The Effects of Childhood Circumstances on Health in Middle and Later Life: Evidence From China.

Background: This study examined the relationship between childhood circumstances and health in middle and later life. We quantified how childhood circumstances contribute to health in later life, both directly and indirectly, through their effects on potential mediators. Methods: This study used three waves of data from the national longitudinal survey of the China Health and Retirement Longitudinal Study (CHARLS). The final model in this study included 7,476 eligible respondents aged 45 years and above. We constructed a simple health status measure based on the first principal component of CHARLS survey responses with 25 health-related information. It is a multi-dimensional measurement that comprehensively reflects the individual's healthy aging. We formulated childhood circumstances factors into five domains: childhood health and nutrition, childhood socioeconomic status, access to health care, parental genetics, and adverse childhood experiences. Ordered logit regression was conducted to analyze the relationship between health in middle and later life and childhood circumstances, with other explanatory variables controlled. Results: Controlling for educational attainment, personal income, and health status in the last wave, adults who experience good childhood health (poor as the base, coefficient 0.448, p < 0.01), and better family financial status (worse as the base, coefficient 0.173, p < 0.01) have significantly better health during their middle and later life, in comparison, being inconvenient to visit a doctor (coefficient -0.178, p < 0.01), and having two or three adverse childhood experiences (0 as the base, coefficient -0.148, p < 0.01) are significantly associated with poorer health. Childhood circumstances appear to act both through a lasting effect of initial health and financial status in childhood and through their impact on achievements in adulthood. Conclusion: Our findings suggest that investments in health during childhood not only contribute to health in later life but also dynamically improve an individual's educational attainment and personal income, as well as other life prospects. All these returns may extend far beyond childhood and continue throughout the lifespan.

Advances on application of fenugreek seeds as functional foods: Pharmacology, clinical application, products, patents and market.

Trigonella foenum-graecum L. (fenugreek) is one of the oldest applied medicinal herbs. Significant pharmacological and clinical evidence have highlighted the medicinal application of fenugreek. Explore the current knowledge regarding the bioactivity (animal aspects) and clinical application of fenugreek and its bioactive components, as well as the products, markets and patents related to fenugreek. This review highlights the phytochemicals, bioactivity (animal aspects) and clinical application of fenugreek from recent literatures and products, markets and patents from database. Until now, more than 100 phytochemicals have been isolated from fenugreek seeds, mainly including polysaccharides, saponins, alkaloids, phenolic acids, and flavonoids. Fenugreek extract and its bioactive compounds showed excellent antidiabetic activity and anti-obesity activity in animal and human study. Although the fenugreek seed has been used as TCM raw materials for a long time of period in China, China is lacking the research of fenugreek in both depth and width.

Research and development of mAb drugs in China: a look from policy perspectives.

Background: Monoclonal antibody (mAb) drugs are increasingly important for the pharmaceutical industry across the globe. In China, mAb drug developments face many challenges. Multiple policies have been implemented recently to reinforce support in various areas. This study aims to investigate the latest landscape of mAb drugs in China from policy perspectives encompassing R&D, clinical trials, marketing approval, and talent pools.Methods: Information about mAb drugs approved in the United States, the European Union, Japan, and China by 2017 and mAb-related policies in China were retrieved from government websites and third-party statistical databases for descriptive, statistical, and comparative analysis.Results and discussion: In China, 21 mAb drugs (10 locally-developed and 11 imported) have so far been approved. For the 11 imported mAb drugs in China, the median drug lag in the marketing approval was estimated at 87.1 months, compared with the U.S. (0 months), the EU (8.9 months), and Japan (43.4 months). However, as far as the dramatically changing innovation supporting system in China is concerned, emergence of new biopharmaceutical companies, transformation of the current drug companies and their shift to antibody therapy, and the pooling of high-level talent contribute to mAb development in China. The number of clinical trials and marketing applications and approvals involving mAb drugs is also growing. Favorable policies will continue to play a role in the sustainable development of mAb drugs in China.Conclusion: The research showed that the reform of multiple policies and incentives for attracting/retaining high-level talent has evidently been effective in addressing the drug lag of mAb drugs in China. In future development, China should actively monitor the global R&D outcomes and industrial development trends of mAb drugs and make the policy environment more attractive to enable more mAb drugs to be marketed in China as soon as possible.

China's new policy for healthcare cost-control based on global budget: a survey of 110 clinicians in hospitals.

