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1.
Rev Saude Publica ; 53: 94, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31644724

RESUMO

OBJECTIVE: To evaluate trends in the use of generic and non-generic medicines to treat hypertension and diabetes under the Farmácia Popular Program (FP) and its impact on generic medicines sales volume and market share in the Brazilian pharmaceutical market. METHODS: This longitudinal, retrospective study used interrupted time series design to analyze changes in monthly sales volume and proportion of medicines sales (market share) for oral antidiabetic and antihypertensive medicines for generic versus non-generic products. Analyses were conducted in a combined dataset that aggregate monthly sales volumes from the Farmácia Popular program and from the QuintilesIMS™ (IQVIA) national market sales data from January 2007 to December 2012. The Farmácia Popular program phases analyzed included: a) 2009 reductions in medicines reference prices (AFP-II) and b) 2011 implementation of free medicines program for hypertension and diabetes, the Saúde não tem preço (SNTP - Health has no price). RESULTS: Patterns of use for FP-covered antidiabetic and antihypertensive medicines were similar to their use in the market in general. After one year of the decreases in government subsidies in April 2010, market share of antidiabetic and antihypertensive medicines experienced relative declines of -54.5% and -59.9%, respectively. However, when FP-covered medicines were made free to patients, overall market volume for antidiabetic and antihypertensive generics increased dramatically, with 242.6% and 277.0% relative increases by February 2012, as well as non-generics with relative increase of 209.7% and 279% for antidiabetic and antihypertensive medicines, respectively. CONCLUSIONS: Ministry of Health policies on the amount of patient cost sharing and on the choice of medicines on coverage lists have substantial impacts on overall generic sales volume in retail pharmacies.


Assuntos
Anti-Hipertensivos/uso terapêutico , Comércio/tendências , Serviços Comunitários de Farmácia/tendências , Medicamentos Genéricos/uso terapêutico , Hipoglicemiantes/uso terapêutico , Programas Nacionais de Saúde/tendências , Brasil , Comércio/estatística & dados numéricos , Serviços Comunitários de Farmácia/estatística & dados numéricos , Diabetes Mellitus/tratamento farmacológico , Política de Saúde , Humanos , Hipertensão/tratamento farmacológico , Análise de Séries Temporais Interrompida , Estudos Longitudinais , Programas Nacionais de Saúde/estatística & dados numéricos , Farmácias/estatística & dados numéricos , Farmácias/tendências , Avaliação de Programas e Projetos de Saúde , Valores de Referência , Estudos Retrospectivos , Fatores de Tempo
2.
Yakugaku Zasshi ; 139(4): 533-538, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-30930383

RESUMO

We have conducted health promotion workshops in Kobe City, beginning in June 2016, to promote the view of pharmacies as community health centers that provide not only medicine but also offer support for maintaining and enhancing a person's health. To this end, we collaborated with Kobe Women's University (KWU). Our health promotion workshops included: 1. Activities of daily living (ADL) exercises led by a KWU professional; 2. Lectures on various diseases by dietitians and pharmacists; 3. Nutritional guidance from a dietitian; 4. Health counseling by a pharmacist; and 5. Measurements of bone density, vascular age, and so on. A significant portion of the participants were relatively healthy and had strong legs. In October 2017, we investigated changes in the participants' awareness about health through a questionnaire study. We analyzed the results of 26 individuals who participated in the workshops more than once-18 of them (69%) expressed increased interest in exercise, 15 (58%) had begun walking regularly, and 11 (42%) changed their diet in terms of dietary fiber and salt. This suggests that our health promotion workshops brought about positive changes in people with regard to awareness of health and a healthy lifestyle. To further explore how pharmacies might contribute to healthy life expectancy, we will continue to investigate the relationship between changes in exercise and diet and people's awareness of health. As a group exercise, from now on we have decided to expand the role of pharmacies as community health promotion centers with the slogan "Extend healthy life expectancy by having fun".


