This document summarizes a study analyzing the money flow pathways within Iran's drug system. 28 distinct pathways were identified through expert interviews. The pathways describe the flow of money from individuals paying for drugs out-of-pocket, to insurance reimbursements, to government subsidies and budgets allocated to universities, hospitals, and drug producers/importers. While domestic drug production meets 95% of domestic demand, issues remain around high out-of-pocket costs for individuals and the need for better management of drug prescribing and use.
Analysis of patient care and facility indicators ijrpppharmaindexing
This document analyzes patient care and facility indicators in public and private health institutions in Wolkite town, South West Ethiopia. Six hundred patients were interviewed prospectively in private and public facilities. The average consultation times were 9.0 minutes in private facilities and 5.5 minutes in public facilities. The average dispensing times were 17.5 seconds in private facilities and 11.1 seconds in public facilities. Shortages of essential drugs, treatment guidelines and drug lists were found in the facilities studied.
Forensic pharmacy applies pharmaceutical sciences to legal issues. Forensic pharmacists can interpret drug and alcohol levels, estimate intoxication levels at the time of events, and provide expertise in criminal cases involving drugs. They review insurance claims for off-label drug use and can testify whether an unlabeled use is reasonable. Forensic pharmacists also help identify fraud such as falsifying medical records, diverting controlled substances, or submitting fraudulent insurance claims. Their training in pharmacology, toxicology, and pharmacokinetics makes them valuable experts in legal cases involving drugs, poisoning, and intoxication.
This study evaluated prescribing patterns in outpatient departments at 24 secondary-level government hospitals in Tamilnadu, India. A total of 4,750 prescriptions were analyzed. The most common diagnoses were diseases of the respiratory system (990 cases), certain infectious and parasitic diseases (427 cases), and diseases of the skin and subcutaneous tissue (667 cases). On average, prescriptions contained 4 drugs, with antibiotics prescribed in 56% of cases. Based on the findings, an essential medicines list was prepared for each hospital category to improve prescribing practices.
This document discusses pharmacoeconomics in the Indian context. It begins by introducing the field of pharmacoeconomics and its growing importance in India given the large population and relatively scarce healthcare resources. It then provides an overview of how pharmacoeconomics can inform decisions regarding drug licensing, reimbursement, and formulary procedures. The role of pharmacology graduates in applying pharmacoeconomic principles to improve resource allocation in community and tertiary hospitals is also discussed.
Unauthorised and unregulated drugs lacking generic identities have flooded the local market through misleading advertising campaigns. These drugs are prescribed by some doctors in large quantities without knowing their effects. Loophole in laws allow import of herbal concoctions falsely labeled as drugs. Stricter implementation of National Drugs Policy is needed to regulate drug importation, distribution and sales. Random quality checks and making importers liable for failed batches can improve screening of imported drugs. Patients' rights include being informed of treatment risks and alternatives to expensive brands lacking proven benefits.
Problems and challenges faced in consumer reporting of adverse drug reactions...Mohammed Alshakka
This document discusses consumer reporting of adverse drug reactions (ADRs) in developing countries like Yemen, Nepal, and Malaysia. It finds that Malaysia has a good system for consumer involvement, while Yemen lacks drug policies and regulation. Nepal's system is still developing and lacks consumer reporting. Consumer reporting can provide additional information to national pharmacovigilance programs and help reduce ADR-related illness, but is still not widely implemented in developing countries.
This document discusses the basic components of clinical pharmaceutical care in Pakistan. It outlines eight components of clinical pharmacy practice: prescribing drugs, administering drugs, documenting services, reviewing drug use, communication, counseling, consulting, and preventing medication errors. It also discusses the scope of clinical pharmacy, including drug information, drug utilization reviews, medication therapy management, and disease state management. The document notes that Pakistan's clinical pharmaceutical system is poor compared to developed countries and identifies areas for improvement, including strengthening therapeutic drug monitoring, pharmacovigilance, and ensuring proper prescription reviews.
Analysis of patient care and facility indicators ijrpppharmaindexing
This document analyzes patient care and facility indicators in public and private health institutions in Wolkite town, South West Ethiopia. Six hundred patients were interviewed prospectively in private and public facilities. The average consultation times were 9.0 minutes in private facilities and 5.5 minutes in public facilities. The average dispensing times were 17.5 seconds in private facilities and 11.1 seconds in public facilities. Shortages of essential drugs, treatment guidelines and drug lists were found in the facilities studied.
Forensic pharmacy applies pharmaceutical sciences to legal issues. Forensic pharmacists can interpret drug and alcohol levels, estimate intoxication levels at the time of events, and provide expertise in criminal cases involving drugs. They review insurance claims for off-label drug use and can testify whether an unlabeled use is reasonable. Forensic pharmacists also help identify fraud such as falsifying medical records, diverting controlled substances, or submitting fraudulent insurance claims. Their training in pharmacology, toxicology, and pharmacokinetics makes them valuable experts in legal cases involving drugs, poisoning, and intoxication.
This study evaluated prescribing patterns in outpatient departments at 24 secondary-level government hospitals in Tamilnadu, India. A total of 4,750 prescriptions were analyzed. The most common diagnoses were diseases of the respiratory system (990 cases), certain infectious and parasitic diseases (427 cases), and diseases of the skin and subcutaneous tissue (667 cases). On average, prescriptions contained 4 drugs, with antibiotics prescribed in 56% of cases. Based on the findings, an essential medicines list was prepared for each hospital category to improve prescribing practices.
This document discusses pharmacoeconomics in the Indian context. It begins by introducing the field of pharmacoeconomics and its growing importance in India given the large population and relatively scarce healthcare resources. It then provides an overview of how pharmacoeconomics can inform decisions regarding drug licensing, reimbursement, and formulary procedures. The role of pharmacology graduates in applying pharmacoeconomic principles to improve resource allocation in community and tertiary hospitals is also discussed.
Unauthorised and unregulated drugs lacking generic identities have flooded the local market through misleading advertising campaigns. These drugs are prescribed by some doctors in large quantities without knowing their effects. Loophole in laws allow import of herbal concoctions falsely labeled as drugs. Stricter implementation of National Drugs Policy is needed to regulate drug importation, distribution and sales. Random quality checks and making importers liable for failed batches can improve screening of imported drugs. Patients' rights include being informed of treatment risks and alternatives to expensive brands lacking proven benefits.
Problems and challenges faced in consumer reporting of adverse drug reactions...Mohammed Alshakka
This document discusses consumer reporting of adverse drug reactions (ADRs) in developing countries like Yemen, Nepal, and Malaysia. It finds that Malaysia has a good system for consumer involvement, while Yemen lacks drug policies and regulation. Nepal's system is still developing and lacks consumer reporting. Consumer reporting can provide additional information to national pharmacovigilance programs and help reduce ADR-related illness, but is still not widely implemented in developing countries.
This document discusses the basic components of clinical pharmaceutical care in Pakistan. It outlines eight components of clinical pharmacy practice: prescribing drugs, administering drugs, documenting services, reviewing drug use, communication, counseling, consulting, and preventing medication errors. It also discusses the scope of clinical pharmacy, including drug information, drug utilization reviews, medication therapy management, and disease state management. The document notes that Pakistan's clinical pharmaceutical system is poor compared to developed countries and identifies areas for improvement, including strengthening therapeutic drug monitoring, pharmacovigilance, and ensuring proper prescription reviews.
A new study adds further evidence to suggest that opioid prescribing in the U.S. is skewed and concentrated among a few providers. Researchers looked at prescribing patterns in data from an unspecified national private insurer between 2003-2017.
Around 670,000 providers prescribed more than 8 million standard doses of opioid prescriptions — but more than a quarter of these prescriptions were written by only 1% of physicians. And in 2017, these physicians prescribed nearly half of all the dispensed opioids. This small group of doctors also prescribed higher doses than recommended, and for longer durations than guidelines allow.
What’s encouraging, the authors suggest, is that the vast majority of physicians do seem to follow guidelines. Some caveats: The study was based on one company’s data, and didn’t look at medical reasons behind prescriptions.
Patients' Perceptions of Community Pharmacy Practice in UAE: An Overviewiosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
The document discusses drug information centers and poison information centers. It provides details on:
- The history and development of the first drug information centers (DICs) and poison control centers (PCCs) in the 1960s in the US and other countries.
- The aims of DICs and PCCs, which include providing drug and poison information to health professionals, developing guidelines, education programs, and participating in research.
- The staffing of DICs and PCCs, which usually includes pharmacists, pharmacy technicians, toxicologists, and others with library sciences backgrounds.
