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Vinther A, Ramnarine E, Gastineau T, O'Brien L, Brehm O, Fryrear D. Approaches to Design an Efficient, Predictable Global Post-approval Change Management System that Facilitates Continual Improvement and Drug Product Availability. Ther Innov Regul Sci 2024; 58:433-442. [PMID: 38369639 DOI: 10.1007/s43441-024-00614-9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 01/08/2024] [Indexed: 02/20/2024]
Abstract
The complexity and inter-connectedness of operating in a global world for drug product supply has become an undeniable reality, further underscored by the COVID-19 pandemic. For Post-Approval Changes (PACs) that are an inevitable part of a product's commercial life, the impact of the growing global regulatory complexity and related drug shortages has brought the Global PAC Management System to an inflection point in particular for companies that have their products marketed in many countries.This paper illustrates through data analyzed for the first time from 145,000 + PACs for 156 countries, collected by 18 global pharma companies over a 3-year period (2019-2021), how severe the problem of global regulatory complexity is. Only PACs requiring national regulatory agency (NRA) approval prior to implementation were included in the data set. 1 of the 156 country NRAs approved all submitted PACs within a period of 6 months. The 6-month timeline was chosen because it is the recommended review timeline for major changes in the WHO guidance for vaccines and biotherapeutic products. 10 out of the 156 (6%) countries had no more than 10% of the PACs reviewed and approved in > 6 months. In 33 (22%) countries more than half of the PACs took > 6 months for approval. It is rare that the same PAC is approved globally within 6 months as individual NRAs take from a few months to years (in some cases > 5 years) for their review.The global PAC management complexity has steadily grown over the past 20 years. Attempts thus far to solve this problem have not made any meaningful difference. Senior leaders and decision-makers across the interdependent components of the complex Global PAC Management System (industry and regulators) must come together and collaboratively manage the problem holistically with the objective of ensuring global drug product availability instead of continuing with distinct stakeholder or country-focused solutions, which can tend to worsen the problem.In this paper, the Chief Quality Officers (CQOs) from 18 of the largest innovator pharma companies (see Acknowledgements) are speaking with One-Voice-of-Quality for PACs (1VQ for PACs Initiative). They are recommending a set of 8 approaches to activate a holistic transformation of the Global PAC Management System. This article presents their view on the problem of global regulatory complexity for managing PACs, it's impact on continual improvement and the risk to drug product supply, as well as approaches that can help alleviate the problem.
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Affiliation(s)
- Anders Vinther
- QBA - Quality Business Administration, San Carlos, CA, USA.
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2
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Conti RM, Frank RG, Cutler DM. The Myth of the Free Market for Pharmaceuticals. N Engl J Med 2024; 390:1448-1450. [PMID: 38647106 DOI: 10.1056/nejmp2313400] [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: 04/25/2024]
Affiliation(s)
- Rena M Conti
- From the Questrom School of Business, Boston University, Boston (R.M.C.), and the Conference on Research in Income and Wealth (R.M.C.), the National Bureau of Economic Research (R.G.F., D.M.C.), and the Department of Economics, Harvard University (D.M.C.), Cambridge - all in Massachusetts; and the Brookings Institution, Washington, DC (R.G.F.)
| | - Richard G Frank
- From the Questrom School of Business, Boston University, Boston (R.M.C.), and the Conference on Research in Income and Wealth (R.M.C.), the National Bureau of Economic Research (R.G.F., D.M.C.), and the Department of Economics, Harvard University (D.M.C.), Cambridge - all in Massachusetts; and the Brookings Institution, Washington, DC (R.G.F.)
| | - David M Cutler
- From the Questrom School of Business, Boston University, Boston (R.M.C.), and the Conference on Research in Income and Wealth (R.M.C.), the National Bureau of Economic Research (R.G.F., D.M.C.), and the Department of Economics, Harvard University (D.M.C.), Cambridge - all in Massachusetts; and the Brookings Institution, Washington, DC (R.G.F.)
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3
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Gabriele SME, Feldman WB. The Problem of Limited-Supply Agreements for Medicare Price Negotiation. JAMA 2023; 330:1223-1224. [PMID: 37713185 DOI: 10.1001/jama.2023.17208] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
This Viewpoint discusses how limited-supply agreements (introduction of generic products in reduced volumes) might thwart efforts to negotiate lower prices on prescription drugs in the US.