Assuntos
Assistência à Saúde/métodos , Promoção da Saúde/métodos , Envelhecimento Saudável , Estilo de Vida Saudável , Colaboração Intersetorial , Expectativa de Vida , Farmácias , Universidades , Atividades Cotidianas , Centros Comunitários de Saúde/tendências , Dieta , Educação , Exercício , Educação em Saúde/métodos , Educação em Saúde/tendências , Humanos , Japão , Farmácias/tendências , Inquéritos e Questionários
3.
J Opioid Manag ; 14(5): 373-380, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30387860

RESUMO

OBJECTIVE: To characterize pharmacy-related theft data reported to the Rx Pattern Analysis Tracking Robberies and Other Losses (RxPATROL®) database during the time periods before (2007-2010) and after (2011-2016) the August 2010 switch to reformulated OxyContin® (oxycodone hydrochloride) extended-release tablets (Purdue Pharma L.P.). METHODS: The RxPATROL® database was queried to identify characteristics associated with theft of drug products. Variables analyzed included incident counts, drugs involved (OxyContin or other oxycodone products), pharmacy-security features, and other incident-related information. The data captured from 2007 to 2010, defined as the original formulation period, were compared with those captured from 2011 to 2016, defined as the post-reformulation period. RESULTS: A total of 6,905 incidents were reported from 2007 to 2016, with robbery (51.8 percent) and burglary (26.4 percent) being the most commonly reported incidents. The number of total robbery incidents reported peaked in 2010 and remained steady. Incidents reported as robberies that involved OxyContin initially increased from 2007 to 2010 and then steadily decreased from 296 in 2010 to 13 in 2016. Total burglary reports decreased from 2009 to 2015 and slightly increased from 2015 to 2016. Total burglary reports that involved OxyContin decreased after 2009. Total burglary reports that involved oxycodone remained steady from 2009 to 2014, decreased from 2014 to 2015, and remained steady from 2015 to 2016. The majority of reported incidents occurred on weekdays and involved suspects who entered and exited through the front door at pharmacies without security features such as alarms, dead bolts, and cameras. CONCLUSION: Following replacement of the original formulation of OxyContin with a new formulation that has abuse-deterrent properties in 2010, pharmacy thefts of OxyContin reported to the RxPATROL® database decreased. The decreases were not fully explained by concurrent trends in total robbery or burglary incidents reported to the RxPATROL® database over the same time period.


Assuntos
Formulações de Dissuasão de Abuso , Analgésicos Opioides/provisão & distribução , Substâncias Controladas/provisão & distribução , Oxicodona/provisão & distribução , Farmácias/tendências , Desvio de Medicamentos sob Prescrição/tendências , Roubo/tendências , Bases de Dados Factuais , Humanos , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Uso Indevido de Medicamentos sob Prescrição/prevenção & controle , Uso Indevido de Medicamentos sob Prescrição/tendências , Fatores de Tempo , Estados Unidos
5.
Farm. comunitarios (Internet) ; 10(3): 3-4, 28 sept., 2018. ilus
Artigo em Espanhol | IBECS | ID: ibc-175233
6.
Rural Policy Brief ; 2018(2): 1-6, 2018 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-30080364

RESUMO

This Policy Brief continues the series of reports from the RUPRI Center updating the number of pharmacy closures in rural America with annual data. See our website for other analyses of trends and assessment of issues confronting rural pharmacies. Key Findings: (1) Over the last 16 years, 1,231 independently owned rural pharmacies (16.1 percent) in the United States have closed. The most drastic decline occurred between 2007 and 2009. This decline has continued through 2018, although at a slower rate. (2) 630 rural communities that had at least one retail (independent, chain, or franchise) pharmacy in March 2003 had no retail pharmacy in March 2018.


