Journal of Pharmaceutical Policy and Practice最新文献

Background: The objective of this case study is to pilot a framework of public contributions examining the origins of products from two major European pharmaceutical companies, Novartis and Novo Nordisk, that received approval from the European Medicines Agency (EMA) between January 2014 and May 2024. Our primary focus was to investigate the extent of public contributions, including government grants, public-private partnerships, and other forms of public funding, that supported the development of these products. Additionally, we explored whether these companies primarily relied on in-house research and development (R&D) capabilities or acquired these products at various stages of their development.

Methods: We conducted a thorough analysis of the products approved during the specified period, identifying the origins of each product. The analysis included detailed examination of public databases, financial disclosures, and scientific publications to trace the flow of public funding. We built on a list of sources from our previous studies to increase the level of detail.

Results: Novartis demonstrated a tendency to acquire promising products and technologies from smaller biotech firms and other pharmaceutical companies, particularly in therapeutic areas where it sought to strengthen its market position like oncology (16 out of 25 products acquired, licensed or co-developed). Conversely, Novo Nordisk predominantly advanced its products through internal R&D efforts, although it also engaged in selective acquisitions to complement its core capabilities (two out of six products acquired, licensed or co-developed). For Novartis eleven products received public support, for Novo Nordisk one product did.

Conclusion: Our findings reveal that both Novartis and Novo Nordisk use strategic acquisitions with Novartis relying more heavily on it than Novo Nordisk. Our framework for analyzing public contributions was sufficient for the product portfolios of the firms analyzed and helped us identifying public contributions.

Background: Complementary and alternative therapies (CATs) are widely used among patients with epilepsy (PWE), yet their impact on adherence to antiepileptic drugs (AEDs) remains limited and unclear. This study aimed to (i) assess the usage, knowledge, attitudes and practices (KAP) related to CATs and (ii) evaluate their impact on AEDs adherence among PWE.

Methods: A cross-sectional study was conducted among 193 PWE, recruited conveniently from three hospitals on the East Coast of Peninsular Malaysia. Participants' data were collected through face-to-face administration of paper-based questionnaires, including a KAP-CATs and the Malaysia Medication Adherence Scale (MALMAS). The SPSS version 26.0 was used to perform descriptive statistics and non-parametric tests.

Results: Among the participants (mean age = 35.3 ± 12.6 years; female = 54.9%; Malay = 96.9%), 59.6% reported had used some types of CATs, with prayers (86.4%) and massage (78.8%) being the most common. Most participants demonstrated moderate knowledge (61.6%), neutral attitudes (78.6%) and a moderate engagement in CATs practices (47.6%). Common reasons for using CATs included greater availability (54.9%), belief in self-healing (45.6%) and the perception of a permanent cure (44.6%). Notably, only 28.5% of CATs users disclosed their use to a healthcare provider. The prevalence of non-adherence to AEDs was 22.8%, and no statistically significant association was found between usage, knowledge, attitude and practice regarding CATs and non-adherence to AEDs (p > 0.05).

Conclusion: The findings highlight widespread use of CATs among PWE, often driven by cultural beliefs and perceived benefits. Thus, further research is warranted to explore integrative care models that ensure safe, coordinated epilepsy management.

Background: Job satisfaction is a critical factor influencing employee performance, motivation, and retention in healthcare, particularly among pharmacists. Positive workplace relationships and psychological well-being are essential contributors to job satisfaction, yet little is known about how these dynamics function in Saudi Arabia. This study investigates the link between workplace relationships and job satisfaction among Saudi pharmacists. It examines psychological well-being as a mediator and personality traits as a moderator in this connection.

Method: A cross-sectional quantitative design was adopted. Data were collected from 384 licensed pharmacists in Tabuk, Saudi Arabia, by using the Workplace relationship quality questionnaire (WRQ), Job satisfaction survey (JSS), Positive and negative affect schedule (PANAS), and HEXACO personality inventory. SPSS and Hayes' PROCESS macro were used for statistical analysis.