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Affiliation(s)
- Sarah M E Gabriele
- Program On Regulation, Therapeutics, And Law, Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - William B Feldman
- Program On Regulation, Therapeutics, And Law, Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
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Grossman A, Prata N, Williams N, Ganatra B, Lavelanet A, Läser L, Asmani C, Elamin H, Ouedraogo L, Rahman MM, Conneh-Duworko MJ, Tehoungue BZ, Chanza H, Phiri H, Bhattarai B, Dhakal NP, Ojo OA, Afolabi K, Kabuteni TJ, Hailu BG, Moses F, Dlamini-Nqeketo S, Zulu T, Rehnström Loi U. Availability of medical abortion medicines in eight countries: a descriptive analysis of key findings and opportunities. Reprod Health 2023; 20:58. [PMID: 37041543 PMCID: PMC10091522 DOI: 10.1186/s12978-023-01574-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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] [Accepted: 01/25/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND In recent years a growing number of manufacturers and medical abortion products have entered country markets and health systems, with varying degrees of quality and accessibility. An interplay of factors including pharmaceutical regulations, abortion laws, government policies and service delivery guidelines and provider's knowledge and practices influence the availability of medical abortion medicines. We assessed the availability of medical abortion in eight countries to increase understanding among policymakers of the need to improve availability and affordability of quality-assured medical abortion products at regional and national levels. METHODS Using a national assessment protocol and an availability framework, we assessed the availability of medical abortion medicines in Bangladesh, Liberia, Malawi, Nepal, Nigeria, Rwanda, Sierra Leone and South Africa between September 2019 and January 2020. RESULTS Registration of abortion medicines-misoprostol or a combination of mifepristone and misoprostol-was established in all countries assessed, except Rwanda. Mifepristone and misoprostol regimen for medical abortion was identified on the national essential medicines list/standard treatment guidelines for South Africa as well as in specific abortion care service and delivery guidelines for Bangladesh, Nepal, Nigeria, and Rwanda. In Liberia, Malawi, and Sierra Leone-countries with highly restrictive abortion laws and no abortion service delivery guidelines or training curricula-no government-supported training on medical abortion for public sector providers had occurred. Instead, training on medical abortion was either limited in scope to select private sector providers and pharmacists or prohibited. Community awareness activities on medical abortion have been limited in scope across the countries assessed and where abortion is broadly legal, most women do not know that it is an option. CONCLUSION Understanding the factors that influence the availability of medical abortion medicines is important to support policymakers improve availability of these medicines. The landscape assessments documented that medical abortion commodities can be uniquely impacted by the laws, policies, values, and degree of restrictions placed on service delivery programs. Results of the assessments can guide actions to improve access.
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Affiliation(s)
- Amy Grossman
- Venture Strategies for Health & Development/OASIS, Berkeley, CA, USA
| | - Ndola Prata
- Venture Strategies for Health & Development/OASIS, Berkeley, CA, USA
- Bixby Center for Population, Health & Sustainability, School of Public Health, University of California, Berkeley, CA, USA
| | - Natalie Williams
- Venture Strategies for Health & Development/OASIS, Berkeley, CA, USA
| | - Bela Ganatra
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland
| | - Antonella Lavelanet
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland
| | - Laurence Läser
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland
| | - Chilanga Asmani
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | - Hayfa Elamin
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | - Leopold Ouedraogo
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | | | | | | | - Harriet Chanza
- World Health Organization, Malawi Country Office, Lilongwe, Republic of Malawi
| | - Henry Phiri
- Ministry of Health, Lilongwe, Republic of Malawi
| | - Bharat Bhattarai
- Department of Drug Administration, Ministry of Health and Population, Kathmandu, Nepal
| | | | | | - Kayode Afolabi
- Reproductive Health, Federal Ministry of Health, Abuja, Federal Republic of Nigeria
| | | | | | - Francis Moses
- Reproductive Health/Family Planning Programme Manager, Ministry of Health, Freetown, Sierra Leone
| | | | - Thembi Zulu
- National Department of Health, Pretoria, Republic of South Africa
| | - Ulrika Rehnström Loi
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland.
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Affiliation(s)
- S Sean Tu
- 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 (S.S.T., A.S.); and West Virginia University College of Law, Morgantown (S.S.T.)
| | - 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 (S.S.T., A.S.); and West Virginia University College of Law, Morgantown (S.S.T.)
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6
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Feldman WB, Tu SS, Alhiary R, Kesselheim AS, Wouters OJ. Manufacturer Revenue on Inhalers After Expiration of Primary Patents, 2000-2021. JAMA 2023; 329:87-89. [PMID: 36594955 PMCID: PMC9857605 DOI: 10.1001/jama.2022.19691] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This study quantifies the revenue earned on all brand-name inhalers approved by the US Food and Drug Administration from 2000 to 2021 and compared earnings before and after expiration of primary patents on these products.
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Affiliation(s)
- William B. Feldman
- Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Boston, Massachusetts
| | - S. Sean Tu
- West Virginia University College of Law, Morgantown
| | - Rasha Alhiary
- University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania
| | - Aaron S. Kesselheim
- Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Olivier J. Wouters
- Department of Health Policy, London School of Economics and Political Science, London, England
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7
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Sakurai A, Kanzaki S, Honda F. Japanese Pharmaceutical Regulations of Engineered Viral Vectors for Medical Use Compared with those in the
United States
and the
European Union. Clin Pharmacol Ther 2022; 113:960-962. [PMID: 36404404 DOI: 10.1002/cpt.2788] [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] [Received: 08/29/2022] [Accepted: 11/01/2022] [Indexed: 11/22/2022]
Affiliation(s)
- Akira Sakurai
- Center for Product Evaluation, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Seiichi Kanzaki
- Office of Cellular and Tissue-based Products, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Futaba Honda
- Office of Cellular and Tissue-based Products, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
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8
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Alexander GC, Mansour O. Distribution of Abatement Funds Arising From US Opioid Litigation. JAMA 2022; 328:1901-1902. [PMID: 36306147 DOI: 10.1001/jama.2022.19667] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This Viewpoint discusses the settlement agreements reached against several major pharmaceutical distributors resulting from the US opioid epidemic and how those funds will be distributed amongst the states.