BACKGROUND: The increasing cost on healthcare exposes China's healthcare budgets and system to financial crisis. To control the excessive growth of healthcare expenditure, China's healthcare reforms emphasize the control of the global budget for healthcare, which leads to the release of relevant policy and a series of cost-control actions implemented by different hospitals. This work aims to identify the effects brought by the cost-control policy and actions via surveying and analysing feedback from clinicians. METHODS: Questionnaires on the cost-control policy and actions were designed for surveying 110 clinicians in hospitals from different regions of China. The data on the implementation of the cost-control actions and doctors' feedback on these actions were analysed using descriptive statistics. Pearson's chi-squared tests were performed to detect associations between doctors' opinions and specific cost-control actions. A value of p < 0.05 was considered statistically significant. Association relationships between doctors' opinions and cost-control actions were modelled into network models, and key factors were identified in a multi-variate framework. Last, we visualized our resultant data using a network model, and further multi-variate analysis was performed. RESULTS: There were three main findings. (1) The cost-control policy has been widely implemented in the sampled hospitals in different regions of China, with more than 80% of those surveyed acknowledging that their hospitals take actions of reducing average prescription fees for outpatients, drug costs, and in-hospitalization durations. (2) Most doctors have a negative view of some cost-control actions; this is mainly due to concerns about the effects of these actions on the doctors' own healthcare performance and patient satisfaction. (3) Cost-control actions that had a significant impact on doctors' performance included limiting average prescription fees for outpatients and limiting the use of examinations/drugs/surgeries. Decreased patient satisfaction was associated with fewer admissions of critically ill patients, reduced use of brand-name drugs, and increased total costs to patients due to increased frequencies of visits to the hospitals. CONCLUSIONS: Cost-control actions implemented in hospitals in response to the government's policy to reduce its national healthcare budget affect both doctors and patients in several ways. Moreover, the cost-control policy and actions can be improved.

Opportunities and Challenges of Multinational Pharmaceutical Enterprises in Transforming Pharmaceutical Market in China.

The surging costs of health care in China is highly related to the high expenses in pharmaceutical costs. Since the Government of China launched the health care reform in 2009, the issue of growing pharmaceutical expenditure continues to grasp policy makers' attention. Since 2015, an ongoing series of drug-related policies have been revised or developed, resulting in profound impact on the overall pharmaceutical market in China, and the dynamic is still evolving. As China has become the second largest pharmaceutical market in the world, any volatility in the Chinese pharmaceutical market may have great implications to multinational pharmaceutical markets that have had their products launched in China or plan to extend their business to the Chinese market. Based on a comprehensive analysis of the most recent health care reform policies in China, the objectives of this study were to identify the major opportunities appealed to and the challenges confronted by multinational pharmaceutical enterprises in the current Chinese pharmaceutical market.

Evolving patterns in a collaboration network of global R&D on monoclonal antibodies.

We investigated the evolution process of collaborative inter-organizational network of the research and development (R&D) on monoclonal antibody (mAb) over the past 30 y. The annual detection of the collaboration network provides dynamics on network structures and relationship changes among different organizations. Our research showed continuous growth of the network's scale and complexity due to the constant entry of new organizations and the forging of new partnering relationships. The evolving topological features reveal a core-periphery structure that became clearer over time and an increasing heterogeneity within the collaborative mAb R&D network. As measured by the number of network participants, dedicated biotechnology firms (DBFs) were the dominant organization form in the field of mAb development, but their average centrality was reduced during the period of 2004-2009, when pharmaceutical companies took over the positions of DBFs. Along with the network evolution, 2 waves of substitution on the leading positions were driven by technological innovations and mergers and acquisitions (M&A). In addition, this study analyzed organizational-level behaviors to help understand the evolution of network structures over the field of mAb development across the different technologically innovative or economic contexts.

Obstacles and opportunities in Chinese pharmaceutical innovation.

BACKGROUND: Global healthcare innovation networks nowadays have expanded beyond developed countries with many developing countries joining the force and becoming important players. China, in particular, has seen a significant increase in the number of innovative firms and research organizations stepping up to the global network in recent years. Nevertheless, the intense Research and Development input has not brought about the expectable output. While China is ascending at a great speed to a leading position worldwide in terms of Research and Development investment, scientific publications and patents, the innovation capabilities in the pharmaceutical sector remain weak. DISCUSSION: This study discusses the challenges and opportunities for pharmaceutical innovation in China. One hand, academic, industrial, institutional and financial constraints were found to be the major and inevitable barriers hindering the development of drug innovation. On the other hand, unique advantages had been observed which included growing pharmaceutical market, Research and Development funding, distinctive source, and international cooperation. The most important thing for China's pharmaceutical sector to leap forward is to break though innovation barriers and integrate own advantages into global value-chain of healthcare product development.

An investigation Into Traditional Chinese Medicine Hospitals in China: Development Trend and Medical Service Innovation.