Results: Workplace relationships positively correlated with psychological well-being (r = .52, p < .01) and job satisfaction (r = .45, p < .01). Mediation analysis confirmed psychological well-being fully mediated the connection between workplace relationships and job satisfaction (β = 0.23, 95% CI [0.12, 0.34]). Conscientiousness negatively moderated this connection (β = -0.18, p = .005).

Conclusion: The findings underscore the importance of cultivating strong workplace relationships and promoting psychological well-being to enhance pharmacist job satisfaction. Personality traits should also be considered in workforce planning to optimise job fit and satisfaction.

Background: Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged as a global health crisis in early 2020, leading to widespread morbidity and mortality. In Qatar, as of December 2024, the disease burden has reached over 500,000 cases and more than 600 deaths. While conventional treatments have evolved throughout the pandemic, the use of Complementary and Alternative Medicine (CAM), particularly herbal medicine, has also become prevalent. This study investigated the prevalence, reasons, uses, types, self-reported benefits, and sociodemographic determinants of utilising herbal medicine among COVID-19 patients in Qatar.

Methods: A cross-sectional study was conducted among patients attending Qatar Primary Health Care Corporation (PHCC) clinics. Of the 10,000 SMS invitations that were sent, 882 survey responses were received from patients diagnosed with COVID-19 between 1 March 2020, and 30th April 2022. Following the exclusion of 31 participants due to missing data, sociodemographic data from 851 participants were analysed using logistic regression to assess predictors of herbal medicine use. Prevalence, patterns, types, and self-reported benefits were analysed using descriptive statistics.

Results: Of the 851 respondents included in the analysis, 440 (51.7%) reported herbal medicine use. Herbal medicine use was associated with better-perceived health outcomes. Women were more likely to use herbal medicine than men (OR = 1.90, 95%CI: 1.30-2.77, p = 0.001). The most used herbal remedies were ginger (n = 347), turmeric (n = 207), and garlic (n = 155). Family tradition (42%), the belief that herbs are natural (34.8%), and the desire to improve health and survival (31.1%) were the leading drivers of herbal medicine use.

Conclusion: Herbal medicine use was prevalent (51.7%) during COVID-19 in Qatar, with a higher prevalence of use among women. This prevalence was driven by cultural beliefs and perceived health benefits. The study contributes insights to guide future research, policy, and practice toward safe and evidence-informed integration of herbal medicine in pandemic preparedness and broader healthcare strategies.

Background: Cytomegalovirus retinitis (CMVR) is an opportunistic infection frequently seen in people living with HIV (PLHIV) and can cause blindness. Intravenous (IV) ganciclovir is a typical CMVR treatment in Thailand, but oral valganciclovir is a more convenient alternative. However, its cost-effectiveness and budget impact remain unclear. Therefore, this study aimed to analyse the cost-utility and budget impact of oral valganciclovir compared with IV ganciclovir for CMVR treatment in PLHIV in Thailand.

Methods: A hybrid decision tree/Markov model was developed to estimate costs, quality-adjusted life years (QALYs), and life years (LYs). Cost, utility, and probability parameters were obtained from the published literature and national databases. A cost-utility analysis was performed to estimate the incremental cost-effectiveness ratios, whereas a budget impact analysis (BIA) was performed to assess the financial implications. Sensitivity analyses were performed to assess model uncertainty.

Results: Oral valganciclovir was the dominant treatment, providing higher QALYs (3.50 vs. 3.23) and LYs (4.78 vs. 4.75) and lower total costs (133,630 THB vs. 163,024 THB) than IV ganciclovir. One-way sensitivity analysis revealed that retinal detachment probability, drug cost, and inpatient service cost were the most influential parameters. Probabilistic sensitivity analysis revealed that 94.3% of the simulations placed oral valganciclovir in the dominant quadrant. BIA revealed an annual cost reduction of 6,408,714 THB when replacing IV ganciclovir with oral valganciclovir.

Conclusion: Oral valganciclovir was cost-effective and demonstrated budget reduction compared with IV ganciclovir. These findings provide valuable insights into enhancing CMVR management and ensuring efficient healthcare resource allocation.