- The processes DICs use to respond to drug information requests, which follow a systematic approach of
This document summarizes a study conducted in Utah that interviewed friends and family of individuals aged 13 and older who died from a drug overdose between October 2008 and October 2009. The study found that overdoses involving prescription opioids were most common among those aged 25-54, with oxycodone, methadone, hydrocodone, and alprazolam most frequently implicated. Characteristics strongly correlated with overdose death included financial problems, past substance abuse, and mental illness. Unemployment, past substance abuse history, and mental illness diagnosis merit further investigation to better understand their relationship to unintentional prescription opioid overdoses.
This document summarizes a study conducted in Lebanon to identify priority policy research questions regarding access to and use of medicines. Literature review found the evidence base on this topic to be weak, with existing studies addressing issues like prescribing behaviors but not comprehensively. Interviews with key informants identified many policy concerns across financing, rational use, pricing, and health systems. Researchers consolidated these into a list of 57 questions, which stakeholders prioritized into a final list of 22 questions. The top five priority questions addressed issues including assessing medicine quality and counterfeits, attitudes towards generic substitution, the role of civil society organizations in improving access, whether access to medicines is a policy priority, and what happens at dispensaries regarding adherence to generics. The
This document summarizes a study on clinical pharmacist interventions in Iraqi hospitals. The study analyzed 4049 interventions made by 54 clinical pharmacists trainees over 12 months. It found that the most common interventions were for drug-drug interactions (40.97%), unavailability of drugs (26.87%), and dosing issues (10.18%). Interventions regarding antibiotics most frequently addressed drug-drug interactions (42.43%) and unavailability (19.34%). The study highlights the important role clinical pharmacists play in optimizing medication use and addressing issues like drug shortages.
This study assessed the prescription pattern of injections at the outpatient pharmacy of Adama Hospital Medical College in Ethiopia. Some key findings include:
- 600 injections were prescribed over 500 prescriptions. The most commonly prescribed classes were injectable antibiotics, anti-pains, and diuretics.
- Prescriptions were generally well filled out, though some lacked information like the patient's address. Prescriber information like qualifications was missing from many.
- Injections were mostly prescribed appropriately in terms of dose, duration and frequency. However, a small percentage showed issues like incorrect antibiotic dosing.
- The study concludes rational injection use was generally found, though some problems need addressing like incomplete
- A study analyzed 1642 patient complaints over 30 months at a large heart center in Tehran, Iran.
- The majority of complaints were related to admission procedures (34.7%) and communication (34.1%). Verbal complaints accounted for 89.2% of total complaints.
- Most complaints were resolved through explanation or apology (over 90%). Policy or procedure changes resulted from 2.1% of complaints, while 4.8% were deemed invalid.
Tertiary literature provides summarized information from primary sources for quick reference. It has advantages of being convenient and easy to use with well-established information, but limitations include potentially outdated information due to delays between original publication and summarization. Tertiary literature is best used for background information or quick answers, and should be evaluated based on author expertise, timeliness, and citation of appropriate sources.
The document discusses corruption in the medical field in Pakistan. It notes that corruption includes ordering unnecessary tests and treatments for kickbacks, absenteeism that harms patient care, and the relationship between doctors and pharmaceutical companies that exploits patients. The document recommends establishing accountability, eliminating financial ties between doctors and pharmaceutical companies, and emphasizing medical ethics to reduce corruption.
Consumer-Oriented Drug Information Service Needs Assessmentiosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
The document discusses the role and functions of a Drug Information Center (DIC). The DIC serves healthcare professionals by answering questions about drug use, side effects, interactions and provides accurate drug information. The DIC is staffed by a director, resident, and students. It is equipped with various drug information resources and receives inquiries from doctors, pharmacists and patients to promote rational drug therapy. The DIC also publishes newsletters and conducts adverse drug reaction monitoring to ensure drug safety.
Patterns of Prescription Writing in Psychiatric ClinicsHafiz Saad Salman
This study analyzed 602 psychiatric prescriptions from private clinics in Peshawar, Pakistan to evaluate prescription writing practices and prescribing trends. The key findings were:
1) On average, 3.34 drugs were prescribed per prescription. Central nervous system drugs accounted for 71% of all drugs prescribed.
2) Important prescription elements like drug strength, quantity, and dosage instructions were missing in about 30% of prescriptions evaluated.
3) The most commonly prescribed medications were fluoxetine (8.4%), sodium valproate (7.9%), and alprazolam (7.7%). Non-steroidal anti-inflammatory drugs and vitamins were also regularly prescribed.
4
This document provides an overview of prescription drug diversion in the United States. It defines diversion as occurring when prescription drugs are rerouted from legal distribution channels to illegal use. It explores common methods of diversion, such as "pill mills," forging documents, scamming doctors, and "doctor shopping" between multiple clinics. It discusses the growing problem of prescription drug abuse in the US, with the number of new nonmedical users rising from 600,000 in 1990 to over 5 million in 2006.
United Arab Emirates Pharmacists’ Practices and Views on Adverse Drug Reactio...iosrjce
Adverse drug reactions (ADRs) constitute a huge burden on health systems, and medication errors
(MEs) are the most common preventable cause of adverse drug events. In developed countries pharmacists
contribute to a great extent in ADR monitoring and reporting, improving patient quality of care and safety. This
review aims to explore pharmacists’ practices and views on ADR reporting, extent and causes of MEs and other
health professionals expectations of pharmacists in this regards. An extensive literature search was conducted
using pertinent electronic health databases (ProQuest, PubMed, Embase, and International Pharmaceutical
Abstracts, and the Cumulative Index to Nursing & Allied Health Literature). Hand-searching of the references
retrieved was also performed. Very few studies were found, none report the prevalence or severity of MEs.
Under-reporting of ADRs is common place among community pharmacists in the UAE. Overall physicians
expressed positive views about clinical pharmacists’ role in medication reviews to identify and prevent drug
interactions and improve patients’ clinical outcomes. More research is required to enhance ADR reporting and
reduce MEs in the UAE. Training about the process of ADR monitoring and reporting at undergraduate level
across health science disciplines and continued education and development led by pharmacists is vital to
improve patient safety.
The document discusses the concept of essential medicines and rational use of drugs. It defines essential medicines as those that meet the priority health care needs of the population. The WHO publishes a Model List of Essential Medicines every two years to guide countries in developing their own national lists. Educational, managerial, economic and regulatory strategies can be used to promote rational drug use and selection of cost-effective treatments. Pharmacists can play a role through drug selection, inventory control, patient education, and pharmaceutical care.
FACTORS ASSOCIATED WITH UNNECESSARY DRUG THERAPY AND INAPPROPRIATE DOSAGE IN ...Jing Zang
To assess factors associated with unnecessary drug therapy and inappropriate dosage in hospitalized patients. A hospital based cross-sectional study design was employed. The study was conducted in Jimma University Specialized Hospital, Jimma, which is 345 Km from South west of Addis Ababa. All patients who were admitted to medical ward from February 5 – March 21, 2011 were included in the study. Data on socio-demographic variables, past medical history, past medication history, current diagnosis, current medications, vital signs and relevant laboratory data were collected by using bed side patient interview guided semi-structured questionnaire and data abstraction formats for card review. The data were analysed by using SPSS version 16 for windows. Descriptive statistics, cross-tabs, chi-square and logistic regression were done. Out of 257 study participants 140(54.5%) had unnecessary drug therapy or inappropriate dosage. The only independent factors which predicted the unnecessary drug therapy in study population was polypharmacy while not considering organ function test, polypharmacy and clinically significant potential drug-drug interaction were independent factors associated with inappropriate dosage . The prevalence of unnecessary drug therapy or inappropriate dosage is significantly high.
Clinical pharmacist Managed Oncology Clinic In University Hospitalfathy alazhary
The document discusses the role and history of clinical pharmacists in managing oncology clinics. It describes how clinical pharmacists began in the 1960s and their role has expanded over the years. The main goals of clinical pharmacists are to assist physicians in prescribing and monitoring drug therapy, assist medical staff, and maximize patient compliance. Oncology pharmacists play a vital role on the healthcare team by ensuring optimal medication regimens for cancer patients, educating patients, and monitoring patients for side effects during chemotherapy treatment.
This study examined health insurance claims data from over 10 million patients who were prescribed opioids to evaluate how opioid receipt differed based on preexisting psychiatric conditions and medications. The study found that patients with a variety of psychiatric conditions and those prescribed various psychoactive medications were more likely to receive opioids, particularly long-term opioid therapy. The increased risk for long-term opioid therapy ranged from 1.5 times higher for those previously prescribed ADHD medications, to over 8 times higher for those with prior opioid use disorder diagnoses. The results provide evidence that commercially insured patients with psychiatric conditions receive opioids more than those without such conditions.