Assuntos
Fechamento de Instituições de Saúde/estatística & dados numéricos , Farmácias/provisão & distribução , Serviços de Saúde Rural/provisão & distribução , Previsões , Fechamento de Instituições de Saúde/tendências , Humanos , Medicare Part D , Farmácias/estatística & dados numéricos , Farmácias/tendências , Serviços de Saúde Rural/tendências , População Rural , Estados Unidos
9.
Int J Clin Pharm ; 40(2): 412-420, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29435910

RESUMO

Background The management of multiple long-term medicines of patients with chronic diseases creates a burden for patients. However, limited research is performed on its impact on patients' daily lives. Objective The aim of this study was to explore the impact of cardiovascular medication on different daily life aspects and to examine differences of these aspects between adherent and non-adherent patients. Setting Two community pharmacies in the Netherlands. Method In this cross-sectional study patients (≥ 45 years) using cardiovascular medication participated. Two equally group sized samples of patients non-adherent as assessed with pharmacy refill data, and patients adherent were selected. Main outcome measure Data were collected by means of the Living with Medicines Questionnaire measuring the impact of medicines use on patients' daily lives. Results In total, 196 patients participated, including 96 non-adherent patients. Substantial proportions of patients experienced medication-related burden on different daily life aspects. This burden was mainly related to the acceptance of long-term medicine use, medication-related concerns or dissatisfaction, the interference of medicines with social and daily lives, and the interaction and communication with health care providers. No statistically significant results were found when comparing the impact on patients' daily lives between adherent and nonadherent patients. Conclusion Health care providers should acknowledge the impact of multiple long-term medicines on patient's daily lives and should make an effort to diminish patients' medication-related burden by improving patient-provider relationships and by providing adequate treatment information incorporating patients' individual circumstances. This may facilitate the integration of long-term medicine use in patients' daily lives.


Assuntos
Atividades Cotidianas , Fármacos Cardiovasculares/administração & dosagem , Adesão à Medicação , Farmácias/tendências , Inquéritos e Questionários , Idoso , Idoso de 80 Anos ou mais , Fármacos Cardiovasculares/efeitos adversos , Estudos Transversais , Esquema de Medicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia
10.
Eur J Health Econ ; 19(8): 1087-1110, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29445942

RESUMO

The present paper provides first empirical evidence on the relationship between market size and the number of firms in the healthcare industry for a transition economy. We estimate market-size thresholds required to support different numbers of suppliers (firms) for three occupations in the healthcare industry in a large number of distinct geographic markets in Slovakia, taking into account the spatial interaction between local markets. The empirical analysis is carried out for three time periods (1995, 2001 and 2010) which characterise different stages of the transition process. Our results suggest that the relationship between market size and the number of firms differs both across industries and across periods. In particular, we find that pharmacies, as the only completely liberalised market in our dataset, experience the largest change in competitive behaviour during the transition process. Furthermore, we find evidence for correlation in entry decisions across administrative borders, suggesting that future market analysis should aim to capture these regional effects.


Assuntos
Competição Econômica/organização & administração , Competição Econômica/tendências , Setor de Assistência à Saúde/organização & administração , Setor de Assistência à Saúde/tendências , Odontólogos/tendências , Setor de Assistência à Saúde/economia , Humanos , Modelos Econômicos , Farmácias/tendências , Médicos/tendências , Características de Residência , Eslováquia , Fatores Socioeconômicos , Análise Espacial
11.
Health Mark Q ; 35(2): 100-119, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30698099

RESUMO

This study investigates current attitudes and opinions toward pharmacies' advertising. The purposes of this study were to determine (a) consumers' attitudes toward advertising by pharmacies and (b) whether age, race, income, marital status, occupation, education, sex, and number of children in household of the consumer accounted for any significant difference in attitudes toward pharmacies that advertise. The intent was to discover information that would be useful to pharmacies in planning marketing strategies and improving the quality of their advertising. The study seems to confirm the belief of many pharmacies that advertising and marketing clearly have a place in the future of pharmacists' services.


