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Drug pricing

Gerard T Vondeling, Qi Cao, Maarten J Postma, Mark H Rozenbaum
OBJECTIVE: The aim of this study was to evaluate the impact of patent expiry on drug prices by means of a systematic literature review. METHODS: A systematic literature search was performed in PubMed to identify all published literature on the impact of patent expiration on drug prices. Additional literature was identified using a less distinct syntax in Google Scholar and EconLit. Data extraction followed a standardized assessment form containing the domains study type, study aim, reported outcomes, number of drugs and drug classes assessed, and originators or generics assessed...
July 17, 2018: Applied Health Economics and Health Policy
Ori Liran, Judit Prus, Noa Gordon, Vered Almog, Tsipora Gruenewald, Daniel A Goldstein
OBJECTIVES: A recent theoretical economic model suggested that oversized vials of cancer drugs lead to $1.8 billion of drug wastage annually in the United States. It is currently unknown how precisely this theoretical model is consistent with the real world. We performed a real-world analysis to assess the economic impact of drug wastage. METHODS: We performed a systematic examination of the usage and wastage of all intravenous cancer drugs in the cancer center of a large tertiary care hospital in Israel...
July 12, 2018: Journal of the American Pharmacists Association: JAPhA
Marta Kucan, Jasenka Mrsic-Pelcic, Dinko Vitezic
PURPOSE: Possible factors that could influence changes in patterns of prescribing antihypertensives could be identified by monitoring national trends in hypertension treatment. The choice of pharmacologic treatment in people with hypertension has important therapeutic and financial implications, due to the fact that the financial costs associated with hypertension continue to increase. The aims of our study were to identify and analyze changes in the usage of antihypertensive drugs in Croatia from 2000 to 2016 and to identify the changes in prescribing patterns as well as mean prices per defined daily dose (DDD)...
July 12, 2018: Clinical Therapeutics
E Roderick, J Penney, T Murrells, P Dargan, I Norman
Background: The pattern of alcohol and substance use is changing, with the introduction of novel psychoactive substances, the internet as a means of acquisition and variations in drug purity and price. Alcohol and substance use among adolescents is associated with behavioural, mental health, health and social difficulties; arising at a vulnerable period in their development. Little is known about adolescent substance use in the UK, especially in rural areas. Aim: To investigate the prevalence of substance use amongst young people, aged 16 -21 years, in Norfolk schools...
July 16, 2018: QJM: Monthly Journal of the Association of Physicians
Wendy Prudhomme O'Meara, Diana Menya, Jeremiah Laktabai, Alyssa Platt, Indrani Saran, Elisa Maffioli, Joseph Kipkoech, Manoj Mohanan, Elizabeth L Turner
BACKGROUND: More than half of artemisinin combination therapies (ACTs) consumed globally are dispensed in the retail sector, where diagnostic testing is uncommon, leading to overconsumption and poor targeting. In many malaria-endemic countries, ACTs sold over the counter are available at heavily subsidized prices, further contributing to their misuse. Inappropriate use of ACTs can have serious implications for the spread of drug resistance and leads to poor outcomes for nonmalaria patients treated with incorrect drugs...
July 2018: PLoS Medicine
Stephen Barlas
Quiet changes in federal health programs make minor but significant consumer-friendly changes in the way drugs are priced for seniors in 2019. The author considers how this lays the groundwork for more radical changes in the future.
July 2018: P & T: a Peer-reviewed Journal for Formulary Management
Xiaodong Guan, Ye Tian, Dennis Ross-Degnan, Chunxia Man, Luwen Shi
OBJECTIVES: The rapid growth of pharmaceutical costs is a major healthcare issue all over the world. The high prices of new drugs, especially those for cancer, are also a concern for stakeholders. Generic drugs are a major price-reducing opportunity and provide more societal value. The aim of this research is to analyse the impact of generic entry on the volume and cost of antineoplastic agents in China. METHODS: An interrupted time-series design examined monthly sales of three antineoplastic drugs (capecitabine, decitabine, imatinib) from 699 public hospitals during January 2011 to June 2016...