This research article analyzes how social structures impact deviant behaviors like substance use. The authors conducted a mixed-methods study of 402 high-risk street drug users in Tehran, Iran in 2008. Through qualitative interviews and quantitative surveys, they identified four main themes for why people used substances: stress, deviant social networks, low social capital, and weak social support. Regression analysis also assessed relationships between demographic/etiological variables and deviant behaviors. The study aims to discuss substance use as a deviant behavior pattern stemming from weaknesses across institutional, relational, and individual social structures.
A new study adds further evidence to suggest that opioid prescribing in the U.S. is skewed and concentrated among a few providers. Researchers looked at prescribing patterns in data from an unspecified national private insurer between 2003-2017.
Around 670,000 providers prescribed more than 8 million standard doses of opioid prescriptions — but more than a quarter of these prescriptions were written by only 1% of physicians. And in 2017, these physicians prescribed nearly half of all the dispensed opioids. This small group of doctors also prescribed higher doses than recommended, and for longer durations than guidelines allow.
What’s encouraging, the authors suggest, is that the vast majority of physicians do seem to follow guidelines. Some caveats: The study was based on one company’s data, and didn’t look at medical reasons behind prescriptions.
Patients' Perceptions of Community Pharmacy Practice in UAE: An Overviewiosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
The document discusses drug information centers and poison information centers. It provides details on:
- The history and development of the first drug information centers (DICs) and poison control centers (PCCs) in the 1960s in the US and other countries.
- The aims of DICs and PCCs, which include providing drug and poison information to health professionals, developing guidelines, education programs, and participating in research.
- The staffing of DICs and PCCs, which usually includes pharmacists, pharmacy technicians, toxicologists, and others with library sciences backgrounds.
- The processes DICs use to respond to drug information requests, which follow a systematic approach of
This document summarizes a study conducted in Utah that interviewed friends and family of individuals aged 13 and older who died from a drug overdose between October 2008 and October 2009. The study found that overdoses involving prescription opioids were most common among those aged 25-54, with oxycodone, methadone, hydrocodone, and alprazolam most frequently implicated. Characteristics strongly correlated with overdose death included financial problems, past substance abuse, and mental illness. Unemployment, past substance abuse history, and mental illness diagnosis merit further investigation to better understand their relationship to unintentional prescription opioid overdoses.
This document summarizes a study conducted in Lebanon to identify priority policy research questions regarding access to and use of medicines. Literature review found the evidence base on this topic to be weak, with existing studies addressing issues like prescribing behaviors but not comprehensively. Interviews with key informants identified many policy concerns across financing, rational use, pricing, and health systems. Researchers consolidated these into a list of 57 questions, which stakeholders prioritized into a final list of 22 questions. The top five priority questions addressed issues including assessing medicine quality and counterfeits, attitudes towards generic substitution, the role of civil society organizations in improving access, whether access to medicines is a policy priority, and what happens at dispensaries regarding adherence to generics. The
This document summarizes a study on clinical pharmacist interventions in Iraqi hospitals. The study analyzed 4049 interventions made by 54 clinical pharmacists trainees over 12 months. It found that the most common interventions were for drug-drug interactions (40.97%), unavailability of drugs (26.87%), and dosing issues (10.18%). Interventions regarding antibiotics most frequently addressed drug-drug interactions (42.43%) and unavailability (19.34%). The study highlights the important role clinical pharmacists play in optimizing medication use and addressing issues like drug shortages.
This study assessed the prescription pattern of injections at the outpatient pharmacy of Adama Hospital Medical College in Ethiopia. Some key findings include:
- 600 injections were prescribed over 500 prescriptions. The most commonly prescribed classes were injectable antibiotics, anti-pains, and diuretics.
- Prescriptions were generally well filled out, though some lacked information like the patient's address. Prescriber information like qualifications was missing from many.
- Injections were mostly prescribed appropriately in terms of dose, duration and frequency. However, a small percentage showed issues like incorrect antibiotic dosing.
- The study concludes rational injection use was generally found, though some problems need addressing like incomplete
- A study analyzed 1642 patient complaints over 30 months at a large heart center in Tehran, Iran.
- The majority of complaints were related to admission procedures (34.7%) and communication (34.1%). Verbal complaints accounted for 89.2% of total complaints.
- Most complaints were resolved through explanation or apology (over 90%). Policy or procedure changes resulted from 2.1% of complaints, while 4.8% were deemed invalid.
Tertiary literature provides summarized information from primary sources for quick reference. It has advantages of being convenient and easy to use with well-established information, but limitations include potentially outdated information due to delays between original publication and summarization. Tertiary literature is best used for background information or quick answers, and should be evaluated based on author expertise, timeliness, and citation of appropriate sources.
The document discusses corruption in the medical field in Pakistan. It notes that corruption includes ordering unnecessary tests and treatments for kickbacks, absenteeism that harms patient care, and the relationship between doctors and pharmaceutical companies that exploits patients. The document recommends establishing accountability, eliminating financial ties between doctors and pharmaceutical companies, and emphasizing medical ethics to reduce corruption.
Consumer-Oriented Drug Information Service Needs Assessmentiosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
The document discusses the role and functions of a Drug Information Center (DIC). The DIC serves healthcare professionals by answering questions about drug use, side effects, interactions and provides accurate drug information. The DIC is staffed by a director, resident, and students. It is equipped with various drug information resources and receives inquiries from doctors, pharmacists and patients to promote rational drug therapy. The DIC also publishes newsletters and conducts adverse drug reaction monitoring to ensure drug safety.
Patterns of Prescription Writing in Psychiatric ClinicsHafiz Saad Salman
This study analyzed 602 psychiatric prescriptions from private clinics in Peshawar, Pakistan to evaluate prescription writing practices and prescribing trends. The key findings were:
1) On average, 3.34 drugs were prescribed per prescription. Central nervous system drugs accounted for 71% of all drugs prescribed.
2) Important prescription elements like drug strength, quantity, and dosage instructions were missing in about 30% of prescriptions evaluated.
3) The most commonly prescribed medications were fluoxetine (8.4%), sodium valproate (7.9%), and alprazolam (7.7%). Non-steroidal anti-inflammatory drugs and vitamins were also regularly prescribed.
4
This document provides an overview of prescription drug diversion in the United States. It defines diversion as occurring when prescription drugs are rerouted from legal distribution channels to illegal use. It explores common methods of diversion, such as "pill mills," forging documents, scamming doctors, and "doctor shopping" between multiple clinics. It discusses the growing problem of prescription drug abuse in the US, with the number of new nonmedical users rising from 600,000 in 1990 to over 5 million in 2006.
United Arab Emirates Pharmacists’ Practices and Views on Adverse Drug Reactio...iosrjce
Adverse drug reactions (ADRs) constitute a huge burden on health systems, and medication errors
(MEs) are the most common preventable cause of adverse drug events. In developed countries pharmacists
contribute to a great extent in ADR monitoring and reporting, improving patient quality of care and safety. This
review aims to explore pharmacists’ practices and views on ADR reporting, extent and causes of MEs and other
health professionals expectations of pharmacists in this regards. An extensive literature search was conducted
using pertinent electronic health databases (ProQuest, PubMed, Embase, and International Pharmaceutical
Abstracts, and the Cumulative Index to Nursing & Allied Health Literature). Hand-searching of the references
retrieved was also performed. Very few studies were found, none report the prevalence or severity of MEs.
Under-reporting of ADRs is common place among community pharmacists in the UAE. Overall physicians
expressed positive views about clinical pharmacists’ role in medication reviews to identify and prevent drug
interactions and improve patients’ clinical outcomes. More research is required to enhance ADR reporting and
reduce MEs in the UAE. Training about the process of ADR monitoring and reporting at undergraduate level
across health science disciplines and continued education and development led by pharmacists is vital to
improve patient safety.
The document discusses the concept of essential medicines and rational use of drugs. It defines essential medicines as those that meet the priority health care needs of the population. The WHO publishes a Model List of Essential Medicines every two years to guide countries in developing their own national lists. Educational, managerial, economic and regulatory strategies can be used to promote rational drug use and selection of cost-effective treatments. Pharmacists can play a role through drug selection, inventory control, patient education, and pharmaceutical care.