Assuntos
Atitude Frente a Saúde , Comportamento do Consumidor , Marketing/tendências , Farmácias/tendências , Criança , Comércio/tendências , Feminino , Humanos , Masculino , Relações Públicas , Fatores Socioeconômicos , Inquéritos e Questionários
12.
Intern Emerg Med ; 12(8): 1081-1086, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28929326

RESUMO

Early identification of atrial fibrillation (AF) is now a priority in cardiovascular prevention because AF is common although often asymptomatic, and is associated with poor outcomes that are highly preventable with appropriate medical treatment. In Italy, AF prevalence among subjects aged ≥65 years ranges from 5 to 6% in observational studies based on the diagnosis recorded by general practitioners to 10-11% in studies where ECG screening is routinely offered. It is thus evident that a large number of subjects are not detected by conventional approach, and new strategies are required to increase early detection of AF. In particular, the changing position of pharmacies in the health system should be considered. Because of its small geographical size, insular nature and captive population, the Isle of Elba represents an ideal setting to test new strategies for stroke reduction. The Elba-FA project was thus designed to determine the feasibility and impact of the combined involvement of pharmacies and general practices to screen undiagnosed AF, with the ultimate aim of reducing the burden of stroke and arterial thromboembolism. The findings obtained with this approach might have broad implications for cardiovascular prevention at the general population level in Italy.


Assuntos
Fibrilação Atrial/diagnóstico , Fibrilação Atrial/tratamento farmacológico , Programas de Rastreamento/métodos , Farmacêuticos/normas , Idoso , Idoso de 80 Anos ou mais , Fibrilação Atrial/epidemiologia , Estudos Transversais , Feminino , Humanos , Itália/epidemiologia , Masculino , Farmácias/tendências , Prevalência , Medição de Risco/métodos , Acidente Vascular Cerebral/prevenção & controle
13.
Trends Psychiatry Psychother ; 39(3): 158-164, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28767928

RESUMO

INTRODUCTION: Clozapine is a well-recognized effective treatment for some patients with treatment-resistant schizophrenia (TRS). Although it has potential benefits and approximately 30% of patients have a clinical indication for clozapine use, prescription rates are low. OBJECTIVE: To evaluate clozapine prescription trends over a 5-year period in a tertiary psychiatric hospital. METHODS: In this observational study, data prospectively collected by the Medical and Statistical File Service (Serviço de Arquivo Médico e Estatístico) and the Pharmacy Division of Instituto de Psiquiatria de Santa Catarina between January 2010 and December 2014 were summarized and analyzed by investigators blinded to data collection. The number of 100 mg clozapine pills dispensed by the Pharmacy Division to the inpatient units was the outcome and considered a proxy measure of clozapine prescriptions. The number of occupied inpatient unit beds and the number of patients admitted with F20-F29 (ICD-10) diagnoses during the study period were considered to be possible confounders. RESULTS: A multiple linear regression model showed that time in months was independently associated with an increase in the number of clozapine pills dispensed by the Pharmacy Division (ß coefficient = 15.82; 95% confidence interval 10.88-20.75). CONCLUSION: Clozapine prescriptions were found to have increased during the 5-year period studied, a trend that is opposite to reports from several other countries.


Assuntos
Antipsicóticos/uso terapêutico , Clozapina/uso terapêutico , Hospitais Psiquiátricos/tendências , Brasil , Feminino , Humanos , Pacientes Internados , Modelos Lineares , Estudos Longitudinais , Masculino , Farmácias/tendências , Estudos Prospectivos , Esquizofrenia/tratamento farmacológico , Esquizofrenia/epidemiologia , Transtorno da Personalidade Esquizotípica/tratamento farmacológico , Transtorno da Personalidade Esquizotípica/epidemiologia , Centros de Atenção Terciária/tendências
14.
BMC Health Serv Res ; 17(1): 606, 2017 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-28851428