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Affiliation(s)
- G Caleb Alexander
- Center for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Omar Mansour
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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9
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Brennan T. Pharmaceutical Marketing Revisited - United States v. Biogen Idec. N Engl J Med 2022; 387:1631-1633. [PMID: 36317763 DOI: 10.1056/nejmp2210637] [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: 11/19/2022]
Affiliation(s)
- Troyen Brennan
- From the Harvard T.H. Chan School of Public Health, Boston
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10
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Affiliation(s)
- Walid F Gellad
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
| | - Inmaculada Hernandez
- Division of Clinical Pharmacy, University of California, San Diego, Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla
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11
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Abstract
This Viewpoint documents the history, value, and success of the 340B Pricing Program, which is under threat from pharmaceutical corporations’ withdrawal and from a pending Supreme Court decision and offers 2 legislative fixes to address the concerns raised by the pharmaceutical companies.
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Affiliation(s)
- Ryan P Knox
- Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, Massachusetts
| | - Aaron S Kesselheim
- Program on Regulation, Therapeutics, and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ameet Sarpatwari
- Program on Regulation, Therapeutics, and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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12
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Affiliation(s)
- Alfred B Engelberg
- From the Engelberg Foundation, Palm Beach, FL (A.B.E.); and the Program on Regulation, Therapeutics, and Law, Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School - both in Boston (J.A., A.S.K.)
| | - Jerry Avorn
- From the Engelberg Foundation, Palm Beach, FL (A.B.E.); and the Program on Regulation, Therapeutics, and Law, Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School - both in Boston (J.A., A.S.K.)
| | - Aaron S Kesselheim
- From the Engelberg Foundation, Palm Beach, FL (A.B.E.); and the Program on Regulation, Therapeutics, and Law, Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School - both in Boston (J.A., A.S.K.)
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13
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14
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Affiliation(s)
- Luke Hawksbee
- Department of Sociology, University of Cambridge, Cambridge, UK
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Lawrence King
- Department of Economics, University of Massachusetts, Amherst, MA, USA
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15
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Adashi EY, Cohen IG, Elberg JT. Transparency and the Doctor-Patient Relationship - Rethinking Conflict-of-Interest Disclosures. N Engl J Med 2022; 386:300-302. [PMID: 35061340 DOI: 10.1056/nejmp2114495] [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: 11/19/2022]
Affiliation(s)
- Eli Y Adashi
- From the Department of Medical Science, Warren Alpert Medical School, Brown University, Providence, RI (E.Y.A.); Harvard Law School and the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics, Harvard University, Cambridge, MA (I.G.C.); and the Center for Health and Pharmaceutical Law, Seton Hall University School of Law, Newark, NJ (J.T.E.)
| | - I Glenn Cohen
- From the Department of Medical Science, Warren Alpert Medical School, Brown University, Providence, RI (E.Y.A.); Harvard Law School and the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics, Harvard University, Cambridge, MA (I.G.C.); and the Center for Health and Pharmaceutical Law, Seton Hall University School of Law, Newark, NJ (J.T.E.)
| | - Jacob T Elberg
- From the Department of Medical Science, Warren Alpert Medical School, Brown University, Providence, RI (E.Y.A.); Harvard Law School and the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics, Harvard University, Cambridge, MA (I.G.C.); and the Center for Health and Pharmaceutical Law, Seton Hall University School of Law, Newark, NJ (J.T.E.)
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16
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Affiliation(s)
- Reshma Ramachandran
- National Clinician Scholars Program, Yale School of Medicine, Department of Internal Medicine, New Haven, Connecticut
- Veterans Affairs Connecticut Healthcare System and Yale University, West Haven, Connecticut
| | - Christopher J Morten
- Columbia Law School, New York, New York
- Global Health Justice Partnership, Yale Law School, New Haven, Connecticut
| | - Joseph S Ross
- National Clinician Scholars Program, Yale School of Medicine, Department of Internal Medicine, New Haven, Connecticut
- Section of General Internal Medicine, Yale School of Medicine, New Haven, Connecticut
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17
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Chopra AS, Lordan R, Horbańczuk OK, Atanasov AG, Chopra I, Horbańczuk JO, Jóźwik A, Huang L, Pirgozliev V, Banach M, Battino M, Arkells N. The current use and evolving landscape of nutraceuticals. Pharmacol Res 2021; 175:106001. [PMID: 34826602 DOI: 10.1016/j.phrs.2021.106001] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/21/2021] [Accepted: 11/22/2021] [Indexed: 12/13/2022]
Abstract
The nutraceutical market is currently a high-impact multi-billion-dollar industry, and it is anticipated to grow rapidly over the next decade. Nutraceuticals comprise diverse food-derived product categories that have become widespread due to increased consumer awareness of potential health benefits and the need for improved wellness. This targeted review is designed to identify the current global trends, market opportunities, and regulations that drive the nutraceutical industry. Safety and efficacy concerns are also explored with a view to highlighting areas that necessitate further research and oversight. Key drivers of the nutraceutical market include aging populations, consumer awareness, consumer lifestyle, increasing cost of healthcare, and marketing channels. Although some nutraceuticals hold promising preventive and therapeutic opportunities, there is a lack of a universal definition and regulatory framework among countries. Moreover, there is a lack of adequate evidence for their efficacy, safety, and effectiveness, which was even further highlighted during the ongoing coronavirus pandemic. Future prospective epidemiological studies can delineate the health impact of nutraceuticals and help set the scientific basis and rationale foundation for clinical trials, reducing the time and cost of trials themselves. Together, an understanding of the key drivers of the nutraceutical market alongside a consistent and well-defined regulatory framework will provide further opportunities for growth, expansion, and segmentation of nutraceuticals applications.