FACTORS ASSOCIATED WITH UNNECESSARY DRUG THERAPY AND INAPPROPRIATE DOSAGE IN ...Jing Zang
To assess factors associated with unnecessary drug therapy and inappropriate dosage in hospitalized patients. A hospital based cross-sectional study design was employed. The study was conducted in Jimma University Specialized Hospital, Jimma, which is 345 Km from South west of Addis Ababa. All patients who were admitted to medical ward from February 5 – March 21, 2011 were included in the study. Data on socio-demographic variables, past medical history, past medication history, current diagnosis, current medications, vital signs and relevant laboratory data were collected by using bed side patient interview guided semi-structured questionnaire and data abstraction formats for card review. The data were analysed by using SPSS version 16 for windows. Descriptive statistics, cross-tabs, chi-square and logistic regression were done. Out of 257 study participants 140(54.5%) had unnecessary drug therapy or inappropriate dosage. The only independent factors which predicted the unnecessary drug therapy in study population was polypharmacy while not considering organ function test, polypharmacy and clinically significant potential drug-drug interaction were independent factors associated with inappropriate dosage . The prevalence of unnecessary drug therapy or inappropriate dosage is significantly high.
Clinical pharmacist Managed Oncology Clinic In University Hospitalfathy alazhary
The document discusses the role and history of clinical pharmacists in managing oncology clinics. It describes how clinical pharmacists began in the 1960s and their role has expanded over the years. The main goals of clinical pharmacists are to assist physicians in prescribing and monitoring drug therapy, assist medical staff, and maximize patient compliance. Oncology pharmacists play a vital role on the healthcare team by ensuring optimal medication regimens for cancer patients, educating patients, and monitoring patients for side effects during chemotherapy treatment.
This study examined health insurance claims data from over 10 million patients who were prescribed opioids to evaluate how opioid receipt differed based on preexisting psychiatric conditions and medications. The study found that patients with a variety of psychiatric conditions and those prescribed various psychoactive medications were more likely to receive opioids, particularly long-term opioid therapy. The increased risk for long-term opioid therapy ranged from 1.5 times higher for those previously prescribed ADHD medications, to over 8 times higher for those with prior opioid use disorder diagnoses. The results provide evidence that commercially insured patients with psychiatric conditions receive opioids more than those without such conditions.
This research article analyzes how social structures impact deviant behaviors like substance use. The authors conducted a mixed-methods study of 402 high-risk street drug users in Tehran, Iran in 2008. Through qualitative interviews and quantitative surveys, they identified four main themes for why people used substances: stress, deviant social networks, low social capital, and weak social support. Regression analysis also assessed relationships between demographic/etiological variables and deviant behaviors. The study aims to discuss substance use as a deviant behavior pattern stemming from weaknesses across institutional, relational, and individual social structures.
COMMUNITY PHARMACY PRESENTATION FINAL.pptxsardarjarrar
This document discusses the application of statistics in medical research and pharmacy. It begins by defining statistics and medical research. It then explains the relationship between medical sciences and statistical approaches, and lists some commonly used statistical tools in medical research like descriptive statistics, inferential statistics, chi square, correlation and regression. The document gives examples of how statistics are applied in areas like data collection, resource allocation, quality improvement, pharmacology, public health, and pharmaceutical marketing. It emphasizes the importance of statistical data in drawing reasonable inferences and making accurate decisions in medical research.
Out-of-Pocket Spending on Out-Patient Care in India: Assessment and Options Based on Results from a District Zone. Innovative Financial Healthcare in India.
- The document analyzes out-of-pocket spending (OOPS) on outpatient care in India using survey data from 8 districts across 3 states.
- It finds the average OOPS per ill person was INR 718, with significant inter-district variation. On average, households with illness spent 10% of monthly consumption on OPD.
- Private providers were the first choice for 79% of patients. The main reasons for provider selection were proximity and reputation. Less than 5% of patients switched providers.
An assessment of healthcare reforms in kazakhstanAlexander Decker
This document summarizes Kazakhstan's healthcare reforms since gaining independence in 1991. It discusses four key aspects of Kazakhstan's healthcare reforms: 1) increased funding for healthcare, 2) improvements to healthcare quality, 3) reforms to the human resources sector, and 4) increased partnerships. The reforms have helped modernize Kazakhstan's healthcare system, though continued reform is still needed as the country transitions from the Soviet system.
Knowledge and attitudes towards complementary and alternative medicine among ...home
The document summarizes a study that examined medical students' knowledge and attitudes toward complementary and alternative medicine (CAM) in Turkey. The study found that the majority of the 943 medical students surveyed were familiar with common CAM methods like herbal treatment, acupuncture, and massage. Most students had positive attitudes toward CAM and expressed willingness to receive training in it. Attitudes declined as students progressed in their medical education. Overall, there was support for integrating CAM into the medical curriculum in Turkey.
Provincial health accounts in Kerman, Iran: an evidence of a “mixed” healthca...Mina Ansari
Provincial Health Accounts (PHA) as a subset of National Health Accounts (NHA) present financial information for health sectors. It leads to a logical decision making for policy-makers in order to achieve health system goals, especially Fair Financial Contribution (FFC). This study aimed to examine Health Accounts in Kerman Province.
Drug abuse has now become a major public health problem in Nigeria requiring urgent attention. Although drug abuse cut across all age groups, the youths are however the most affected. This study aimed at assessing Community Pharmacists involvement in the rehabilitation of drug abuse victims. The study was carried out in Abuja Municipal Area Council, questionnaires were administered to Community Pharmacists practicing within the Area Council. A total of 176 Community Pharmacists participated in the study, and slightly above a quarter (27.43%) of them had post-graduate degrees. More than three-quarters (79.5%) of the study participants had received training on drug abuse. A total of 89.2% of the study participants had come across persons suspected to be abusing prescription medicines. Almost all (96.6%) of the study participants indicated that they are willing to advise persons suspected to be abusing drugs on the dangers of drug abuse, and 88.1% of the study participants had spoken to clients concerning abuse of prescription medicines. Also, more than three-quarters (80.1%) of the study participants indicated that pharmacists’ role in the prevention of drug abuse is very important. The study has revealed that Community Pharmacists can play an invaluable role in the rehabilitation of drug abuse victims in Nigeria.
ANALYSIS OF DRUG COST TOWARD CAPITATION COST FOR TOP DISEASES IN SPECIAL REGI...UniversitasGadjahMada
This study was to analyze the differences between actual and standard of prescription cost. Researchers also conducted an analysis to see whether there was a difference between actual and standard of drug value in the amount of capitation fund. This study was a retrospective observational analytic. Medical prescriptions (January 2015–June 2015) were obtained at several Puskesmas in D.I Yogyakarta. Mann–Whitney test was performed to identify whether there was a difference between actual and standard of prescription cost. Independent sample t-test was performed to conduct whether there was a difference between actual and standard of drug value in the amount of capitation fund. Based on the data, it showed that there was a significant difference (p<0.05) between actual and standard of prescription cost. There was also a significant difference between actual and standard of drug value in the amount of capitation fund at Puskesmas in Yogyakarta city and Bantul district. The difference of value caused by prescription cost value factor that there is duration component in calculation. Yet in Sleman district, there was no significant difference (p>0.05).
CHINESE PHARMACISTS LAW MODIFICATION, HOW TO PROTECT PATIENTS‘INTERESTS?hiij
The pharmacy profession is relatively new in China. Recently, the demand for pharmacists has increased as China's hospital system has been unable to support a large patient population due to the increasing demand for health care. This paper discusses how to improve the Chinese pharmacist law. To make reasonable laws on pharmacists, used to regulate and manage communication between pharmacists and patients, the ethical relationships, financial support and degree requirement, and governance of pharmacists. Improving pharmacist laws can help improve the quality of pharmacists' work, protect patient privacy, and enhance pharmacists' work efficiency. I will use government reports and authoritative data collected by myself as examples to analyze what needs to be improved in pharmacist law.
CHINESE PHARMACISTS LAW MODIFICATION, HOW TO PROTECT PATIENTS‘INTERESTS?hiij
The pharmacy profession is relatively new in China. Recently, the demand for pharmacists has increased
as China's hospital system has been unable to support a large patient population due to the increasing
demand for health care. This paper discusses how to improve the Chinese pharmacist law. To make
reasonable laws on pharmacists, used to regulate and manage communication between pharmacists and
patients, the ethical relationships, financial support and degree requirement, and governance of
pharmacists. Improving pharmacist laws can help improve the quality of pharmacists' work, protect patient
privacy, and enhance pharmacists' work efficiency. I will use government reports and authoritative data
collected by myself as examples to analyze what needs to be improved in pharmacist law.
This study analyzed 4,607 medical prescriptions from 63 health centers in Belo Horizonte, Brazil. The prescriptions were grouped as either internal (from municipal health centers) or external (from other facilities). The following were found:
1) On average, there were 2.4 drugs prescribed per consultation for both internal and external prescriptions.