RESUMO

BACKGROUND: Community pharmacies are major contributors to health care systems across the world. Several studies have been conducted to evaluate community pharmacies services in health care. The purpose of this study was to estimate the social and economic benefits of current and potential future community pharmacies services provided by pharmacists in health care in Portugal. METHODS: The social and economic value of community pharmacies services was estimated through a decision-model. Model inputs included effectiveness data, quality of life (QoL) and health resource consumption, obtained though literature review and adapted to Portuguese reality by an expert panel. The estimated economic value was the result of non-remunerated pharmaceutical services plus health resource consumption potentially avoided. Social and economic value of community pharmacies services derives from the comparison of two scenarios: "with service" versus "without service". RESULTS: It is estimated that current community pharmacies services in Portugal provide a gain in QoL of 8.3% and an economic value of 879.6 million euros (M€), including 342.1 M€ in non-remunerated pharmaceutical services and 448.1 M€ in avoided expense with health resource consumption. Potential future community pharmacies services may provide an additional increase of 6.9% in QoL and be associated with an economic value of 144.8 M€: 120.3 M€ in non-remunerated services and 24.5 M€ in potential savings with health resource consumption. CONCLUSIONS: Community pharmacies services provide considerable benefit in QoL and economic value. An increase range of services including a greater integration in primary and secondary care, among other transversal services, may add further social and economic value to the society.


Assuntos
Farmácias , Qualidade de Vida , Valores Sociais , Serviços Comunitários de Farmácia/economia , Assistência à Saúde , Previsões , Humanos , Farmácias/economia , Farmácias/tendências , Portugal
15.
J Am Pharm Assoc (2003) ; 57(6): 661-669, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28807659

RESUMO

OBJECTIVES: Gaps in vaccination coverage leave populations vulnerable to illnesses. Since the 1990s, there has been a growing movement to improve vaccination access by giving pharmacists the authority to administer vaccines according to state laws. Understanding the variation of pharmacist vaccination laws over time is critical to understanding the effect of improving access to vaccination services. METHODS: We identified relevant statutes and regulations with the use of Westlaw legal databases. A 4-stage coding process identified 220 legal variables of pharmacist vaccination authority. Each jurisdiction's laws were coded against these 220 legal variables. The resulting legal dataset was then evaluated to determine whether jurisdictions expanded or restricted pharmacist vaccination authorities over time. RESULTS: From 1971 to 2016, jurisdictions made 627 changes to statutes and regulations relating to pharmacist vaccination authority. There were 85 expansions, 3 restrictions, and 22 regulatory clarifications. Eight changes were deemed to be unclear, and 479 changes did not substantively alter the scope of pharmacist vaccination authority. CONCLUSION: Collectively, the laws in 50 states and DC paint a clear picture: the scope of pharmacists' vaccination authority is expanding. Jurisdictions are allowing pharmacists to administer more vaccines to younger patients with less direct prescriber oversight. This clear expansion of pharmacist vaccination authority stands in contrast to the reservations expressed by some physician groups for pharmacists as vaccination providers. However, laws in some states still do not permit pharmacists to vaccinate according to the Advisory Committee on Immunization Practices recommendations.


Assuntos
Serviços Comunitários de Farmácia/legislação & jurisprudência , Regulamentação Governamental , Planejamento em Saúde/legislação & jurisprudência , Política de Saúde/legislação & jurisprudência , Farmácias/legislação & jurisprudência , Farmacêuticos/legislação & jurisprudência , Papel Profissional , Governo Estadual , Vacinação/legislação & jurisprudência , Serviços Comunitários de Farmácia/tendências , Assistência à Saúde/legislação & jurisprudência , Planejamento em Saúde/tendências , Política de Saúde/tendências , Disparidades em Assistência à Saúde/legislação & jurisprudência , Humanos , Farmácias/tendências , Farmacêuticos/tendências , Formulação de Políticas , Fatores de Tempo , Estados Unidos , Vacinação/efeitos adversos , Vacinação/tendências
16.
J Popul Ther Clin Pharmacol ; 24(2): e20-e50, 2017 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-28594479

