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At least 685 records · Page 38Linked to original sources
PubMed2003

A 3-stage model for assessing the probable economic effects of direct-to-consumer advertising of pharmaceuticals.

BACKGROUND: The pharmaceutical industry employs a variety of marketing strategies that have previously been directed primarily toward physicians. However, mass media direct-to-consumer (DTC) advertising of prescription drugs has emerged as a ubiquitous promotional strategy. OBJECTIVE: This article explores the economics of DTC advertising in greater depth than has been done in the past by using a 3-stage economic model to assess the pertinent literature and to show the probable effects of DTC advertising in the United States. METHODS: Economics literature on the subject was searched using the Journal of Economic Literature. Health services literature was searched using computer callback devices. RESULTS: Spending on DTC advertising in the United States increased from $17 million in 1985 to $2.5 billion in 2000. Proponents of DTC advertising claim that it provides valuable product-related information to health care professionals and patients, may contribute to better use of medications, and helps patients take charge of their own health care. Opponents argue that DTC advertising provides misleading messages rather than well-balanced, evidence-based information. The literature is replete with opinions about the effects of prescription drug advertising on pharmaceutical drug prices and physician-prescribing patterns, but few studies have addressed the issues beyond opinion surveys. The economic literature on advertising effects in other markets, however, may provide insight. CONCLUSION: DTC advertising indirectly affects the price and the quantity of production of pharmaceuticals via its effect on changes in consumer demand.

Advertising↗
PubMed2004

[Health economic studies in dermatology--review of the literature, evaluation and practical aspects].

BACKGROUND: Health economic studies attempt to objectivity treatment results to place them in economic. These studies summarize both physician care and other medical services to allow a more rational use of limited resources and are of great value. METHODS: The health economic studies in the literature were analyzed by the conducting countries, financing, the study period and the interval until publication. A quantitative comparison to other specialties in medicine was performed. On the basis of a checklist of basic criteria, a qualitative assessment of the studies was performed to rate the significance. RESULTS: The number of studies showed a fivefold increase. A third of the dermatological studies (n = 71) were conducted in the United States, 23.94% in Great Britain, 9.86% in Sweden and 35.23% in other countries. The interval until publication was 0 to 9 years. CONCLUSIONS: The increase in the number of studies may be explained by the growing demand for clarification of the economical situation. Reasons for the significant differences between different countries might be the financing of the studies or the nature of the dominant health care system. Whereas American studies are predominantly sponsored by pharmaceutical companies, the ones in Great Britain and Sweden are supported by public authorities. The long delays in publishing may be accounted for by long review periods and by difficulties in transferring large amounts of data in international studies. Particularly the introduction of the DRG system in Germany has increased demands for cost-effective action on the basis of well-founded and high-quality health economic studies.

Cost-Benefit Analysis↗
PubMedDate not supplied

Use of pharmacoeconomics information--report of the ISPOR Task Force on use of pharmacoeconomic/health economic information in health-care decision making.

OBJECTIVES: Despite the growing number of pharmacoeconomic (PE)/health economic (HE) studies, very little is known about their use by decision makers. The objectives of the Task Force were to ensure that the good research practices of PE/HE studies pay attention to the needs of health-care decision makers and to develop a "toolbox" for the health-care decision maker wanting to interpret and use PE/HE studies. METHODS: The membership of the Task Force consisted of individuals involved in making decisions about the availability or use of medicines and researchers into the use of economic evaluations. The group communicated by E-mail and face-to-face meetings. A literature review of decision makers' attitudes toward PE/HE studies and published economic evaluation guidelines was undertaken. In addition, a focus group discussion was held with opinion leaders in managed care pharmacy. RESULTS: The literature review identified 16 surveys of decision makers' attitudes toward PE/HE studies and 15 published guidelines that outlined reporting requirements for economic evaluations. These were reviewed and classified. Based on the published literature and comments from decision makers, seven additional reporting requirements for studies were specified. CONCLUSIONS: While the Task Force's additional reporting requirements may be helpful to decision makers, they raise a number of issues. These include the feasibility of meeting the additional requirements, whether decision makers should receive more education in economic evaluation, and whether there should be more study of health-care decision-making procedures themselves.

Cost-Benefit Analysis↗
PubMed2006

Using the Delphi technique in economic evaluation: time to revisit the oracle?