2) 84.3% of internal prescriptions and 85.5% of external prescriptions provided no instructions for medication use. Information on dosage regimen was present in over 50% of prescriptions but varied between groups.
3) Generic drug names were specified for 51.9% of internal prescriptions but only 28.
Preferences of multinational & national brands in health care departmentAlexander Decker
This document summarizes a study on the preferences of health care consultants for multinational and national brands in Pakistan. The study collected data from four hospitals in Bannu District through a survey of 120 health care consultants working in pediatric departments. The study aimed to determine if there were relationships between consultant brand preferences and factors like price, quality, efficacy, availability, marketing visits, country of origin, and government policies. The results showed significant associations between preferences and prices/quality of products as well as marketing visits. Relationships were also found for efficacy, country of origin, and government policies.
Read Logica’s paper on the need for convergence of healthcare and pharmaCGI
As the biggest industry sector in most European economies, healthcare is already given a big chunk of the gross domestic product (GDP). This portion is expected to become even bigger and have a huge impact on employment, the opportunities to grow businesses and economies in general.
This document summarizes findings from a survey of pharmacists in India. Key findings include:
- 75% of licensed pharmacists were working in pharmacy or a related field, down from 88% in 2009. 22% were retired or not working.
- Characteristics of actively practicing pharmacists showed an increase in hospital pharmacy (29.4%) and decreases in community pharmacy (44.1%).
- Hours worked remained similar, with full-time pharmacists working an average of 44 hours/week. The gap in hours worked between male and female pharmacists continued to narrow.
The document discusses the importance of consumer reporting of adverse drug reactions (ADRs) in Malaysia. It notes that while Malaysia has a national pharmacovigilance program, it suffers from weaknesses like under-reporting and a lack of consumer involvement. Consumer reporting can help address under-reporting by capturing ADRs not reported by healthcare professionals. It also promotes consumer rights and participation. The document argues for establishing a consumer reporting program in Malaysia and enhancing the existing national pharmacovigilance program through improved awareness, a national drug prescription database, and strategies to improve reporting.
The document discusses the role of pharmacists in achieving therapeutic efficacy and cost-effectiveness in the management of allergic rhinitis. It outlines that pharmacists can play a key role in providing professional advice for self-medication of intermittent and mild persistent allergic rhinitis using over-the-counter antihistamines. This can help ensure good disease control while reducing healthcare costs for individuals and health insurance funds. The document also discusses how pharmacist counseling is important for proper administration of medications and treatment monitoring to prevent inappropriate drug use.
Patients' satisfaction towards doctors treatmentmustafa farooqi
This document provides an introduction, literature review, and proposed framework for a study on patient satisfaction towards doctor treatment at state hospitals in Multan, Pakistan. The study aims to examine if patients are satisfied with the healthcare process, doctor treatment and behavior, and information/communication. The conceptual framework identifies background variables, independent variables related to doctor treatment, and dependent variables of patient satisfaction. The literature review discusses several prior studies that examined factors influencing patient satisfaction like doctor competence, communication, and attitudes. The theoretical framework discusses social identity theory and satisfaction theory in understanding patient attitudes and expectations.
Patients' satisfaction towards doctors treatmentmustafa farooqi
The mood of the care recipient to see if the impression (expectations) of service are met by the patient may be defined as patient satisfaction. The current perspective on service efficiency tends to be that patient treatment meets public standards and requirements in terms of interpersonal support as well as professional assistance. (Hardy et al. 1996).
For various reasons, customer satisfactions in the healthcare industry have been investigated. First it was important to decide on the extent and the degree to which patient care seekers, the meeting of drugs criteria and the continuous use of these services have effect, satisfaction as a quality of service metric, as well as allowing doctors and health services to better appreciate and use the input of the patient. (Ong et al. 2000).
Consumer satisfaction with healthcare services is a multi-panel term that refers to the core facets of treatment and suppliers, while PS medical services with the quality enhancement systems from the patient context, full control of quality and the intended outcomes of services are considered to be of primary importance (Janicijevic et al. 2013).
The Pakistani health system is being changed somewhat and there are wonderful scope for applying standard of services to health care. Patients in Pakistan now have access to increased quality health care. Obviously, the staff and staff are the most important winners of a successful health care environment of every community sector framework (Bakari et al. 2019).
The medical clinic of today's study is the product of a long and complicated war of civilization to quantify produce and study and to give thought to the thoughtful (Fullman et al. 2017).
Similar to A comprehensive analysis of drug system money map in islamic republic of iran (20)
Abnormalities of hormones and inflammatory cytokines in women affected with p...Alexander Decker
Women with polycystic ovary syndrome (PCOS) have elevated levels of hormones like luteinizing hormone and testosterone, as well as higher levels of insulin and insulin resistance compared to healthy women. They also have increased levels of inflammatory markers like C-reactive protein, interleukin-6, and leptin. This study found these abnormalities in the hormones and inflammatory cytokines of women with PCOS ages 23-40, indicating that hormone imbalances associated with insulin resistance and elevated inflammatory markers may worsen infertility in women with PCOS.
A usability evaluation framework for b2 c e commerce websitesAlexander Decker
This document presents a framework for evaluating the usability of B2C e-commerce websites. It involves user testing methods like usability testing and interviews to identify usability problems in areas like navigation, design, purchasing processes, and customer service. The framework specifies goals for the evaluation, determines which website aspects to evaluate, and identifies target users. It then describes collecting data through user testing and analyzing the results to identify usability problems and suggest improvements.
A universal model for managing the marketing executives in nigerian banksAlexander Decker
This document discusses a study that aimed to synthesize motivation theories into a universal model for managing marketing executives in Nigerian banks. The study was guided by Maslow and McGregor's theories. A sample of 303 marketing executives was used. The results showed that managers will be most effective at motivating marketing executives if they consider individual needs and create challenging but attainable goals. The emerged model suggests managers should provide job satisfaction by tailoring assignments to abilities and monitoring performance with feedback. This addresses confusion faced by Nigerian bank managers in determining effective motivation strategies.
A unique common fixed point theorems in generalized dAlexander Decker
This document presents definitions and properties related to generalized D*-metric spaces and establishes some common fixed point theorems for contractive type mappings in these spaces. It begins by introducing D*-metric spaces and generalized D*-metric spaces, defines concepts like convergence and Cauchy sequences. It presents lemmas showing the uniqueness of limits in these spaces and the equivalence of different definitions of convergence. The goal of the paper is then stated as obtaining a unique common fixed point theorem for generalized D*-metric spaces.
A trends of salmonella and antibiotic resistanceAlexander Decker
This document provides a review of trends in Salmonella and antibiotic resistance. It begins with an introduction to Salmonella as a facultative anaerobe that causes nontyphoidal salmonellosis. The emergence of antimicrobial-resistant Salmonella is then discussed. The document proceeds to cover the historical perspective and classification of Salmonella, definitions of antimicrobials and antibiotic resistance, and mechanisms of antibiotic resistance in Salmonella including modification or destruction of antimicrobial agents, efflux pumps, modification of antibiotic targets, and decreased membrane permeability. Specific resistance mechanisms are discussed for several classes of antimicrobials.
A transformational generative approach towards understanding al-istifhamAlexander Decker
This document discusses a transformational-generative approach to understanding Al-Istifham, which refers to interrogative sentences in Arabic. It begins with an introduction to the origin and development of Arabic grammar. The paper then explains the theoretical framework of transformational-generative grammar that is used. Basic linguistic concepts and terms related to Arabic grammar are defined. The document analyzes how interrogative sentences in Arabic can be derived and transformed via tools from transformational-generative grammar, categorizing Al-Istifham into linguistic and literary questions.
A time series analysis of the determinants of savings in namibiaAlexander Decker
This document summarizes a study on the determinants of savings in Namibia from 1991 to 2012. It reviews previous literature on savings determinants in developing countries. The study uses time series analysis including unit root tests, cointegration, and error correction models to analyze the relationship between savings and variables like income, inflation, population growth, deposit rates, and financial deepening in Namibia. The results found inflation and income have a positive impact on savings, while population growth negatively impacts savings. Deposit rates and financial deepening were found to have no significant impact. The study reinforces previous work and emphasizes the importance of improving income levels to achieve higher savings rates in Namibia.
A therapy for physical and mental fitness of school childrenAlexander Decker
This document summarizes a study on the importance of exercise in maintaining physical and mental fitness for school children. It discusses how physical and mental fitness are developed through participation in regular physical exercises and cannot be achieved solely through classroom learning. The document outlines different types and components of fitness and argues that developing fitness should be a key objective of education systems. It recommends that schools ensure pupils engage in graded physical activities and exercises to support their overall development.