RESUMO

BACKGROUND: We hypothesized that medication adherence is affected by the number of pharmacies a patient frequents. OBJECTIVES: The objective was to estimate the strength of association between the number of pharmacies a patient frequents and adherence to statins. METHODS: Using administrative data from the Nova Scotia Seniors' Pharmacare program, a retrospective cohort study was conducted among subjects aged 65 years and older first dispensed statin between 1998 and 2008. The Usual Provider of Care (UPC), was defined as the number of dispensation days from the most frequented pharmacy divided by the total number of dispensation days. Estimated adherence of over 80% of the Medication Possession Ratio was defined as adherent. Data were analyzed using hierarchical linear regression. RESULTS: The cohort of 25,641 subjects was 59% female with a mean age of 74 years. During follow-up, subjects filled prescriptions in a median of 2 (mean = 2; standard deviation = 0.88) pharmacies and visited pharmacies a median of 28 (mean = 30) times. During that time, 61% of patients used one pharmacy exclusively. Among subjects using 1 pharmacy, 59% were adherent while 58% using more than one pharmacy were adherent. However, upon adjustment for differences in distributions of age, sex, and other confounders, subjects who used more than one pharmacy had 10% decreased odds of statin adherence (odds ratio: 0.90, 95% confidence interval: 0.86-0.96). These results were robust in sensitivity analyses. CONCLUSIONS: Among seniors newly starting statin therapy, using a single community pharmacy was modestly associated with adherence.


Assuntos
Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Adesão à Medicação , Conduta do Tratamento Medicamentoso/tendências , Farmácias/tendências , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Seguimentos , Humanos , Masculino , Nova Escócia/epidemiologia , Estudos Retrospectivos
17.
Am J Health Syst Pharm ; 74(14): 1076-1083, 2017 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-28522642

RESUMO

PURPOSE: Overall and specific class trends in systemic antifungal expenditures in various U.S. healthcare settings from 2005 through 2015 were evaluated. METHODS: Systemic antifungal expenditures from January 1, 2005, through December 31, 2015, were obtained from the QuintilesIMS National Sales Perspective database, which provides a statistically valid projection of medication purchases from multiple markets throughout the United States. Summary data for total antifungal expenditures over the entire period are reported, as are growth and the percentage change in expenditures from one year to the next. Expenditures were also assessed specifically by year, class, and healthcare setting. Expenditure trends over the study period were assessed using simple linear trend regression models. RESULTS: Overall expenditures for the 11-year period were $9.37 billion. The greatest proportion of expenditures occurred in nonfederal hospitals (47.2%) and for triazoles (57.6%). From 2005 through 2015, total expenditures decreased from $1.1 billion to $894 million (-18.8%, p = 0.09); however, expenditures in clinics and retail pharmacies increased (202%, p < 0.01, and 13.8%, p = 0.04, respectively), a trend most pronounced after 2012. Expenditures for flucytosine also increased (968.1%, p < 0.01), particularly in clinics where there was a dramatic 6,640.9% increase (p < 0.01). CONCLUSION: From 2005 through 2015, an increase in systemic antifungal expenditures was observed in community settings, despite an overall decrease in total antifungal expenditures in the United States. Large increases in flucytosine expenditures were observed, particularly in the community.


Assuntos
Antifúngicos/classificação , Antifúngicos/economia , Custos de Medicamentos/classificação , Custos de Medicamentos/tendências , Gastos em Saúde/tendências , Bases de Dados Factuais/tendências , Economia Hospitalar/tendências , Humanos , Farmácias/economia , Farmácias/tendências , Estudos Retrospectivos , Estados Unidos
18.
BMC Pharmacol Toxicol ; 18(1): 11, 2017 02 14.
Artigo em Inglês | MEDLINE | ID: mdl-28193258