BACKGROUND: This paper aims to investigate the development trend of traditional Chinese medicine (TCM) hospitals in China and explore their medical service innovations, with special reference to the changing co-existence with western medicine (WM) at TCM hospitals. METHODS: Quantitative data at macro level was collected from official databases of China Health Statistical Yearbook and Extracts of Traditional Chinese Medicine Statistics. Qualitative data at micro level was gathered through interviews and second-hand material collection at two of the top-level TCM hospitals. RESULTS: In both outpatient and inpatient sectors of TCM hospitals, drug fees accounted for the biggest part of hospital revenue. Application of WM medical exanimation increased in both outpatient and inpatient services. Even though the demand for WM drugs was much higher in inpatient care, TCM drugs was the winner in the outpatient. Also qualitative evidence showed that TCM dominated the outpatient hospital service with WM incorporated in the assisting role. However, it was in the inpatient medical care that WM prevailed over TCM which was mostly applied to the rehabilitation of patients. CONCLUSION: By drawing on WM while keeping it active in supporting and strengthening the TCM operation in the TCM hospital, the current system accommodates the overriding objective which is for TCM to evolve into a fully informed and more viable medical field.

Research and Development of Hepatitis B Drugs: An Analysis Based on Technology Flows Measured by Patent Citations.

Despite the existence of available therapies, the Hepatitis B virus infection continues to be one of the most serious threats to human health, especially in developing countries such as China and India. To shed light on the improvement of current therapies and development of novel anti-HBV drugs, we thoroughly investigated 212 US patents of anti-HBV drugs and analyzed the technology flow in research and development of anti-HBV drugs based on data from IMS LifeCycle databases. Moreover, utilizing the patent citation method, which is an effective indicator of technology flow, we constructed patent citation network models and performed network analysis in order to reveal the features of different technology clusters. As a result, we identified the stagnant status of anti-HBV drug development and pointed the way for development of domestic pharmaceuticals in developing countries. We also discussed about therapeutic vaccines as the potential next generation therapy for HBV infection. Lastly, we depicted the cooperation between entities and found that novel forms of cooperation added diversity to the conventional form of cooperation within the pharmaceutical industry. In summary, our study provides inspiring insights for investors, policy makers, researchers, and other readers interested in anti-HBV drug development.

Is the United States still dominant in the global pharmaceutical innovation network?

The dramatic growth of research and development activities in the pharmaceutical sector in emerging economies raises the question of whether the United States still keeps its dominant role in the global pharmaceutical innovation landscape. This paper focuses on investigating the role of the United States in global pharmaceutical innovation, and differs from previous studies by shifting attention to a network analytic perspective to track the global distribution of pharmaceutical inventions. Our sample is composed of key patents covering all new drugs approved by the Food and Drug Administration between 1996 and 2010. The results show that the United States still dominates in the global pharmaceutical innovation network, especially when it comes to essential core inventions. However, the United States shows a slightly decreasing prominence in the networks of either total new drugs or New Molecular Entity (NME) drugs in the time period 2006-2010 as compared to previous time periods, revealed by subtle traces of network centralities.

Patent indicators: a window to pharmaceutical market success.

Pharmaceutical success in the market is the best reward for pharmaceutical investors undergoing the lengthy, costly and risky process of pharmaceutical Research and Development (R&D). Drugs with high market revenues trigger fierce competition between pharmaceutical enterprises, as is demonstrated by the increasing Mergers & Acquisitions (M&A) cases focusing on seizing the best-selling products. On the other hand, patents, as the best shield for innovative drugs against generic drugs, become a powerful weapon for pharmaceutical enterprises to win the substantial returns generated by market exclusivity. Patents seem to be directly responsible for the commercial success of new medicines. In this context, it is of great significance to find out the empirical associations between pharmaceutical commercial success and patents. By comprehensively analysing 127 drugs marketed in the USA and their 621 American patents, this article identifies the evidence to link various patent indicators with pharmaceutical sales in actual market.

Multi-target drugs: the trend of drug research and development.

Summarizing the status of drugs in the market and examining the trend of drug research and development is important in drug discovery. In this study, we compared the drug targets and the market sales of the new molecular entities approved by the U.S. Food and Drug Administration from January 2000 to December 2009. Two networks, namely, the target-target and drug-drug networks, have been set up using the network analysis tools. The multi-target drugs have much more potential, as shown by the network visualization and the market trends. We discussed the possible reasons and proposed the rational strategies for drug research and development in the future.

[Analysis on layout of traditional Chinese medicine industry based on location quotient].

To observe the layout and evolution of the traditional Chinese medicine (TCM) medical industry, classify the industry by region and conduct a preliminary study on its professional advantages, competitiveness and possible cause by using the theory of location quotient in regional economics, in order to provide suggestions for the layout of the TCM medical industry.