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Affiliation(s)
| | - Ronan Lordan
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States; Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
| | - Olaf K Horbańczuk
- Warsaw University of Life Sciences, Faculty of Human Nutrition, Nowoursynowska 159 C, 02-776 Warsaw, Poland.
| | - Atanas G Atanasov
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, 05-552 Jastrzebiec, Poland; Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria.
| | | | - Jarosław O Horbańczuk
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, 05-552 Jastrzebiec, Poland
| | - Artur Jóźwik
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, 05-552 Jastrzebiec, Poland
| | - Linfang Huang
- Institute of Medicinal Plant Development (IMPLAD), Peking Union Medical College, Chinese Academy of Medical Sciences (CAMS), Beijing, PR China
| | - Vasil Pirgozliev
- National Institute of Poultry Husbandry, Harper Adams University, Shropshire TF10 8NB, UK
| | - Maciej Banach
- Department of Preventative Cardiology and Lipidology, Medical University of Lodz, Lodz, Poland
| | - Maurizio Battino
- Department of Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy; International Research Center for Food Nutrition and Safety, Jiangsu University, Zhenjiang, PR China
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18
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Gill J, Sarpatwari A, Prasad V. The implications of Industry-Funded Disease Awareness Campaigns in the Rare Disease Setting. Mayo Clin Proc 2021; 96:2305-2308. [PMID: 34481596 DOI: 10.1016/j.mayocp.2020.12.041] [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] [Received: 06/24/2020] [Revised: 12/07/2020] [Accepted: 12/22/2020] [Indexed: 10/20/2022]
Affiliation(s)
- Jennifer Gill
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Ameet Sarpatwari
- Program on Regulation, Therapeutics, and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Vinay Prasad
- Department of Epidemiology and Biostatistics, University of California, San Francisco. https://twitter.com/vprasadmdmph
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19
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Affiliation(s)
- Matthew M Kavanagh
- Georgetown University Law Center, Washington, DC
- Department of International Health, Georgetown University, Washington, DC
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20
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Sheikhan NY, Pinto AM, Nowak DA, Abolhassani F, Lefebvre P, Duh MS, Witek TJ. Compliance With Cannabis Act Regulations Regarding Online Promotion Among Canadian Commercial Cannabis-Licensed Firms. JAMA Netw Open 2021; 4:e2116551. [PMID: 34251442 PMCID: PMC8276085 DOI: 10.1001/jamanetworkopen.2021.16551] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE As global jurisdictions shift toward cannabis legalization, 2 areas of public health importance relate to exposure to youth and to truthful promotion. Although Canada's Cannabis Act specifies many prohibitions related to cannabis promotion, no systematic monitoring or enforcement among licensed firms exists. Compliance with marketing regulations has effects beyond Canadian citizens because of the global outreach of websites and social media. OBJECTIVES To evaluate compliance among licensed firms with the Cannabis Act and analyze trends among violations regarding promotional material. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study evaluated cannabis-licensed firms after cannabis legalization. Data were extracted from online public platforms, including company websites, Facebook, Instagram, and Twitter, from October 1, 2019, to March 31, 2020. Descriptive statistics, Poisson regression, and logistic regression were used to analyze the associations of covariates with promotion violations. MAIN OUTCOMES AND MEASURES The primary outcome was characterization of type and prevalence of promotion violations. Secondary outcomes were the role of various covariates (namely, licensed firm characteristics and online platforms) in the frequency and probability of violations. Hypotheses were formulated before data collection. RESULTS Among 261 licensed firms, 211 (80.8%) had an online platform, including 204 (96.7%) with websites, 128 (60.7%) with Facebook, 123 (58.3%) with Instagram, and 123 (58.3%) with Twitter. Of all licensed firms with an online platform, 182 (86.3%) had at least 1 violation. Compared with websites, the risk of violations was significantly higher on Facebook (rate ratio [RR], 1.24; 95% CI, 1.11-1.39) and Instagram (RR, 1.19; 95% CI, 1.05-1.34). The most common violations included lack of age restrictions, brand glamorization, and omission of risk information. With websites as the reference group, lack of age restrictions was approximately 15 times more likely to occur on Facebook (odds ratio [OR], 14.76; 95% CI, 8.06-27.05); the odds of an age restriction violation were also higher on Instagram (OR, 2.48; 95% CI, 1.43-4.32) and Twitter (OR, 4.03; 95% CI, 2.29-7.09). For unsubstantiated claims, the odds of violations were significantly decreased on Facebook (OR, 0.23; 95% CI, 0.11-0.48) and Instagram (OR, 0.28; 95% CI, 0.14-0.57). The odds of glamorization were associated with an increase on Instagram (OR, 2.90; 95% CI, 1.72-4.88). CONCLUSIONS AND RELEVANCE In this cross-sectional study, widespread violations were observed in online Canadian cannabis promotion. To protect public health and safety amid legalization, decision-makers should make explicit federal regulation and enforcement regarding promotional activities of cannabis retailers. These results suggest that policy and enforcement of cannabis promotion in Canada would have an international impact, from ease of access to online media and downstream consequences of unregulated promotion.