A theory of efficiency for managing the marketing executives in nigerian banksAlexander Decker
This document summarizes a study examining efficiency in managing marketing executives in Nigerian banks. The study was examined through the lenses of Kaizen theory (continuous improvement) and efficiency theory. A survey of 303 marketing executives from Nigerian banks found that management plays a key role in identifying and implementing efficiency improvements. The document recommends adopting a "3H grand strategy" to improve the heads, hearts, and hands of management and marketing executives by enhancing their knowledge, attitudes, and tools.
This document discusses evaluating the link budget for effective 900MHz GSM communication. It describes the basic parameters needed for a high-level link budget calculation, including transmitter power, antenna gains, path loss, and propagation models. Common propagation models for 900MHz that are described include Okumura model for urban areas and Hata model for urban, suburban, and open areas. Rain attenuation is also incorporated using the updated ITU model to improve communication during rainfall.
A synthetic review of contraceptive supplies in punjabAlexander Decker
This document discusses contraceptive use in Punjab, Pakistan. It begins by providing background on the benefits of family planning and contraceptive use for maternal and child health. It then analyzes contraceptive commodity data from Punjab, finding that use is still low despite efforts to improve access. The document concludes by emphasizing the need for strategies to bridge gaps and meet the unmet need for effective and affordable contraceptive methods and supplies in Punjab in order to improve health outcomes.
A synthesis of taylor’s and fayol’s management approaches for managing market...Alexander Decker
1) The document discusses synthesizing Taylor's scientific management approach and Fayol's process management approach to identify an effective way to manage marketing executives in Nigerian banks.
2) It reviews Taylor's emphasis on efficiency and breaking tasks into small parts, and Fayol's focus on developing general management principles.
3) The study administered a survey to 303 marketing executives in Nigerian banks to test if combining elements of Taylor and Fayol's approaches would help manage their performance through clear roles, accountability, and motivation. Statistical analysis supported combining the two approaches.
A survey paper on sequence pattern mining with incrementalAlexander Decker
This document summarizes four algorithms for sequential pattern mining: GSP, ISM, FreeSpan, and PrefixSpan. GSP is an Apriori-based algorithm that incorporates time constraints. ISM extends SPADE to incrementally update patterns after database changes. FreeSpan uses frequent items to recursively project databases and grow subsequences. PrefixSpan also uses projection but claims to not require candidate generation. It recursively projects databases based on short prefix patterns. The document concludes by stating the goal was to find an efficient scheme for extracting sequential patterns from transactional datasets.
A survey on live virtual machine migrations and its techniquesAlexander Decker
This document summarizes several techniques for live virtual machine migration in cloud computing. It discusses works that have proposed affinity-aware migration models to improve resource utilization, energy efficient migration approaches using storage migration and live VM migration, and a dynamic consolidation technique using migration control to avoid unnecessary migrations. The document also summarizes works that have designed methods to minimize migration downtime and network traffic, proposed a resource reservation framework for efficient migration of multiple VMs, and addressed real-time issues in live migration. Finally, it provides a table summarizing the techniques, tools used, and potential future work or gaps identified for each discussed work.
A survey on data mining and analysis in hadoop and mongo dbAlexander Decker
This document discusses data mining of big data using Hadoop and MongoDB. It provides an overview of Hadoop and MongoDB and their uses in big data analysis. Specifically, it proposes using Hadoop for distributed processing and MongoDB for data storage and input. The document reviews several related works that discuss big data analysis using these tools, as well as their capabilities for scalable data storage and mining. It aims to improve computational time and fault tolerance for big data analysis by mining data stored in Hadoop using MongoDB and MapReduce.
1. The document discusses several challenges for integrating media with cloud computing including media content convergence, scalability and expandability, finding appropriate applications, and reliability.
2. Media content convergence challenges include dealing with the heterogeneity of media types, services, networks, devices, and quality of service requirements as well as integrating technologies used by media providers and consumers.
3. Scalability and expandability challenges involve adapting to the increasing volume of media content and being able to support new media formats and outlets over time.
This document surveys trust architectures that leverage provenance in wireless sensor networks. It begins with background on provenance, which refers to the documented history or derivation of data. Provenance can be used to assess trust by providing metadata about how data was processed. The document then discusses challenges for using provenance to establish trust in wireless sensor networks, which have constraints on energy and computation. Finally, it provides background on trust, which is the subjective probability that a node will behave dependably. Trust architectures need to be lightweight to account for the constraints of wireless sensor networks.
This document discusses private equity investments in Kenya. It provides background on private equity and discusses trends in various regions. The objectives of the study discussed are to establish the extent of private equity adoption in Kenya, identify common forms of private equity utilized, and determine typical exit strategies. Private equity can involve venture capital, leveraged buyouts, or mezzanine financing. Exits allow recycling of capital into new opportunities. The document provides context on private equity globally and in developing markets like Africa to frame the goals of the study.
This document discusses a study that analyzes the financial health of the Indian logistics industry from 2005-2012 using Altman's Z-score model. The study finds that the average Z-score for selected logistics firms was in the healthy to very healthy range during the study period. The average Z-score increased from 2006 to 2010 when the Indian economy was hit by the global recession, indicating the overall performance of the Indian logistics industry was good. The document reviews previous literature on measuring financial performance and distress using ratios and Z-scores, and outlines the objectives and methodology used in the current study.
A comprehensive analysis of drug system money map in islamic republic of iran
1. Journal of Economics and Sustainable Development www.iiste.org
ISSN 2222-1700 (Paper) ISSN 2222-2855 (Online)
Vol.4, No.1, 2013
A comprehensive analysis of drug system money map in Islamic
Republic of Iran
Kambiz Abachi zade 1, Peivand Bastani2,3, Masoud Abolhalaj2*, Maryam Ramezanian2, Najme Tamizkar4
1. School of Medicine, Shahid Behesti University of Medical Sciences
2. Research Center for Health Services Management, Kerman University of Medical Sciences,
Kerman, Iran
Ministry of Health and Medical Education , Tehran, Iran
3. School of Management and Information Sciences, Tehran University of medical sciences,Tehran,
Iran
Dr Abachizade and Mrs Bastani have equal participation as co- first authors.
4. Budget and performance monitoring Bruea, Ministry of health and medical education
Email of Co responding autor: mohme2003@gmail.com
Abstract
This study is the first comprehensive analysis of the money Path of drug system in Islamic Republic of Iran. It
has a qualitative methodology applying content analysis to explain and describe drug system monetary path, the
studied Population was key informants and experts in the field of finance and insurance, accuracy and robustness
of the study was assessed using Guba and linkelen criteria as well. On developing the money map of drug
system in Iran, 28 paths have been identified and described completely. It seems that this track description can be
the best way in order to identify strengths and problems of the country's drug money system.
Key words: Money path, drug system, Islamic Republic of Iran
Introduction
The drug industry is strategically important industries in the world and also is directly related to human`s life (1).
On the other hand, drug is the most important and most expensive element in the healthy supply chain and more
than other elements of the health chain is associated with the management and economics (2).
As evidence of this claim, studies suggest that drug industry has significant turnover in the world and in our
country too (1). In this respect, historical review of records about industry's growth process suggests that despite
25 percentage of market share in the manufacture of drugs, that are not completely independent, but the scores of
foreign companies, this figure in 1387s, is enhanced to more than 95 percent quantitatively and of approximately
64% in terms of Rial (excluding subsidy) (3). However, it is predicted that in 1404, Iranian drug market value
with 360 percent growth is equivalent to $ 10 billion, numerical volume of pharmaceutical market with growth
of 200% is equivalent to 60 billion numbers, and pharmaceutical exports value with growth of 250% is
equivalent to $ 250 million(4).
In the other hand, evidence suggests that in 1387s, the average price of domestically produced drugs was £ 485
average price of imported drugs was £ 5750. Meanwhile, drug capitation in Iran has been estimated about 33 U.S.
dollars. While in 2008, drug capitation in the world was $ 100 averagely (3).
In addition to the monetary and numerical growth of pharmaceutical products, in the categories of drug
distribution, Iran has an advanced distribution system includes more than 7,000 pharmacies and 15 drug national
wholesaler and many major local seller. In addition, there are more than 800 hospital pharmacies in the country
which some of them are also allowed to sell drugs to outpatient (5).