BACKGROUND AND OBJECTIVE: Although the Delphi technique has been commonly used as a data source in medical and health services research, its application in economic evaluation of medicines has been more limited. The aim of this study was to describe the methodology of the Delphi technique, to present a case for using the technique in economic evaluation, and to provide recommendations to improve such use. METHODS: The literature was accessed through MEDLINE focusing on studies discussing the methodology of the Delphi technique and economic evaluations of medicines using the Delphi technique. RESULTS AND DISCUSSION: The Delphi technique can be used to provide estimates of health care resources required and to modify such estimates when making inter-country comparisons. The Delphi technique can also contribute to mapping the treatment process under investigation, to identifying the appropriate comparator to be used, and to ensuring that the economic evaluation estimates cost-effectiveness rather than cost-efficacy. CONCLUSION: Ideally, economic evaluations of medicines should be based on real-patient data. In the absence of such data, evaluations need to incorporate the best evidence available by employing approaches such as the Delphi technique. Evaluations based on this approach should state the limitations, and explore the impact of the associated uncertainty in the results.

Delphi Technique↗
PubMed1989

Medical education and economics.

The time available to medical students for learning is scarce in relation to the knowledge they are asked to absorb. New material should not therefore be added to medical curricula without careful consideration of the benefits of the extra knowledge compared to the costs of obtaining this knowledge. In this paper a justification for integrating economic principles into medical education is presented. It would benefit society by encouraging the practice of efficient medicine, and benefit students by giving them the ability to absorb the growing economic content of the medical literature and by encouraging an appreciation of why economic factors will influence their clinical decision-making. These benefits would accrue at little cost because only a limited number of economic concepts need to be absorbed by medical students. The critical concepts are outlined and some of the obstacles to students applying this knowledge in practice are considered. The paper concludes by suggesting that the impact of teaching economics to medical students should be evaluated, but this will require further research into ways of evaluating the outcome of medical education programmes in general.

Curriculum↗
PubMed2005

Economic impacts of the mortality rate for suckling pigs in the United States.

OBJECTIVE: To measure economic impacts attributable to the mortality rate for suckling pigs in the United States. DESIGN: Economic analysis that incorporated data from various sources. SAMPLE POPULATION: Suckling pigs on U.S. swine farms. PROCEDURE: Economic impacts associated with the mortality rate for suckling pigs during 1995 were estimated from supply-and-demand curves for pork and from an estimate of the elasticity of production for pigs entering the grower-finisher phase of production. RESULTS: A decrease in the mortality rate for suckling pigs would have caused an increase in pork production and a decrease in price and total value of production. Assuming no suckling pigs had died during 1995, consumer surplus would have increased by (mean +/- SE) 430 +/- 160 million dollars, whereas producer surplus would have decreased by 180 +/- 140 million dollars. The total gain to the US economy would have been 250 +/- 30 million dollars. CONCLUSIONS AND CLINICAL RELEVANCE: Researchers who attempt to estimate the economic impact of mortality and morbidity rates of livestock should not ignore the influence of demand and the possibility of price adjustments. Consumers would stand to benefit from an increase in pork production associated with a reduction in the mortality rate for suckling pigs, whereas the swine industry would experience an economic loss. Individual producers need to compare the costs of measures intended to reduce the mortality rate for suckling pigs with the anticipated benefits.

Animal Husbandry↗
PubMedDate not supplied

Health economics--concepts and conceptual problems.

Awareness of the economic manifestation of health and diseases and the limited resources allocated to health care services has brought to the focus a new discipline - health economics. Cost accounting, cost benefit, cost effectiveness methods etc. are increasingly becoming an integral part of the health management and evaluation of health programmes. Various concepts and problems relating to health economics are discussed in the present paper. More efforts should be made to conduct health economic studies in hospitals and health centres by which the process of standardisation of the concepts, would be easier. Health economics should also find its due place in the medical curriculum.

Cost-Benefit Analysis↗
PubMed1990

[Changing economic environment of hospitals: management challenges of the 1990s].

The modern hospital is an organization which is influenced by the external environment in which it functions. A major relevant area is the economic environment. In recent years the western world has been facing the challenge of rising costs of health care and an increase in their proportion to the gross national product of most countries. Consequently, hospitals as major providers of health care are under pressure from governments and health insurance companies to cut costs and to "produce" more efficiently. Since hospitals worldwide are finding it hard and painful to function in the new environment in which attitudes to hospitals are changing, a potential managerial-economic crisis may be the next phase. How can the hospital adapt to these changes? First, by adopting managerial attitudes and the tools of the business sector. These include: the strategic planning process, hospital operative autonomy, creating medical-economic responsibility centers as departments, cost-accounting for medical procedures, and case-mix budgeting. Management information systems are necessary during the transition. The hospital information system should include functions at the operative level, such as outpatient visits, and admissions and discharges of patients; and also clinical, diagnostic and laboratory procedures related to the patient case-mix. The second level is a management information system which includes salaries of personnel, case-mix budgeting with variance analysis, prices of procedures and epidemiological data. The authors believe that only the managerial approach combining medical and economic disciplines can meet the challenges of the changing modern economic environment.

