Rising health care costs and life-cycle management in the pharmaceutical market

Prevalence of self-medication in Ghana: a systematic review and meta-analysis

OBJECTIVES

This study estimates the prevalence of self-medication and provides an understanding of the reasons for self-medication in Ghana through the synthesis of relevant literature.

METHODS

A comprehensive search was conducted in PubMed, Science Direct and African Journals Online to identify observational studies published from inception to March 2022. Google scholar and institutional websites were searched for grey literature. We included studies reporting primary data on the prevalence and/or reasons for self-medication in Ghana. Random-effects meta-analysis was used to estimate the prevalence of self-medication. Subgroup analysis was performed with the study population (pregnant women, patients and students), geopolitical zone (coastal, middle and northern) and study setting (rural and urban). Using inductive thematic analysis, reasons for self-medication were classified and tallied under key themes.

RESULTS

Thirty studies involving 9271 participants were included in this review. The pooled prevalence of self-medication in Ghana was 53.7% (95% CI 46.2% to 61.0%; I²=98.51%, p<0.001). Prevalence of self-medication was highest among pregnant women (65.5%; 95% CI 58.1% to 72.5%; I2=88%), in the middle belt of the country (62.1%; 95% CI 40.9% to 82.0%; I²=98%; p<0.001) and in rural settings (61.2%; 95% CI 36.5% to 84.5%; I²=98%; p<0.001). The most cited reasons for self-medication included long waiting time at health facilities (73.3%), previous use of drugs (66.7%) and the perceived unseriousness of diseases (53.3%).

CONCLUSION

This study has revealed that self-medication is still an unresolved public health challenge in Ghana, with a high prevalence estimate. Self-medication is influenced by inconveniences associated with accessing healthcare coupled with poor health seeking behaviours. There is the need for improved access to quality healthcare and the promotion of appropriate health-seeking behaviours.

Understanding 'Evergreening': Making Minor Modifications Of Existing Medications To Extend Protections

Recent studies have examined strategic behaviors in the pharmaceutical industry that extend patent and regulatory protection, known alternatively as "lifecycle management" or "evergreening." This literature highlights the extent to which the patent system is increasingly focused on granting new protections for minor modifications of existing innovations. The phenomenon raises questions regarding the value of the trend to society and its potential effects on innovation. Specifically, is there value in tinkering with existing medication, and does that value justify the extensive rewards available with a "golden" patent? Could aspects of the current system be distorting how companies choose to spend their precious innovation time and money? As a society, we may decide that certain parts of the system are valuable and that others require reform, but we cannot make any considered evaluation without understanding how the system works on the ground.

Interventions for the Current COVID-19 Pandemic: Frontline Workers' Intention to Use Personal Protective Equipment

BACKGROUND

Frontline workers (FLWs) are at a higher risk of COVID-19 infection during care interactions than the general population. Personal protective equipment (PPE) is regarded as an effective intervention for limiting the transmission of airborne viruses. However, research examining FLWs' intention to use PPE is limited.

OBJECTIVES

This study addresses this research gap and also contributes by expanding the conceptual mechanism of planned behavior theory by incorporating three novel dimensions (perceived benefits of PPE, risk perceptions of the epidemic, and unavailability of PPE) in order to gain a better understanding of the factors that influence FLWs' intentions to use PPE.

METHOD

Analysis is based on a sample of 763 FLWs in Pakistan using a questionnaire survey, and the structural equation modeling approach is employed to evaluate the suppositions.

RESULTS

Study results indicate that attitude, perceived benefits of PPE, and risk perceptions of the epidemic have positive influence on FLWs' intention to use PPE. In comparison, the unavailability of PPE and the cost of PPE have opposite effects. Meanwhile, environmental concern has a neutral effect.

CONCLUSIONS

The study results specify the importance of publicizing COVID-19's lethal impacts on the environment and society, ensuring cheap PPE, and simultaneously enhancing workplace safety standards.