Background: The Pharmacy Services Questionnaire (PSQ) was developed to measure patient satisfaction with pharmaceutical care. However, it has not been translated into Cantonese-Chinese and validated in the Hong Kong population. To develop and validate a Cantonese-Chinese-translated PSQ among native Chinese patients who have used pharmacy services at community pharmacies in Hong Kong.

Methods: The PSQ was developed and translated into Cantonese-Chinese using iterative forward-backwards translation. Subjects were recruited by convenience sampling at three community pharmacies. Internal consistency, construct validity, discriminant validity, known-group comparison and Confirmatory Factor Analysis (CFA) were performed to confirm that the Cantonese-Chinese-translated PSQ is a valid measure of its intended constructs. Qualitative think-aloud interviews were carried out to test for comprehension and content validity. The subjects' views and interpretation of each questionnaire item were also explored to determine the relevance, comprehensiveness, and adequacy of the response options.

Results: A total of 236 adult subjects were recruited to complete the Cantonese-Chinese PSQ and the Chinese 5-Level EuroQol 5-Dimension (EQ-5D-5L HK) questionnaire. Additionally, think-aloud interviews were carried out with 15 subjects. Most subjects were able to understand and interpret the Cantonese-Chinese PSQ with relative ease. The internal consistency of Cantonese-Chinese PSQ was excellent (Cronbach's α > 0.96) for the full-scale, Friendly explanation (FE) subscale and Managing therapy (MT) subscale. CFA confirmed the hypothesised two-factor structure of the Cantonese-Chinese PSQ. Individuals with higher education levels showed statistically significantly higher satisfaction levels in the overall PSQ score and MT scale score compared to those with lower levels of education. Additionally, there was no statistically significant correlation between the Cantonese-Chinese PSQ and EQ-5D-5L HK scores, demonstrating discriminant validity.

Conclusion: The Cantonese-Chinese translation of the PSQ is a validated, reliable, and semantically equivalent instrument used to assess satisfaction towards services provided by community pharmacies.

Background: Medication errors (MEs) represent avoidable harm that occurs within the healthcare system. While most MEs do not pose significant safety threats, some can result in severe harm, disability, or even death for patients. We aimed to describe the prevalence, characteristics, and outcomes of MEs due to transcribing errors.

Methods: Retrospective analysis of data from the Medication Error Reporting System (MERS) in Malaysia. All ME reports submitted to MERS were verified and classified by trained pharmacists from the Ministry of Health Malaysia. Transcribing errors were identified from all ME reports submitted to MERS that were classified as 'data entry error'. All data from public health facilities (hospitals and clinics) submitted in 2018-2022 were included in the analysis. Descriptive analyses were conducted on frequencies and characteristics of the transcribing errors.

Results: From January 2018 to December 2022, 265,194 MEs were reported to the MERS, of which 12,049 (4.5%) were transcribing errors. The large proportion of transcribing error was related to dose error, i.e. incorrect dose (48.6%) and incorrect frequency (19.9%), followed by drug error (incorrect drug, 13.3% and incorrect patient, 6.3%). The majority of the errors do not reach patients (94.8%). The most possible error causes and contributing factors were work and environment followed by staff factors, task and technology, and medication-related.

Conclusion: There was an increase in voluntary reporting over the years, reflecting a growing culture of reporting among healthcare professionals. These findings offer valuable insights into medication errors caused by transcribing processes in Malaysia, which can inform efforts to improve pharmacy practices, design appropriate interventions, and reduce harm to patients.

Background: Lived experience with suicide - none, vicarious, or personal - may help explain how pharmacists respond to a person at risk of suicide. Leveraging self-determination theory, we explore the motivational pathways of identified, introjected, and amotivation through which lived experience informed pharmacists' intentions to engage in suicide screening, as well as both recommended and unrecommended mental health support.