But despite the growth and expansion of the pharmaceutical industry in the production and distribution of
158
2. Journal of Economics and Sustainable Development www.iiste.org
ISSN 2222-1700 (Paper) ISSN 2222-2855 (Online)
Vol.4, No.1, 2013
medicines and achieving to self-sufficiency boundary, statistics show that the proportion of paying out of pocket
for the drug is still high in our country (6). In such circumstances, it is essential that in allocation of funds to
health services, particularly in the pharmaceutical sector, with a major revision attempt to promote credit sources
proportion to health from the national income, distribution of the source components be modified, and for the
purpose of application, required modification be provided according to the sector needs (7).
While this is one of the most important factors for financing costs of health services in general, and medicine in
particular, increasing the level of government financial contribution, and giving attention to its trustee to protect
the public interest. Also other cases such as resources, participation of households in financial payments and
prepayments thread, and the amount of social services coverage in private health insurance, have particular
importance in the financing of these costs.(8)
So due to the importance of medication sector financial management, it is necessary to provide oral explanation
of financial transactions in this section, because such a view of the pharmaceutical sector, is underlying the
effective policy making in the area of financial management of drug section. In other words, due to the unique
features of the pharmaceutical sector in the health system, including the dominance of the economic aspects,
there are certain complexities, therefore, any financial involvement in the various components of the drug can
cause multiple and sometimes unpredictable effects in other parts of the health system. So having a large and
comprehensive view of the financial transactions of the drug is essential to offer interventions and for
determining future strategies, moreover, trust in management and economics science, and integrating them with
drug industry and trade may be a proper solution to finding the answers to the questions in the manufacturing,
distribution and supplying the drugs and creating a new window in the pharmaceutical configuration
qualification, more than before. This study is the first comprehensive analysis of the money Path of drug system
in Islamic Republic of Iran.
Methodology
This study is a qualitative study and has been done using content analysis to explain and describe drug system
monetary path, the studied Population was key informants and experts in the field of finance and insurance, that
among them, there were 6 experts Of The NHS and Social Security insurance, and 5 cases of financial
professionals and Budget Ministry of Health and Medical Education and also 5 Experts from the Food and Drug
Administration and they were selected through the purposeful sampling with maximum variation and all
selected individuals participated in three special panels.
Data collecting methods were semi-structured interviews. First, a general question regarding the money map of
pharmaceutical system were asked to start the interview and due to the answers, interview procedure was
conducted. Time and place of the interviews had been reported prior to participants. Length of each panel
sessions ranged from 120 to 180 minutes. All interviews were conducted by researchers, recorded and typed
word for word, and immediately analyzed were. At the beginning, each interview was read to gain an initial
understanding, the important lines were highlighted and connotative codes (researcher interpretations of
statements) were used. In the next step, Codes that were conceptually similar were clarified for the meaning of
summarizing and were classified as number of categories and sub-categories. . In fact, data analysis was done
continuously and simultaneous with data collection. The process of data collection continued until data
saturation, it means that the data collected be iteration of previous data and no new information be obtained.
In this study the accuracy and robustness was assessed using Guba and linkelen criteria (9) to ensure reliability,
the researcher had close interact and adequate participation with the participants. Revision was conducted by
foreign observers and participants and the comments of expert teachers were used. Researchers were evaluated
the consistency (stability) of data by measures like review done by experts. Compliance or objectivity was done
through the withdrawal of with previous beliefs and prejudices of the researchers. In addition, these findings`
159
3. Journal of Economics and Sustainable Development www.iiste.org
ISSN 2222-1700 (Paper) ISSN 2222-2855 (Online)
Vol.4, No.1, 2013
authenticity was approved by participants.
Also in this study, participants were asked to sign the consent for Conscious participation in this study and they
were given assurances that all personal information will remain confidential at results publication time, and was
emphasized on ability to freely withdraw from the study at any stage due to a lack of willingness to continue
cooperation.
Results and Discussion
On developing the money map of drug system in Iran, 28 paths have been identified. This map is fully presented
elsewhere (10). This study was discussed to describe and explain related28 branches:
a) The first track on the money map of Iranian drug system is Indicator of the money that people pay for
medicines in private pharmacies. Usually for insurance medications, 30% of the fee is paid by the patient as
franchise and the rest by insurance. Otherwise the whole drug costs paid by the public. Drug supply price
calculated based on the policies of pharmaceuticals overseeing office and mainly its basis is the total cost and
certain profit for the importer, distributor and dealer. Figures for sales of the drug is related to the entire market
and the exact number of how much money people pay for medicines in private pharmacies are not reported
separately.
b) The second path represents the cost of drugs paid by the private hospitals; this cost is paid by the patient,
along with other hospital expenses. The cost paid by patients (franchise) for drugs covered by insurance, is 10
percent of total price.
c) The third route is indicating the money is spent by people in public hospitals for treatment, public hospital pay
the medical expenses from their general budget and do not receive separate funding for drug, which this leads to
waste of resources and reduce the transparency of performance. Meanwhile, the rate of budget and drug use
information in hospitals is not available as concentrated.
d) The fourth path is related to the costs paid by people to state pharmacies. Often subsidized foreign imported
medications which approved by specialist and relevant expert, is offered by the state chemist.
e) The fifth way is special for people paid costs to health care networks. The major drugs in health centers
related to the Iranian health care network are free or with a small franchise. In rural insurance scheme, medicine
drug list is limited to 193 items. Information of Ministry of Health show that in 2001, essential medicines
availability in the PHC system is satisfactorily. And an average of 90% of the drugs was available in the studied
centers.
f) The sixth track was relevant to the insurance premium paid by people to the basis insurance Fund, the figure
cannot be calculated accurately due to the insurance funds Scattering, various premiums and as well as absence
of separate drug costs in premium payment. However, although the health insurance system in Iran is largely
furcated and different insurance gain their resources from different groups of the population, but the list of
insurance covered drugs are similar. So as, providing 70 percent of the cost of outpatient prescription drugs and
90 per cent of prescription medicines in hospital and covering more than 80 percent of drugs in official medicine
list are considerable performance the insurance. Drug consumers (patients) in addition to paying 30% of drug
costs as franchises; pay about 0.3 to 0.5 dollars as the technical pharmacy (Dispensing Fee) that this amount
varies based on the price of drugs.
g) The seventh path represents the insurance contributions from state budgets. Note that according to the
principle of insurance organizations, social services and health care insurance organizations, the contribution of
drug costs is about 30% of total medical costs, which is a remarkable figure.
h) The eighth track shows the insurance reimbursement to private pharmacies. 70 percent of costs of drugs
covered by insurance organizations are paid to pharmaceutical providers.
i) The ninth track and also the tenth are related to the insurance reimbursement to hospitals (public and private)
160
4. Journal of Economics and Sustainable Development www.iiste.org
ISSN 2222-1700 (Paper) ISSN 2222-2855 (Online)
Vol.4, No.1, 2013
for drug costs. 90 percent of costs of drugs covered by the insurance are paid by insurance organizations to
inpatient services providers.
j) Eleventh path, which specifies the payment by the insurance to the State pharmacy.
k) The twelfth path show possible payment of insurance to health care networks , which in the current system,
insurance agencies do not pay a separate charge for the supplied medicines in health care systems (In fact, these
drugs are purchased by Medical Sciences universities and are offered to medical centers).
l) Routes numbered 13 to 16 show payments of public and private pharmacies and hospitals to the drug
distributor companies. Pharmacies and hospitals with a contract start to buy medicines from pharmaceutical
distribution companies. Distributor companies supply their required drugs from domestic pharmaceutical
companies. . 44 drug produce domestic companies are providing more than 90 percent of the total consumption
of drugs in the country (From 9595 million distributed drug units, 8814 million of them are produced in the
country). Of 90%, 87.6 is the share of 26 percent government-owned companies and public institutions and 12.4
for 18 private domestic medicines production companies.
m) Path number 17 shows the potential paying of health care networks to that the drug distributor companies. In
the current system, health care networks usually do not deal with companies that produce and distribute the drug,
but their required drugs are provided by the University of Medical Sciences.
n) Path 18 shows medical universities` payments to government hospitals in the pharmaceutical sector, which the
university provides the budget for medicines in health centers.
p) Path 20 determines the money that the Health and Medical Education Ministry assigned to the university. This
means that the budget of the Medical Sciences University is provided by Ministry of Health. However, the
budget dedication is due to seasonal division and there are no separate rows for the medicines separately.
q) Track number 21 determines Health budget allocation from the state budget places. Subsidize relevant to the
drug has independent rows that in the subsequent track will be analyzes completely.
r) Twenty-second track shows the payments from the Department of Health to the foreign drugs importing
companies. In this regard, the Ministry of Health pays the drug subsidy that is on independent rows to the foreign
drug Importer companies.
s) twenty-third track specifies payment of foreign drug Importer companies to Iranian drug manufacturer.