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Affiliation(s)
- Natasha Y. Sheikhan
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Ashlyn M. Pinto
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Dominik A. Nowak
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Farbod Abolhassani
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Mei Sheng Duh
- Analysis Group Inc, Boston, Massachusetts
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Theodore J. Witek
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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21
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Wright JSF, Doukas D. Challenges to sovereign ambitions: forces of convergence and divergence within the global pharmaceutical sector and the UK's withdrawal from the European Union. Health Econ Policy Law 2021; 16:256-272. [PMID: 32583755 DOI: 10.1017/s174413312000016x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/11/2023]
Abstract
This paper maps key regulatory, governance and legal challenges associated with the UK's withdrawal from the European Union (EU) in terms of convergent and divergent pressures within the global pharmaceutical sector. These include (i) convergent regulatory pressures associated with the European framework for pre-market licensing; (ii) convergent and divergent industry pressures with regard to drug discovery and manufacturing; and (iii) divergent and convergent market pressures associated with the supply, pricing and assessment of medicines. The UK's sovereign ambitions risk a loss of influence over the licensing and surveillance of pharmaceuticals under convergent regulatory and industry pressures to engage in unilateral participation in the European regime. Further, they also risk a loss of influence over processes for pricing and assessing the effectiveness of new treatment regimens under divergent market pressures from larger pharmaceutical markets outside the EU, notably the United States.
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Affiliation(s)
- John S F Wright
- Public Policy, Regulation and Governance, Institute for Public Policy and Governance, University of Technology Sydney, PO Box 123 Broadway, Sydney, NSW2007, Australia
| | - Dimitrios Doukas
- EU Law, School of Law, The University of Manchester, Oxford Road, ManchesterM13 9PL, UK
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Affiliation(s)
| | - I Glenn Cohen
- Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics, Harvard Law School, Harvard University, Cambridge, Massachusetts
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Watters K, Munro N, Feher M. 'Doctor, will this medicine give me cancer?': Lessons from nitrosamines and extended-release metformin. Diabet Med 2021; 38:e14421. [PMID: 33063883 DOI: 10.1111/dme.14421] [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] [Received: 09/21/2020] [Accepted: 10/12/2020] [Indexed: 11/29/2022]
Affiliation(s)
- K Watters
- Diabetes Centre Chelsea and Westminster Hospital, London, UK
| | - N Munro
- Department of Clinical and Experimental Medicine, University of Surrey, Guilford Surrey, UK
- Diabetes Centre, Dumfries and Galloway Royal Infirmary, Dumfries, UK
| | - M Feher
- Diabetes Centre Chelsea and Westminster Hospital, London, UK
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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24
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Affiliation(s)
- Kayvan Bozorgmehr
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, D-33501 Bielefeld, Germany; Section for Health Equity Studies and Migration, Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany.
| | - Rosa Jahn
- Section for Health Equity Studies and Migration, Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - David Stuckler
- Department of Social and Political Sciences, Bocconi University, Milan, Italy
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
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25
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Abstract
This cross-sectional study uses data from the US Food and Drug Administration (FDA) to review the postmarketing requirements and commitments attached to new vaccines approved for use in the past 15 years in the United States.
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Affiliation(s)
- Osman Moneer
- Program on Regulation, Therapeutics and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Yale School of Medicine, Yale University, New Haven, Connecticut
| | - ChangWon C. Lee
- Program on Regulation, Therapeutics and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jerry Avorn
- Program on Regulation, Therapeutics and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Aaron S. Kesselheim
- Program on Regulation, Therapeutics and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
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26
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Watson CJ, Whitledge JD, Siani AM, Burns MM. Pharmaceutical Compounding: a History, Regulatory Overview, and Systematic Review of Compounding Errors. J Med Toxicol 2021; 17:197-217. [PMID: 33140232 PMCID: PMC7605468 DOI: 10.1007/s13181-020-00814-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [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: 06/30/2020] [Revised: 09/13/2020] [Accepted: 09/17/2020] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Medications are compounded when a formulation of a medication is needed but not commercially available. Regulatory oversight of compounding is piecemeal and compounding errors have resulted in patient harm. We review compounding in the United States (US), including a history of compounding, a critique of current regulatory oversight, and a systematic review of compounding errors recorded in the literature. METHODS We gathered reports of compounding errors occurring in the US from 1990 to 2020 from PubMed, Embase, several relevant conference abstracts, and the US Food and Drug Administration "Drug Alerts and Statements" repository. We categorized reports into errors of "contamination," suprapotency," and "subpotency." Errors were also subdivided by whether they resulted in morbidity and mortality. We reported demographic, medication, and outcome data where available. RESULTS We screened 2155 reports and identified 63 errors. Twenty-one of 63 were errors of concentration, harming 36 patients. Twenty-seven of 63 were contamination errors, harming 1119 patients. Fifteen errors did not result in any identified harm. DISCUSSION Compounding errors are attributed to contamination or concentration. Concentration errors predominantly result from compounding a prescription for a single patient, and disproportionately affect children. Contamination errors largely occur during bulk distribution of compounded medications for parenteral use, and affect more patients. The burden falls on the government, pharmacy industry, and medical providers to reduce the risk of patient harm caused by compounding errors. CONCLUSION In the US, drug compounding is important in ensuring access to vital medications, but has the potential to cause patient harm without adequate safeguards.