Economics↗
PubMed1989

Economic theory and international migration.

The modern literature on the economics of immigration focuses on 3 related issues: 1) what determines the size and skill composition of immigrants flows to any particular host country; 2) how do the immigrants adapt to the host country's economy; and 3) what is the impact of immigrants on the host country's economy? This article reviews the theoretical framework and empirical evidence provided by the economics literature on these questions. It demonstrates that the economic approach, using the assumption that migration behavior is guided by the search for better economic opportunities and that the exchanges among the various players are regulated by an immigration market, leads to substantial insights in to these issues.

Behavior↗
PubMed1985

Economic-demographic models for forecasting interregional migration.

"A class of spatial economic-demographic forecasting models is proposed. The models combine elements of traditional Markov and economic gravity models. A base-period probability structure is modified by the changing relative distribution of economic opportunity. Estimation issues are addressed, and an empirical application to US interstate migration during the late 1970s is described. It is contended that the framework represents a merger of past demographic and economic modeling traditions in a spatial interaction framework."

Americas↗
PubMed1985

Migration in an economic-demographic model for the Canadian provinces.

"This paper is a description of the structure of a multiregion economic-demographic model for the Canadian provinces. An important part of the demographic model is the estimation of net migration equations based on a human capital approach and incorporating the adding-up constraint that arises since the sum of the net migration flows across all provinces must be 0 in each period. These endogenous migration flows allow for variables from the economic model (wage rates and unemployment rates) to influence the source population, the labour force and, therefore, the unemployment rate and other variables in the economic model." The model is used in simulation experiments in order to illustrate the interaction between economic and demographic factors and how this interaction affects the impact of policies.

Americas↗
PubMed2004

Do economic cycles have a permanent effect on population health? Revisiting the Brenner hypothesis.

The Brenner hypothesis is essentially that economic cycles, characterized by unemployment and fluctuations in per capita income can have profound negative implications for population health. A number of subsequent studies have identified shortcomings in Brenner's model and have reported results that for the most part contradict his results. This paper argues that the failure to account for the time-series properties (i.e. the potential for unit root behaviour) of macro level data is a key omission in Brenner's and other subsequent studies. To address this omission an error correction model specification was applied to American data for the period 1948-1996. The findings suggest that economic cycles do have a permanent effect on population health. Paradoxically, they also suggest that economic growth and increases in unemployment reduce aggregate mortality risk. A need for measures of economic change that are perhaps more sensitive to the effects of economic cycles on groups that may be at greater risk of unemployment was identified.

Health Status↗
PubMed1981

Economic change and mental health in an uncontaminated setting.

Recent research has suggested that economic change in a community is followed by increases in illness and psychopathology. The data necessary for a test of this hypothesis are often confounded by overlapping political and economic boundaries. The present study uses economic indicators and mental health service first admissions from the State of Hawaii, where the political and economic organizations are coterminous and assumed to be insulated from interacting with other communities by geographic separation. Monthly data from September 1972 through December 1975 were detrended and analyzed by cross-correlation with leads and lags of 1 to 3 months. Measures of economic change which depict upturns and downturns in the economy were found to be predictive of first admissions for a number of population subgroups at lags of 2 and 3 months. The implications of the findings for planners and policy-makers are discussed.

Adult↗
PubMed1995

Symposium on health economics in oncology. Freiburg, Germany, June 1995.

Dr. E. Enghofer (Wien, Austria) summarized the content of the presentations and discussions of the symposium in his concluding remarks. 1. The organizers should be congradulated on their initiative in bringing together at the symposium experts from different disciplines, i.e., medicine, ethics, health economics, jurisprudence, the pharmaceutical industry and, last but not least, cost providers. 2. Health economics as an issue in health care has been around for quite some while. One example can be found in the German Drug Guidelines dating back to 1990, where the following terms have already been defined: therapeutic benefit, medical needs, and achieving therapeutic goals. 3. Health economics serves as a "support function" in the medical decision-making process. It has as yet no decisive role in the application to license a drug nor in questions concerning a physician's liability. Health economics as a discipline, however, was a reminder of, and served as a catalytic function for: a) The differentiation between the benefit of a medical intervention and its pure effectiveness. b) The definition of medical standards as a means to compare the quality of health care between different institutions, to uncover quality deficits and to develop strategies for the optimization of medical quality (quality management). Routine deviation from these standards is unethical. The German Cancer Society has taken on the task of defining such standards in cancer care. c) The difference between rationalising and rationing health care. The spending of the current health-care budget needs to be screened for unnecessary and/or inappropriate diagnostic procedures and treatment modalities as well as for "below-standard" care. The money that can be saved here can then be shifted towards financing "state of the art" medicine or can be used in the decision to substitute certain procedures. 4. The a priori definition of the desired outcome of a medical intervention is of paramount importance for the evaluation of the actual treatment result. Economical evaluations are easier when cure rather than palliation is the aim of a particular treatment and when alternative therapies do exist such that cost comparisons are possible. In any case, therapeutic interventions need to be adapted to the desired treatment goal; only then can the question be answered whether or not the means (cost) are (is) justified. 5. Outcome studies need to take into account every relevant medical aspect (i.e. disease management studies), and they should be accompanied by evaluation studies. The latter must also include unselected patients in daily practice.(ABSTRACT TRUNCATED AT 400 WORDS)