Therefore, the foreign medicine importer company usually buys the drug from a foreign manufacturer at
internationally announced prices.
t) twenty-fourth track shows the money paid by the state pharmacy to foreign drug Importer companies. State
pharmacy deals costs to the foreign drug Importer companies according to exclusive supply of specific drugs in
specific state pharmacy.
u) Track number 25 specifies payments from domestic drug production companies to the internally raw material
production company. That about 5 to 10 percent of raw material required by domestic producing companies is
supplied by domestic companies.
v) Track number 26 shows payment of domestic drug companies to the production to the foreign raw material
producing company. It should be mentioned that, the main raw material required for domestic companies is
provided from foreign companies such as Spanish and Indian companies.
w) Twenty-seventh track indicating payment from foreign consumers to domestic drug manufacturing companies
which introduce drugs` export. Now more than 45 million drug exports take place.
x) The final track or track number 28, determine payment from the Department of Health to the domestic
pharmaceutical production companies. Dedicating subsidies to imported drugs due to the drug type and related
disease conditions in the country are managed by Food and Drug Administration and are provided to importers.
Subsidized medicines consumer price is established and determined by the legal pricing commission, the
161
5. Journal of Economics and Sustainable Development www.iiste.org
ISSN 2222-1700 (Paper) ISSN 2222-2855 (Online)
Vol.4, No.1, 2013
consumer price will be calculated of the importer to consumer. Subsidy rate is equal to the difference between
the total costs and the sale price minus 13 percent. In cases which the margin is less than 4%, the subsidy is the
difference between the selling price and the importer's cost plus 4%.
According to what was presented above, this track description can be the best way in order to identify strengths
and problems of the country's drug money system. In this regard, the findings suggest that in the area of drug
production and prices, country had been in relatively good condition, So that 95% of the needed drugs are
provided by domestic production (11). However, the pharmaceutical manufacturing industries in the world,
mainly concentrated in 5 countries are including America, Japan, Germany, France and the UK. So that these
countries are the owner of two-thirds of the production drugs values and most of the world pharmaceutical
market is in the hands of a few transnational companies and 10 transnational companies are the owner of half the
world pharmaceutical market and from 1987 onwards, focus considerably increased. Medicine worldwide
transactions from 5 billion dollars in 1980 have been reached to 120 billion in 2000, about 1.8 percent of world
trade (12).
In Iran, it is estimated that medicine market is doubling every four years. Despite these favorable conditions, the
findings show that there are some problems in the monetary system in the country's pharmaceutical. For example,
increasing the share paid out of pocket are the outstanding issues in the field of Medicine. This enhancement is
mainly due to the emergence of new expensive drugs, minimal coverage of insurance for imported drugs (except
for certain drugs); and induced demand by doctors for expensive new drugs. Irrational Medicine prescribing and
use of antibiotics, especially in the area of injection drugs adds to this issue. Therefore, the need of mechanisms
for HTA (Health Technology Assessment), including evaluation of cost, effectiveness, cost - benefit and other
analyzes to confirm the entry of drugs into the country's health system, is essential. Medicine subsidy
controversy and its allocation problem is an important part of the medical system. Allocations of certain
subsidies to minority of specific patients and don’t considering many other needy patients, make it necessary to
review the policy in this field. Overview of the pharmaceutical market in the last decade shows that since 77s,
the market value from 1965 billion rials has been reached to 19 thousand rials in 86s. In other words,
government subsidies support (excluding local payment) from 60% of the total drug sales in 77s has been
dropped to about 12 percent this year. This issue can be one of the reasons of people pay out of pocket
enhancement (out of pocket) during this decade. On the other hand, about the inside produced drugs, price
reform has not happened to compensate this difference (13).
One of the problems, don’t considering the role of research and its required funding in the country's
pharmaceutical system. However, this area has focused on industrialized countries and governments and the
private pharmaceutical companies that are most important financial resources supplier are approximately equal
for research and new drugs discovery. 10 main pharmaceutical companies in the world are allocated between 4 to
17 percent of their sales to research & development (14). In 2001, Farmasya and Straznka companies are
allocated 17 percent, and Pfizer 15 percent, of their sales to research & development (15). Pharmaceutical
companies are attributed the high cost of drugs to the research. This causes problems such as is ignoring the
disease of poor groups of community (neglected diseases). However, research and development for new drugs is
usually based on market needs rather than health priorities. Which clearly shows the local research is assisted.
Data related to the WHO's National Health Accounts (NHA), which has the most comprehensive information on
medicines management, shows that financial resources spending on drugs is at least one-third higher than other
health items. Drugs have allocated 15% of health costs in the global level. According to NHA information in
1386 in Iran, total spent cost for drugs was around 9/1 billion dollars, with this assumption that health budget
will be around 8 billion; this proportion is about 20 percent (16). In 2000, the capitation spending for medicines
in countries with high-income levels, is about $ 400 and in low-income countries is about $ 4. This spending in
162
6. Journal of Economics and Sustainable Development www.iiste.org
ISSN 2222-1700 (Paper) ISSN 2222-2855 (Online)
Vol.4, No.1, 2013
our country in 1384, was $ 20.
However, 90% of the drug purchase in terms of value is conducting by 15 percent of the world population in
high-income countries. This trend has intensified in recent years. America's pharmaceutical market share from 18
percent in 1976 has reached to 52 percent in 2000. In low-income countries, medicines purchase share from 3.9
percent in 1985 has been reached to 2.9 percent in 1999, medicines sales share has been reached from 98% to 64%
percent (17).
Conclusion:
The major percentage of drug turnover of drug system is in the public sector, which includes the drug
manufacturing companies, insurance companies and the importer. This situation is contrary to the path that is
considering in the world. This trend has increased in the 90's. Governments' contribution in investments for the
drug sector is declining faster than the state's contribution in health. It is worth mentioning that to create a
balance between the demands for drugs in low and middle-income countries and also the role of foreign
investment need more important role playing of state sector.
References:
1- Noori H (2012), Potentials and challenges of distribution system in drug sector, The first Drug
Administration and Economics cross congress [Persian]
2- The world health report 2006- Working together for health (2006). World Health Organization, Geneva
3- Achievements, challenges and prospects facing the health system of the Islamic Republic of Iran (2010),
Volume II, Ministry of Health and Medical Education Policy Council [Persian]
4- Hossaini S A, Esma`el zade H, Darabvi Sh, Dinaravan R (2012) . Determining the position of the
pharmaceutical sector in health care system. The first Drug Administration and Economics cross congress
[Persian]
5- The national report of pharmecutical sector evaluation in Islamic Republic of Iran according to
suggested model of health system reform unit (2006), Practical researches Bruea, Food and Drug
departmant[Persian]
6- Amin loo H (2012), There is dissatisfaction and shortage in spite of growth in health budget , Medical News
[Persian]
7- Abolhlaj M , Fazal Hashemi S I, Kazemian M, Ramezanian M (2007), financial and economic policies in
the health sector, research and analysis projects of the health system status: review of the health financing
system and the proposed interventions, Ministry of Health and Medical Education [Persian]
8- Paolucci F (2011). Health care financing and insurance, options for design,Springer
9- Strubert Speziale HY, Alen J, Carpenter DR (2003).Qualitative Research in Nursing, 3rd Ed.Philadelphia:
Williams & Wilkings
10- Abachi Zade K, Abolhalaj M, Bastani P, Ramezanian M, Tamizkar N (2012), Developing the money map of
Iranian drug sector, WASJ ,In press
11- Islamic Republic of Iran national drug policy (2003), Ministry of Health and Medical Education, Food and
Drug departmant[Persian]
12- Pigvani E. Studying the Pharmaceutical Area - Module 11. World health organization, Geneva, 2006.
13- Strategic plan of drug sector (As a part of national comprehendive scientific projedt) (2006), Ministry of
Health and Medical Education, Food and Drug departmant[Persian]
163
7. Journal of Economics and Sustainable Development www.iiste.org
ISSN 2222-1700 (Paper) ISSN 2222-2855 (Online)
Vol.4, No.1, 2013
14- Nikfar S , Majdzadeh A, Abdollahi A (2005).Monitoring of national drug policy and standard indicator
conformity to decision of the national drug selectioning committee in Iran. Biomed central international
health and human rights; 5(5).
15- Basmanji K. Pharmaceuticals in Iran: An Overview. Arch Iranian Med. 2004; 7(2). 158-164.
16- Strategic plan of pharmaceutical science research(2006), national center for medical sciences researches,
Iran [Persian]
17- Strategic plan of pharmacology council (2006), Educational department of Ministry of Health and Medical
Education [Persian]
164