RESUMO

BACKGROUND: Non-prescription access to antimicrobials is common, and self-prescribing is increasingly popular in Russian society. The aim of this study was to assess the attitudes of community pharmacists regarding antibiotic use and self-medication. METHODS: We conducted a cross-sectional study from September-December 2015 of community pharmacists in the Saint-Petersburg and Leningrad region, Russia. A self-administered questionnaire was used to assess antibiotic use and self-medication practices. The data were analysed using logistic regression and Pearson chi-squared tests. RESULTS: Of the 316 pharmacists (77.07%) who completed the questionnaire, 230 (72.8%) self-medicated with antibiotics. Antibiotics were mostly used to self-treat upper (53.3%) and lower respiratory tract infections (19.3%), relying on their own knowledge (81.5%), previous treatment experience (49%) and patients' prescriptions (17%). The most commonly used antibiotics were macrolides (33.2%). Characteristics such as age, education and experience were related to antibiotic use and self-medication. CONCLUSIONS: The study confirmed that self-prescription of antibiotics is a common practice amongst pharmacists in Saint Petersburg and also identified personal and professional characteristics of pharmacists strongly associated with self-medication.


Assuntos
Antibacterianos/administração & dosagem , Atitude do Pessoal de Saúde , Farmácias/normas , Farmacêuticos/normas , Automedicação/normas , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Farmácias/tendências , Farmacêuticos/psicologia , Farmacêuticos/tendências , Federação Russa/epidemiologia , Automedicação/psicologia , Automedicação/tendências , Autorrelato , Adulto Jovem
19.
J Manag Care Spec Pharm ; 22(9): 1010-7, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27574742

RESUMO

BACKGROUND: The past 25 years have seen a substantial increase in the effect of specialty drugs on patient care. These agents were initially not considered financially viable because they often served a comparatively small market of patients. However, the extended monopoly afforded to manufacturers of these drugs by the Orphan Drug Act of 1983 has made treatment of rare diseases, which specialty drugs often target, a more viable option. As a result, pharmaceutical companies began to increase research and development expenditures in this area, and the pipeline of specialty drugs began to grow in the late 1980s. OBJECTIVE: To analyze the annual change in wholesale acquisition cost (WAC) pricing of specialty drugs sold over a period of 11 years. METHODS: Pharmacy claims data, including date and WAC, were collected for each specialty drug transaction that occurred from 2002 through 2013 at the University of Illinois at Chicago Ambulatory Care Pharmacy Department. The data were organized to create a chronological sequence of WAC values from the initial to final sales of each available drug. Those values were then used to calculate annual percentage of change in WAC. These results were grouped into subsets and graphed in order to illustrate the effects that various factors had on the annual changes in price. RESULTS: The price of the specialty drugs studied has generally shown a greater rate of increase since experiencing a trough rate increase in 2009 of 4.08%. The economic crisis of 2008 created a short pause in this overall trend, but increases in the rate of price growth have since rebounded. WACs increased at a rate of 7.03% or greater from 2010 through the end of the study period. There was a clear increase over the last few years of the study in the number of drugs with more than 10% annual increases in WAC, which has also shown a rebound after the economic crisis at the end of the last decade. CONCLUSIONS: Specialty drugs are getting more expensive at a faster rate over time. The period from 2010 to 2013, the final year of this study, has also seen biologic agents take a more prominent role in driving these annual increases in WAC. DISCLOSURES: No funding was provided for the commission of this study. The source data was provided by the University of Illinois at Chicago Ambulatory Care Pharmacy Department and described de-identified data from customer transactions from 2002 through 2013. The authors report no conflicts of interest. Study concept and design and data interpretation were contributed by Stubbings and Penington. The manuscript was written primarily by Penington with assistance from Stubbings.


Assuntos
Produtos Biológicos/economia , Comércio/economia , Comércio/tendências , Custos de Medicamentos/tendências , Farmácias/tendências , Feminino , Humanos , Masculino , Produção de Droga sem Interesse Comercial/economia , Assistência Farmacêutica/economia , Assistência Farmacêutica/tendências , Farmácias/economia , Farmácia/tendências , Estudos Retrospectivos
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