Methods: An anonymous online cross-sectional vignette study was distributed to registered pharmacists (n = 291), interns, and students (n = 281) in Australia. The vignette describes a patient in a community pharmacy expressing signs of a potential suicide-related issue or crisis. Following on, participants responded to validated measures assessing their motivation to help, intentions to suicide screen, and use both recommended and unrecommended support. Participant demographics, including their lived experience with suicide, was collected. Analyses were performed using SPSS 28.0.1 with the PROCESS macro (Model 4; Hayes, 2022).

Results: Those with no lived experience of suicide were more likely to screen patients for suicide but also more likely to use unrecommended helping compared to those with vicarious and personal experience. Vicarious, relative to no lived experience, was positively associated with suicide screening and recommended helping through identified motivation. Personal lived experience, relative to vicarious, was positively associated with more amotivation that increased both suicide screening as well as unrecommended helping.

Conclusion: Overall, our findings highlight the need to consider pharmacists' lived experience with suicide, as it shapes their motivations to intervene and carries important implications for patient care. Our findings suggest key implications for pharmacy practice, including the importance of self-awareness and reflection on lived experience, integrating pharmacists with vicarious experience into training, and strengthening support for suicide prevention training.

Background: Medication adherence improves health outcomes and overall well-being. Questionnaires and reporting scales remain the most accessible and cost-effective assessment tools for adherence; however, they must demonstrate validity, reliability, and sensitivity to change. The aim of this study is to assess the validity and reliability of the Medication Adherence Report Scale (MARS-5) in the adult population of Albania and to examine the correlations between the adjusted summary scores of MARS-5 and the sociodemographic and health status characteristics of the study population.

Methods: A cross-sectional study was conducted in Albania during November-December 2024, including a sample of 256 individuals ≥18 years with hypertension, diabetes, or both conditions. The Albanian version of MARS-5 translated, according to guidelines, was administered twice (over two weeks) in-person to patients visiting primary health care settings (≈56% females; response: ≈85%). Participants also reported on sociodemographic factors and health status characteristics. Cronbach's alpha was used to measure internal consistency and Pearson's correlation coefficient for the assessment of test-retest reliability.

Results: Cronbach's alpha was 0.89 for the test and 0.91 for the retest. Test-retest reliability was high (r = 0.95, P < 0.001). Above median scores of adherence (adjusted summary score: > 4) were positively associated with urban residence, higher educational attainment, a higher income level, and periodic medical check-ups, but inversely related to duration of hypertension, number of medications for hypertension, overall number of medications, number of times per day using medications, and the total number of daily doses of medications.

Conclusion: MARS-5 is a valid and reliable tool for assessing medication adherence in the adult population of Albania.

Background: The Commonwealth Health Ministers' meetings (2021-2023) identified medicines shortages, pricing, and price transparency as critical issues. This led to the establishment of the Voluntary Information and Price Sharing Database (VIPSD) in 2021, aimed at enhancing procurement transparency, reducing costs, and sharing information on health products amongst member states. However, adoption has been limited due to competing initiatives like pooled procurement systems introduced during the pandemic.

Methods: This scoping review focused on eight Commonwealth countries: Bangladesh, Dominica, Kenya, Malaysia, Malta, Solomon Islands, South Africa, and St. Vincent and the Grenadines. Nations were selected to represent diverse health systems, population sizes, and procurement practices. External researchers conducted literature reviews and standardised data collection to ensure consistency.

Results: The review revealed varied pricing policies and procurement frameworks. Nations like Malta, Bangladesh, Malaysia, and South Africa had pharmaceutical policies ensuring affordability, while others lacked comprehensive pricing policies. Seven countries implemented pooled procurement programmes, enhancing value and reducing costs; three nations operated national health insurance schemes affecting medicine pricing. Five countries used pharmaceutical management information systems to streamline procurement. Despite these efforts, disparities persist due to fragmented frameworks, stock-outs, budget constraints, and delayed procurement processes.

Conclusion: The VIPSD was identified as a potentially transformative tool to enhance transparency, promote fair pricing, improve collaboration, and ensure equitable access to innovative health products. To maximise its impact, the database requires clear scope definition, comprehensive data collection, funding, and robust maintenance. Expanding its adoption could help mitigate price disparities and strengthen medicine accessibility across Commonwealth member states.