Assessment of public intention to get vaccination against COVID-19: Evidence from a developing country

OBJECTIVES

Widespread acceptance of the COVID-19 vaccine will be the next important step in fighting the novel coronavirus disease. Though the Pakistani government has successfully implemented robust policies to overcome the COVID-19 pandemic; however, studies assessing public intention to get COVID-19 vaccination (IGCV) are limited. The aim of this study is to deal with this literature gap and has also expanded the conceptual framework of planned behaviour theory. We have introduced three new considerations (risk perceptions of the pandemic, perceived benefits of the vaccine, and unavailability of vaccine) to have a better understanding of the influencing factors that encourage or discourage public IGCV.

METHODS

Results are based on a sample collected from 754 households using an inclusive questionnaire survey. Hypotheses are tested by utilizing the structural equation modelling approach.

RESULTS

The results disclose that the intention factors, that is, attitude, risk perceptions of the pandemic, and perceived benefits of the vaccine, impart positive effects on public IGCV. In contrast, the cost of the vaccine and the unavailability of the vaccine have negative effects. Notably, environmental concern has an insignificant effect.

CONCLUSIONS

Research findings emphasize the importance of publicizing the devastating impacts of COVID-19 on society and the environment, ensuring vaccination availability at an accessible price while simultaneously improving public healthcare practices.

Assessing Public Willingness to Wear Face Masks during the COVID-19 Pandemic: Fresh Insights from the Theory of Planned Behavior

Face masks are considered an effective intervention in controlling the spread of airborne viruses, as evidenced by the 2009's H1N1 swine flu and 2003's severe acute respiratory syndrome (SARS) outbreaks. However, research aiming to examine public willingness to wear (WTW) face masks in Pakistan are scarce. The current research aims to overcome this research void and contributes by expanding the theoretical mechanism of theory of planned behavior (TPB) to include three novel dimensions (risk perceptions of the pandemic, perceived benefits of face masks, and unavailability of face masks) to comprehensively analyze the factors that motivate people to, or inhibit people from, wearing face masks. The study is based on an inclusive questionnaire survey of a sample of 738 respondents in the provincial capitals of Pakistan, namely, Lahore, Peshawar, Karachi, Gilgit, and Quetta. Structural equation modeling (SEM) is used to analyze the proposed hypotheses. The results show that attitude, social norms, risk perceptions of the pandemic, and perceived benefits of face masks are the major influencing factors that positively affect public WTW face masks, whereas the cost of face masks and unavailability of face masks tend to have opposite effects. The results emphasize the need to enhance risk perceptions by publicizing the deadly effects of COVID-19 on the environment and society, ensure the availability of face masks at an affordable price, and make integrated and coherent efforts to highlight the benefits that face masks offer.

A Drug-Centric View of Drug Development: How Drugs Spread from Disease to Disease

Drugs are often seen as ancillary to the purpose of fighting diseases. Here an alternative view is proposed in which they occupy a spearheading role. In this view, drugs are technologies with an inherent therapeutic potential. Once created, they can spread from disease to disease independently of the drug creator's original intentions. Through the analysis of extensive literature and clinical trial records, it can be observed that successful drugs follow a life cycle in which they are studied at an increasing rate, and for the treatment of an increasing number of diseases, leading to clinical advancement. Such initial growth, following a power law on average, has a degree of momentum, but eventually decelerates, leading to stagnation and decay. A network model can describe the propagation of drugs from disease to disease in which diseases communicate with each other by receiving and sending drugs. Within this model, some diseases appear more prone to influence other diseases than be influenced, and vice versa. Diseases can also be organized into a drug-centric disease taxonomy based on the drugs that each adopts. This taxonomy reflects not only biological similarities across diseases, but also the level of differentiation of existing therapies. In sum, this study shows that drugs can become contagious technologies playing a driving role in the fight against disease. By better understanding such dynamics, pharmaceutical developers may be able to manage drug projects more effectively.