Antineoplastic Agents↗
PubMed1988

Training health services managers: improving health by more health economics?

In times of rising health expenditures and imminent health problems, efficiency is a crucial element for maintaining and improving health care and, finally, health. One major support measure is the effective management of health services. This paper considers possible improvements of health care by training health services managers in health economics. It surveys the current state of health economics training, presents approaches towards the key issues of health economics, discusses the impact of health economics by two examples, and considers management aspects of health economics training.

Curriculum↗
PubMed1987

Relation of economic change to Swedish health and social well-being, 1950-1980.

To what extent, and through what mechanisms, does the deterioration of economic conditions affect the health of the population at the national level? In this paper, the author presents the results of a study of Swedish data, analyzing the post-World War II changes in mortality rates in relation to deleterious economic changes, especially unemployment, business failure rates, and declines in real per capita income. The analysis uses a version of the 'Economic Change Model of Pathology' which includes the influence of health risks related to patterns of consumption and production. It is found that economic growth plays a principal role in reducing mortality at nearly all ages, and specifically mortality due to total cardiovascular disease, cerebrovascular disease, total heart disease, ischemic heart disease, total malignancies, disorders of infancy, and motor vehicle accidents. Economic recession, by contrast, is related to increases in total mortality for virtually all age groups, in both sexes, for major causes of death and causes due to psychopathological conditions. Per capita alcohol consumption, by specific beverage, is an important risk to mortality rates in cerebrovascular disease, malignancies, cirrhosis, motor vehicle accidents, suicide, homicide, and infant diseases. Cigarette consumption rates are positively related to mortality due to cardiovascular, malignant, and infant diseases; fat consumption rates are positively related to cardiovascular and cancer mortality.

Economics↗
PubMed2005

Economics and physical activity: a research agenda.

Both economic and public health/medical perspectives play an important role in the policy process, but often approach policy questions in an incompatible way. Economics and public health perspectives can complement each other, although harnessing any synergy requires an understanding of the other perspective. This article contrasts the two perspectives and reviews existing economic research in physical activity. Much effort has gone into producing cost-of-illness numbers or cost-offset claims with limited value from an economic perspective, although some simple steps could make them more informative. A more notable advance for active living research would be the adoption of standardized cost-effectiveness analysis methods, even just as an add-on to ongoing intervention trials. Probably the most challenging and exciting area, however, is the emerging research on the interaction between environmental incentives and physical activity. An economic perspective with its explicit focus on market failures is an important complement to ongoing active living research as policymakers in the United States are more likely to rely on the market to solve policy problems than on regulation. It is imperative to understand how the market works in actuality, not in the abstract, an area wide open for empirical research.

Cost of Illness↗
PubMed2005

Social memory, social stress, and economic behaviors.

Social memory plays a pivotal role in social behaviors, from mating behaviors to cooperative behaviors based on reciprocal altruism. More specifically, social/person recognition memory is supposed, by behavioral-economic and game-theoretic analysis, to be required for tit-for-tat like cooperative behaviors to evolve under the N-person iterated prisoner's dilemma game condition. Meanwhile, humans are known to show a social stress response during face-to-face social interactions, which might affect economic behaviors. Furthermore, it is known that there are individual differences in a social stress response, which might be reflected in individual differences in various types of economic behaviors, partially via different capacities of social memory. In the present study, we investigated the acute effects of social stress-induced free cortisol (a stress hormone) elevation on hippocampus-dependent social memory by utilizing the Trier social stress test (consisting of a public speech and a mental arithmetic task). We also examine the correlation between an economic behavior-related personality trait (i.e., general trust scale) and social stress-induced cortisol elevations. We found that (1) social stress acutely impairs social memory during social interaction and (2) interpersonal trust reduces social stress response. Together, interpersonal trust may modulate economic behaviors via stress hormone's action on social cognition-related brain regions.

Adult↗