 PMCID: PMC4607233 DOI: 10.1177/2050312114555722] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 09/18/2014] [Indexed: 11/16/2022] Open
Abstract
Objectives: To investigate the impact of an educational intervention on doctors’ knowledge and perceptions towards generic medicines and their generic (international non-proprietary name) prescribing practice. Methods: This is a single-cohort pre-/post-intervention pilot study. The study was conducted in a tertiary care hospital in Perak, Malaysia. All doctors from the internal medicine department were invited to participate in the educational intervention. The intervention consisted of an interactive lecture, an educational booklet and a drug list. Doctors’ knowledge and perceptions were assessed by using a validated questionnaire, while the international non-proprietary name prescribing practice was assessed by screening the prescription before and after the intervention. Results: The intervention was effective in improving doctors’ knowledge towards bioequivalence, similarity of generic medicines and safety standards required for generic medicine registration (p = 0.034, p = 0.034 and p = 0.022, respectively). In terms of perceptions towards generic medicines, no significant changes were noted (p > 0.05). Similarly, no impact on international non-proprietary name prescribing practice was observed after the intervention (p > 0.05). Conclusion: Doctors had inadequate knowledge and misconceptions about generic medicines before the intervention. Moreover, international non-proprietary name prescribing was not a common practice. However, the educational intervention was only effective in improving doctors’ knowledge of generic medicines.
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Affiliation(s)
- Mohamed Azmi Hassali
- Discipline of Social & Administrative Pharmacy, School of Pharmaceutical Sciences, UniversitiSains Malaysia, Penang, Malaysia
| | - Zhi Yen Wong
- Pharmacy Department, Hospital TelukIntan, Perak, Malaysia
| | - Alian A Alrasheedy
- Discipline of Social & Administrative Pharmacy, School of Pharmaceutical Sciences, UniversitiSains Malaysia, Penang, Malaysia
| | - Fahad Saleem
- Discipline of Social & Administrative Pharmacy, School of Pharmaceutical Sciences, UniversitiSains Malaysia, Penang, Malaysia
| | | | - Hisham Aljadhey
- College of Pharmacy, KingSaudUniversity, Riyadh, Saudi Arabia
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Exploring pharmacists' opinions regarding PHARMAC's interventions in promoting brand changes. Res Social Adm Pharm 2014; 11:96-110. [PMID: 24811426 DOI: 10.1016/j.sapharm.2014.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 03/23/2014] [Accepted: 03/24/2014] [Indexed: 11/22/2022]
Abstract
BACKGROUND In New Zealand, the use of generic medicines is advocated by the Pharmaceutical Management Agency of New Zealand (PHARMAC). Among other interventions, PHARMAC uses educational awareness campaigns to educate pharmacists to promote the uptake of generic medicines. However, the opinion of pharmacists regarding these interventions has not yet been evaluated. OBJECTIVES The objective of this study was to explore pharmacists' opinions regarding PHARMAC's interventions in promoting medicine brand changes. METHOD A cross-sectional study design was employed to explore pharmacists' opinions regarding brand changes. A questionnaire was sent to 500 randomly selected pharmacists in New Zealand. In second component of the study, five community pharmacies in the Auckland region were selected through convenience sampling, and a semi-structured interview was conducted with a pharmacist in each site. RESULTS One-hundred and eighty seven questionnaires were returned and analyzed (response rate of 37.4%). Sixty-eight percent of pharmacists supported brand changes and 98.4% mentioned that PHARMAC is responsible for informing them of brand changes. Over half (51.3%) of pharmacists found the current interventions effective, and 39.6% were satisfied with the current brand change information provided by PHARMAC. The majority (94.7%) of pharmacists currently receive faxed information but many indicated (70.8%) that they prefer email notifications. Cilazapril was considered the least difficult medicine to substitute in the past 10 years and omeprazole the most difficult. Patient acceptance and claims about effectiveness were the main factors in determining the difficulty of brand substitution. Fewer than half of the respondents felt that interventions were implemented with enough preparation time for a brand change. The ideal lead-in time was in the range of three to six months. Pharmacists expressed a number of concerns about brand changes such as the frequency at which they occur and the lack of generic stock availability when a brand change occurs. CONCLUSION Over one-third of respondents were satisfied with brand change information provided by PHARMAC. Cilazapril was the least difficult medicine to substitute, while omeprazole and salbutamol changes were the most difficult. Claims about effectiveness, quality and side effects were the main factors identified as barriers to generic substitution.
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