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At least 73 records · Page 4Linked to original sources
PubMed1980

The economics of pharmaceutical policy in Ghana.

Pharmaceutical expenditure in Ghana accounts for about one-third of the total recurrent costs of the Ministry of Health, but in isolation this figure is a misleading indicator of economic importance. In the primary care sector up to 75-80 percent of the running cost of a health center may be accounted for by pharmaceuticals, and because the Ghanaian currency is heavily overvalued, even these proportions understate the true value of resources used on important drugs. An apparent lack of central control of drugs expenditure led to a study of the existing allocation procedures and prescribing practices. The results suggest large-scale wastage through overprescribing, often in response to patients' preferences for more costly medication. Approaches to improved planning of drug use, including the setting of expenditure norms based on recommended prescribing routines, are detailed, and it is concluded that the resultant savings could allow a sizable extension of the coverage given to rural populations by the primary health care system.

Drug Utilization↗
PubMed1997

[Distribution of methadone by pharmacies--the Hamburg method].

This article presents the results of a study in Hamburg about the dispensation of methadone in pharmacies. Experience in Hamburg (since 1988) shows that this "Pharmacy-model" is not only flexible, but also user-friendly. Furthermore the fear that methadone-patients would steal, use violence or harass not only the pharmacist but also other customers proved to be wrong. These experiences call for a reform of the drug-laws permitting the dispensation of methadone in pharmacies in Germany, as it is already practice in some other European countries.

Ambulatory Care↗
PubMedDate not supplied

Pharmacy school graduates by state and region: 1990-1999.

OBJECTIVE: To describe the distribution of pharmacy schools and graduates (first professional degree) at the state, divisional, and regional levels during the 10-year period from 1990 through 1999, as well as enrollment patterns by residential status. DESIGN: Yearly school-level graduate counts from 1990 through 1999 were obtained from the American Association of Colleges of Pharmacy and analyzed at the state, division, region, and national levels. Comparisons were made before and after adjusting for state population. In-state enrollment patterns for 1998 were examined. SETTING: United States. MAIN OUTCOME MEASURES: At various geographic levels, the distribution of schools and new graduates adjusted to population; cumulative production of graduates; percentage of in-state enrollment. RESULTS: Over the 10-year study period, 73,541 new pharmacists graduated from U.S. pharmacy schools, about 9,500 more than graduated in the 1980s. The number of schools varied across states (range, 0-5), as did cumulative graduate counts (range, 0-7,303), with high-producing states including those with four and five schools. Nationally, 28 new pharmacists graduated per year per 1 million population. Several populous states, including California, Florida, Illinois, and Texas, produced pharmacists at a rate substantially below the national average when computed as graduates per year per million population. The West region had the lowest annual graduate count adjusted for population. In-state enrollment was consistently high, with nearly 80% of individuals graduating from schools in their state of residence. CONCLUSION: The number of pharmacy schools and graduates increased during the 1990s, a period of substantial educational and workforce change in pharmacy. Numbers of schools and graduates varied significantly across states. The West region and several populous states had graduate counts less than one-half the national average. With the current national pharmacist shortage, greater attention should be directed to the development of strategies to address imbalances between supply and demand within individual states.

Education, Pharmacy, Graduate↗
PubMed2003

[Area distribution of out-issued prescriptions from Saiseikai Kurihashi Hospital and behavior patterns of outpatients for selection of pharmacy].

The area distribution of out-issued prescriptions for outpatients in Saiseikai Kurihashi Hospital was surveyed over 6 months from the first day of out-issue. Behavior patterns of outpatients in the selection of pharmacy were also investigated. Our survey included the out-issued prescriptions in eight surrounding newly established pharmacies together with the first out-issue. Computer simulation indicated that 70% of the outpatients selected the surrounding pharmacies when they received their out-issued prescriptions the first time. However, the percentage of surrounding pharmacies selected by the patients decreased to 60% the second time, and then again increased to 80% the third time. The results suggest that most outpatients use surrounding pharmacies, although they try to use the pharmacies near their homes for a time.

Choice Behavior↗
PubMedDate not supplied

Profitability, third-party reimbursement, and access to community pharmacies.

The purpose of this study was to analyze the extent to which third-party reimbursement programs have affected the profitability and availability of community pharmacies. Data were taken from records maintained by the Virginia Board of Pharmacy and a survey of 177 community pharmacies. Between 1989 and 1994, 258 outpatient pharmacies opened and 342 closed. Chain and independent pharmacies suffered net losses, and supermarket and mass merchandiser pharmacies experienced net increases. Few significant changes occurred in the distribution of pharmacies over the study period. Fifty-nine chain and independent pharmacies and 1 supermarket pharmacy chain provided usable profit and reimbursement data. These pharmacies experienced declines in profits and increases in the percentage of prescriptions reimbursed by private third-party prescription programs over the last several years. Regression analyses indicated that higher ratios of sales of private third-party prescriptions to private-pay prescriptions were associated with lower profits. All respondents indicated that changes in private third-party reimbursement had substantially reduced profits over the past 5 years. The results indicate that the growth of private third-party payment has led to lower pharmacy profits but has not yet resulted in problems of consumer access.

Costs and Cost Analysis↗
PubMed1991

Expanding staff pharmacists' responsibilities to maintain pharmacy services in a neonatal intensive-care unit.

The conversion of pharmacist responsibilities in a neonatal intensive-care unit (NICU) pharmacy satellite from drug distribution to both clinical services and drug distribution is described. When the pharmacy department could not recruit a specialty-trained clinical practitioner to fill an open NICU position, the position was converted to a fourth satellite pharmacist position, and each of the four NICU satellite pharmacists assumed clinical responsibilities for the NICU. Clinical and distributive functions had previously been separate. Staff development programs and a contract with the previous NICU clinical practitioner for consultative services helped to ease the transition. NICU pharmacists currently provide inservice education to medical residents and the nursing staff, provide drug information, monitor drug therapy, perform pharmacokinetic monitoring, are involved in research, and work to streamline satellite operations. For one of every four months, the NICU pharmacists primarily provide clinical services; the remainder of the time clinical activities are combined with drug distribution responsibilities. The staffing schedule has enabled the department to extend the hours that clinical services are available. The NICU pharmacists maintain secondary areas of staffing, and other pharmacists periodically staff the NICU satellite. Staff pharmacists in the NICU pharmacy satellite developed clinical skills that permitted integration of clinical and distributive pharmacy services.

Hospital Bed Capacity, 500 and over↗
PubMed1991

Drug use and the role of patients and prescribers.

In order to move towards rational drug use in any national or local setting the methods of inquiry have to be expanded. Both the public and private sector have to be addressed. In the latter the pharmacists might be studied using a tracer, fictitious client. One important factor influencing prescribing, drug information, has rarely been assessed scientifically. Experimental studies using group randomization are, however feasible even in developing countries. The individual human being must be in the focus of drug studies and health care and health in the foreground. The combination of qualitative and quantitative methods will assist us to achieve rational drug use that is culturally acceptable, economically feasible and pharmacologically sound.

Developing Countries↗