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Affiliation(s)
- C James Watson
- Harvard Medical Toxicology Program, Boston Children's Hospital, 333 Longwood Avenue, Mailstop 3025, Boston, MA, 02215, USA.
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
| | - James D Whitledge
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | - Michele M Burns
- Harvard Medical Toxicology Program, Boston Children's Hospital, 333 Longwood Avenue, Mailstop 3025, Boston, MA, 02215, USA
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA
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27
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Affiliation(s)
- William B Feldman
- From the Program on Regulation, Therapeutics, and Law, Division of Pharmacoepidemiology and Pharmacoeconomics (W.B.F., B.N.R., J.A., A.S.K.) and the Division of Pulmonary and Critical Care Medicine (W.B.F.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School (W.B.F., B.N.R., J.A., A.S.K.) - both in Boston
| | - Benjamin N Rome
- From the Program on Regulation, Therapeutics, and Law, Division of Pharmacoepidemiology and Pharmacoeconomics (W.B.F., B.N.R., J.A., A.S.K.) and the Division of Pulmonary and Critical Care Medicine (W.B.F.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School (W.B.F., B.N.R., J.A., A.S.K.) - both in Boston
| | - Jerry Avorn
- From the Program on Regulation, Therapeutics, and Law, Division of Pharmacoepidemiology and Pharmacoeconomics (W.B.F., B.N.R., J.A., A.S.K.) and the Division of Pulmonary and Critical Care Medicine (W.B.F.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School (W.B.F., B.N.R., J.A., A.S.K.) - both in Boston
| | - Aaron S Kesselheim
- From the Program on Regulation, Therapeutics, and Law, Division of Pharmacoepidemiology and Pharmacoeconomics (W.B.F., B.N.R., J.A., A.S.K.) and the Division of Pulmonary and Critical Care Medicine (W.B.F.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School (W.B.F., B.N.R., J.A., A.S.K.) - both in Boston
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28
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Affiliation(s)
- Y Tony Yang
- Center for Health Policy and Media Engagement, George Washington University School of Nursing, Washington, DC
- Department of Health Policy and Management, George Washington University Milken Institute School of Public Health, Washington, DC
| | - Diana J Mason
- Center for Health Policy and Media Engagement, George Washington University School of Nursing, Washington, DC
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29
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Gabriel JM, Holman B. Clinical trials and the origins of pharmaceutical fraud: Parke, Davis & Company, virtue epistemology, and the history of the fundamental antagonism. Hist Sci 2020; 58:533-558. [PMID: 32713203 DOI: 10.1177/0073275320942435] [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] [Indexed: 06/11/2023]
Abstract
This paper describes one possible origin point for fraudulent behavior within the American pharmaceutical industry. We argue that during the late nineteenth century therapeutic reformers sought to promote both laboratory science and increasingly systematized forms of clinical experiment as a new basis for therapeutic knowledge. This process was intertwined with a transformation in the ethical framework in which medical science took place, one in which monopoly status was replaced by clinical utility as the primary arbiter of pharmaceutical legitimacy. This new framework fundamentally altered the set of epistemic virtues-a phrase we draw from the philosophical field of virtue epistemology-considered necessary to conduct reliable scientific inquiry regarding drugs. In doing so, it also made possible new forms of fraud in which newly emergent epistemic virtues were violated. To make this argument, we focus on the efforts of Francis E. Stewart and George S. Davis of Parke, Davis & Company. Therapeutic reformers within the pharmaceutical industry, such as Stewart and Davis, were an important part of the broader normative and epistemic transformation we describe in that they sought to promote laboratory science and systematized clinical trials toward the twin goals of improving pharmaceutical science and promoting their own commercial interests. Yet, as we suggest, Parke, Davis & Company also serves as an example of a company that violated the very norms that Stewart and Davis helped introduce. We thus seek to describe one possible origin point for the widespread fraudulent practices that now characterize the pharmaceutical industry. We also seek to describe an origin point for why we conceptualize such practices as fraudulent in the first place.
