Sources of bias in the economic analysis of new drugs. Health Outcomes Committee Pharmaceutical Research and Manufacturers of America, Washington, DC.
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Biomedical subjects
Publications and source records attributed to J P Gagnon.
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One proposal for community pharmacies to survive in an increasingly competitive market is to offer services that consumers want and need. This study examined the effects of such a value-added pharmacy services (VAPS) program implemented at 19 experimental pharmacies; another 16 pharmacies served as a control group. The study found that patrons of VAPS pharmacies received more pharmacy services and were more likely to report that the pharmacist talked to them about their medication than patrons of control pharmacies. This study demonstrates that a value-added services program can have an impact on pharmaceutical services.
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A study of patients, physicians, and third party prescription plan administrators was conducted to identify those pharmacy services they believe are important and valuable and to determine whether third party plan administrators would reimburse pharmacists for such services. Patient and physician focus groups indicated that both wanted personalized services related to medications. Physicians believe that pharmacists are talking to patients about their medications, whereas patients want more drug information but report that pharmacists are not always providing such information. A mail survey of 41 third party prescription plan administrators indicated they believe that pharmacy services are important to consumers and that pharmacists are already providing most of the services identified. One-third of the third party administrators said their companies would consider implementing a structured pharmacist incentive plan to improve enrollee satisfaction. Those whose companies would not most often gave "increased cost" as the reason. No clear relationship was shown between number or type of services and the incentive value offered. Providing administrators with evidence that enhanced pharmacy services will increase overall program cost savings may lead to implementation of pharmacy incentives.
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The advent of prospective reimbursement in hospitals has forced hospital administrators, pharmacy directors, and pharmacy and therapeutic committees to carefully compare the cost and benefits of similar drugs. Accomplishing this task is difficult. This paper reviews the literature on drug-drug cost effectiveness procedures and outlines a methodology that might be used to contrast and compare two drugs with similar therapeutic outcomes. The data to conduct this analysis can be obtained from published articles on clinical studies and company sources and entered into a microcomputer electronic spreadsheet. The study discusses the implications and use of cost effectiveness analysis to evaluate drugs by hospital formulary committees.
The research question addressed in this study was, "Do changes in promotional expenditure cause changes in the size of the market (primary demand) or market share (selective demand)?" Two types of promotion were evaluated; sales calls to physicians and medical journal advertising. The sales elasticities of each of these promotional techniques were estimated through the use of ARIMA modeling. The market expansive effects and the market share effects were measured for each of 7 drugs in two therapeutic categories, the benzodiazepines and diuretics. The results of the analysis showed that there was no correlation between changes in detailing or journal advertising expenditures and primary or selective demand. Thus, it was assumed that the primary and selective demand elasticities for pharmaceutical advertising may be equal to zero. Drug manufacturers should evaluate the effects of reductions in their promotional expenditures, changes in promotional content, as well as seek alternative methods of advertising which may have a higher sales elasticity and effectiveness.
Legally accountable to the public, state boards of pharmacy are continually confronted with the problem of maintaining the quality of pharmacy practice. One approach to accomplishing this task has been to implement mandatory continuing education requirements for relicensure. This study evaluated the perceived effectiveness and deficiencies of various states' continuing education regulations. A 40-question survey was mailed to 600 pharmacy board members and continuing education providers to determine their attitudes toward continuing education, support of mandatory continuing education, and their opinion of alternative methods for improving the quality of pharmacy practice. Responses from approximately one-half of those surveyed indicate board members and continuing education providers were positively disposed toward continuing education. However, there was room for improvement in most states' mandatory continuing education regulations. A relicensure examination was considered to be the best method to ensure competency, while mandatory continuing education was viewed as acceptable to pharmacists, and relatively easy to administer. The consequences of the study's findings for modifying state continuing education regulations is discussed.
The purpose of this study was to investigate the extent of consumer demand for patient-oriented pharmacy services. Data, collected via a self-administered questionnaire distributed to 300 households, were analyzed using Kruskal's program for additive conjoint analysis. The results indicate substantial consumer demand for making advisory services available on request, moderate demand for provision of patient medication records, and little demand for voluntary provision of advisory services.
Over the past 20 years, much research has focused on evaluating pharmacists' performance as drug consultants to patients and on identifying factors that affect pharmacists' performance in this role. Little has been done, however, to assess the impact of patient characteristics, such as age, income, education, and drug expenditures, on pharmacists' performance as drug consultants. The purpose of this study was to examine this impact. Data were gathered via a mail survey of 300 households in Raleigh, NC. Multiple regression analysis was used to analyze the data. Results indicated that pharmacists generally are available to answer patients' drug-related questions, that pharmacists usually do not provide counseling to patients voluntarily, and that pharmacists are significantly more likely to counsel patients who have lower educational attainment and higher drug expenditures. These results appear to suggest that pharmacists have adopted the role of drug consultant to patients, but only to a limited extent.
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This study was conducted to examine the association between drug price, drug category, duration of coverage of the original prescription, units prescribed per day, and a patient's failure to obtain authorized refills of prescription medication. A two-stage sampling of pharmacies and prescriptions yielded a total sample of 1,058 prescriptions. The Drug Possession Ratio (DPR), defined as the ratio of number of days of medication dispensed to number of days of medication prescribed, was significantly related to drug price and drug category (p less than 0.05). The highest DPR was associated with the most expensive medication. Tranquilizers, antidepressants, and sedative hypnotics exhibited high DPR, while antihistamines and decongestants exhibited low DPR.
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