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31
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Vogler S, Fischer S. How to address medicines shortages: Findings from a cross-sectional study of 24 countries. Health Policy 2020; 124:1287-1296. [PMID: 33032846 PMCID: PMC7505130 DOI: 10.1016/j.healthpol.2020.09.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 11/04/2022]
Abstract
Shortages of medicines have become a major public health challenge. The aim of this study was to survey national measures to manage and combat these shortages. A questionnaire survey was conducted with public authorities involved in the Pharmaceutical Pricing and Reimbursement Information (PPRI) network. Reponses relating to measures as of March / April 2020 were received from 24 countries (22 European countries, Canada and Israel). In 20 countries, manufacturers are requested to notify - usually on an obligatory basis - upcoming and existing shortages, which are recorded in a register. Further measures include a regular dialogue with relevant stakeholders (18 countries), financial sanctions for manufacturers in cases of non-supply and/or non-compliance with reporting or stocking requirements (15 countries) and simplified regulatory procedures (20 countries). For defined medicines, supply reserves have been established (14 countries), and legal provisions allow the issuing of export bans (10 countries). Some measures have been introduced since the end of 2019 and countries are planning and discussing further action. While governments reacted by taking national measures, the COVID-19 crisis might serve as an opportunity to join forces in cross-country collaboration and develop joint (e.g. European) solutions to address the shortage issue in a sustainable manner. A practical first step could be to work on a harmonisation of the national registers.
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Affiliation(s)
- Sabine Vogler
- WHO Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies, Pharmacoeconomics Department, Gesundheit Österreich (GÖG / Austrian National Public Health Institute), 1010 Vienna, Austria.
| | - Stefan Fischer
- WHO Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies, Pharmacoeconomics Department, Gesundheit Österreich (GÖG / Austrian National Public Health Institute), 1010 Vienna, Austria.
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32
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Abstract
This study describes financial penalties levied on pharmaceutical companies for illegal activities by type of activity and dollar value between 2003 and 2016.
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Affiliation(s)
- Denis G. Arnold
- Belk College of Business, University of North Carolina at Charlotte
| | - Oscar Jerome Stewart
- The Lam Family College of Business, San Francisco State University, San Francisco, California
| | - Tammy Beck
- College of Business, University of Nebraska, Lincoln
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33
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Thibault J. America's Oldest Drug Cartel: Civil RICO Action In re Insulin Pricing Litigation and the Case for Overruling the Indirect Purchaser Rule. Am J Law Med 2020; 46:470-500. [PMID: 33413015 DOI: 10.1177/0098858820975534] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Julia Thibault
- J.D. Anticipated May 2021, Boston University School of Law, concentrations in Health Law and Health Care Compliance; B.A. Biochemistry/Molecular Biology, Hastings College. Thank you to Professor Jack Beermann for his advice on this Note, and to Hannah Brennan for her guidance on topic choice. All opinions and errors are my own
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34
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Abstract
The legacy of male bias within pharmaceutical research, regulation, and commercialisation needs to be rectified, argue Sundari Ravindran and colleagues
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Affiliation(s)
| | - Yot Teerawattananon
- Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Thailand
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Cara Tannenbaum
- Institute of Gender and Health, Canadian Institutes of Health Research, Canada
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35
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36
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Affiliation(s)
- Ameet Sarpatwari
- Program on Regulation, Therapeutics, and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA 02120, USA
| | - Jerry Avorn
- Program on Regulation, Therapeutics, and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA 02120, USA
| | - Aaron S Kesselheim
- Program on Regulation, Therapeutics, and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA 02120, USA
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37
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Chowdhury S. MEDICINE AND COLONIAL PATENT LAW IN INDIA: A Study of Patent Medicines and the Indian Patents and Designs Act, 1911 in Early- Twentieth-Century India. J Hist Med Allied Sci 2020; 75:408-428. [PMID: 33036029 DOI: 10.1093/jhmas/jraa027] [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] [Indexed: 06/11/2023]
Abstract
This paper investigates the history of drugs sold as "patent medicines" in India in the early twentieth century. The paper investigates their legitimacy as patenting of medicines was forbidden by the Indian Patents and Designs Act, 1911 (IPDA). The paper argues that the instrument of letters patents functioning as the prerogative of the Crown that gave monopolistic rights to grantees to sell any compound without having to disclose its constituents was the reason behind this seemingly conflicting historical relationship between the law and the market. Colonial law-making left sufficient space within the ambit of the IPDA for letters patents to have their ill effects. The colonial state made attempts to address this as a public health issue by incorporating concerns related to this class of medicines within regulations addressed to the drugs market in the 1930s. The currency of patent medicines in the market was further added to by Indian indigenous entrepreneurs fueled by cultural nationalism of Swadeshi ideology in Bengal in the early twentieth century. However, even such indigenous responses or attempts at hybridization of manufacturing and selling practices related to patent medicines were mostly informed by upper-caste/ upper-class interests and not so much by those of consumers of these medicines.
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38
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Phelan AL, Eccleston-Turner M, Rourke M, Maleche A, Wang C. Legal agreements: barriers and enablers to global equitable COVID-19 vaccine access. Lancet 2020; 396:800-802. [PMID: 32910908 PMCID: PMC7832682 DOI: 10.1016/s0140-6736(20)31873-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 09/02/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Alexandra L Phelan
- Center for Global Health Science and Security, Georgetown University Medical Center, Washington, DC, USA; O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC, USA.
| | | | - Michelle Rourke
- Law Futures Centre, Griffith University, Nathan, QLD, Australia; CSIRO, Synthetic Biology Future Science Platform, Brisbane, QLD, Australia
| | - Allan Maleche
- Kenya Legal and Ethical Issues Network on HIV and AIDS, Nairobi, Kenya
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González-González A. [Case: bioethical disputes of the donations of the pharmaceutical companies to the health centers]. Cuad Bioet 2020; 31:423-427. [PMID: 33375807 DOI: 10.30444/cb.80] [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] [Received: 11/10/2018] [Accepted: 11/26/2018] [Indexed: 06/12/2023]
Abstract
The interaction between doctors and pharmaceutical companies has been and is common, occurs in multiple ways and has proven, in many cases, to be necessary for the development of medicine. However, some of the sales techniques of the pharmaceutical industry are not ethically acceptable and can compromise the independence of physicians. An ethical dilemma arises from a real case in which the search for vulnerability in prescription based on a donation by a pharmaceutical company was not easy to identify.
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Affiliation(s)
- Abel González-González
- Sección de Endocrinología y Nutrición. Hospital General Universitario de Ciudad Real. Avda/ Obispo Rafael Torija, s/n. 13005 Ciudad Real. Tfno: 926 278000. Extensión: 77437.
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40
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Affiliation(s)
- Jenny S Guadamuz
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago College of Pharmacy
| | - Dima M Qato
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago College of Pharmacy
| | - G Caleb Alexander
- Center for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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41
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Affiliation(s)
- Lawrence O Gostin
- O'Neill Institute for National and Global Health Law, Georgetown University, Washington, DC
| | | | - Patricia A Cuff
- National Academies of Sciences, Engineering, and Medicine, Washington, DC
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43
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44
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Ausness R. 2019-2020 Southern Illinois University National Health Law Moot Court Competition. J Leg Med 2020; 40:447-465. [PMID: 33797325 DOI: 10.1080/01947648.2020.1868944] [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: 06/12/2023]
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45
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Cooney D, Moriarty J, Sklar E, Hudson J. In the Supreme Court of the United States Docket No. 18-102. J Leg Med 2020; 40:467-498. [PMID: 33797323 DOI: 10.1080/01947648.2020.1868959] [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: 06/12/2023]
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46
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Mazer-Amirshahi M, Fox ER, Nelson LS, Smith SW, Stolbach AI. ACMT Position Statement on Prescription Drug Shortages. J Med Toxicol 2020; 16:349-351. [PMID: 32297150 PMCID: PMC7320088 DOI: 10.1007/s13181-020-00775-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 03/25/2020] [Accepted: 03/25/2020] [Indexed: 10/24/2022] Open
Affiliation(s)
- Maryann Mazer-Amirshahi
- Department of Emergency Medicine, MedStar Washington Hospital Center, Georgetown University School of Medicine, Washington, DC, USA
| | - Erin R Fox
- Department of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, UT, USA
| | | | - Silas W Smith
- Ronald O. Perelman Department of Emergency Medicine, NYU Langone Health, New York, NY, USA
- Institute for Innovations in Medical Education, NYU Langone Health, New York, NY, USA
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47
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Affiliation(s)
- Huseyin Naci
- From the Department of Health Policy, London School of Economics and Political Science, London (H.N.); and the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston (H.N., A.S.K.)
| | - Aaron S Kesselheim
- From the Department of Health Policy, London School of Economics and Political Science, London (H.N.); and the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston (H.N., A.S.K.)
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48
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Affiliation(s)
- James C Robinson
- From the University of California, Berkeley, School of Public Health, Berkeley
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49
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Abstract
Opioid litigation continues a growing public health litigation trend in which governments seek to hold companies responsible for population harms related to their products. The litigation can serve to address gaps in regulatory and legislative policymaking and in market self-regulation pervasive in the prescription opioid domain. Moreover, prior opioid settlements have satisfied civil tort litigation objectives of obtaining compensation for injured parties, deterring harmful behavior, and holding certain opioid manufacturers, distributors and pharmacies accountable for their actions. In this way, opioid litigation represents progress over prior public health litigation campaigns involving tobacco, lead paint, and asbestos, which had more limited tort litigation effects. Although opioid litigation is not a comprehensive solution to the opioid crisis, it can complement other strategies and infuse much needed money, behavior changes, and public accountability for prescription opioid and related harms.
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Affiliation(s)
- Rebecca L Haffajee
- Rebecca L. Haffajee, J.D., Ph.D., M.P.H., is a Policy Researcher at RAND Corporation and an Adjunct Assistant Professor in the Department of Health Management and Policy at the University of Michigan
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50
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Abstract
This paper examines the lawsuits brought by state and local government entities against prescription opioid producers and sellers. It examines their potential liability as well as some of the defenses they might raise. The paper also discusses multidistrict litigation and government lawsuits in state court. It concludes that litigation is not the best solution to the opioid crisis.
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Affiliation(s)
- Richard C Ausness
- Richard C. Ausness, J.D., LL.M., is the University Research Professor and Sites & Harbison Professor of Law at the University of Kentucky
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