July 16, 2018: BMJ Open
Selva Rupa Christinal Immanuel, Deepanwita Banerjee, Mayooreshwar P Rajankar, Anu Raghunathan
Strategies towards optimal violacein biosynthesis, a potential drug molecule, need systems level coordination of enzymatic activities of individual genes in a multigene operon vioABCDE. Constraints-based flux balance analysis of an extended iAF1260 model (iAF1260vio) with a reconstructed violacein module predicted growth and violacein yields in Escherichia coli accurately. Shadow price (SP) analysis identified tryptophan metabolism and NADPH as limiting. Increased tryptophan levels in Δpgi & ΔpheA were validated using in silico gene deletion analysis...
July 3, 2018: Bio Systems
Nicholas Buss, Jean-Martin Lapointe, Lolke de Haan, Sally Price, Andrea Ahnmark, Lorraine Irving, Andrew Buchanan, Feenagh Keyes, Pia Davidsson, Rakesh Dixit, Daniel Lindén
Fibroblast Growth Factors (FGFs) and their receptors (FGFRs) have been proposed as potential drug targets for the treatment of obesity. The aim of this study was to assess the potential toxicity in rats of three anti-FGFR1c mAbs with differential binding activity prior to clinical development. Groups of male rats received weekly injections of either one of two FGFR1c-specific mAbs or an FGFR1c/FGFR4-specific mAb at 10 mg/kg for up to 4 weeks. All three mAbs caused significant reductions in food intake and weight loss leading to some animals being euthanized early for welfare reasons...
July 2, 2018: Toxicology and Applied Pharmacology
Melanie K Claborn, Debra L Stevens, Cheri K Walker, Brooke L Gildon
OBJECTIVE: To review the efficacy and safety of nusinersen (Spinraza) in the treatment of spinal muscular atrophy (SMA). DATA SOURCES: An English-language literature search of PubMed and MEDLINE (1946 to June 2018) was performed using the terms nusinersen, ISIS-SMN (Rx), and spinal muscular atrophy. Manufacturer prescribing information, abstracts, article bibliographies, and data were incorporated for additional materials. STUDY SELECTION/DATA EXTRACTION: All clinical trials of nusinersen were identified and analyzed in the review...
July 1, 2018: Annals of Pharmacotherapy
Marita Zimmermann, David Rind, Rick Chapman, Varun Kumar, Sonya Kahn, Josh Carlson
BACKGROUND: Moderate-to-severe atopic dermatitis can be difficult and costly to treat. The long-term health and economic outcomes of a new therapy, dupilumab, have yet to be evaluated. We aimed to identify the cost-effectiveness of dupilumab compared to usual care in moderate-to-severe atopic dermatitis. METHODS: We compared dupilumab to usual care with emollients for adults with moderate-to-severe atopic dermatitis inadequately controlled with topical therapy, or for whom topical therapies were medically inadvisable...
July 1, 2018: Journal of Drugs in Dermatology: JDD
Sarah L Berry, Hamza Hameed, Anna Thomason, Marissa L Maciej-Hulme, Somaia Saif Abou-Akkada, Paul Horrocks, Helen P Price
The protozoan parasite Leishmania causes leishmaniasis; a spectrum of diseases of which there are an estimated 1 million new cases each year. Current treatments are toxic, expensive, difficult to administer, and resistance to them is emerging. New therapeutics are urgently needed, however, screening the infective amastigote form of the parasite is challenging. Only certain species can be differentiated into axenic amastigotes, and compound activity against these does not always correlate with efficacy against the parasite in its intracellular niche...
July 12, 2018: PLoS Neglected Tropical Diseases
Nitesh K Kunda, Dominique N Price, Pavan Muttil
Pulmonary delivery of drugs and vaccines is an established route of administration, with particulate-based carriers becoming an attractive strategy to enhance the benefits of pulmonary therapeutic delivery. Despite the increasing number of publications using the pulmonary route of delivery, the lack of effective and uniform administration techniques in preclinical models generally results in poor translational success. In this study, we used the IVIS Spectrum small-animal in vivo imaging system to compare the respiratory tract deposition and distribution pattern of a microsphere suspension (5 µm) in mice after 1, 4, and 24 h when delivered by oropharyngeal aspiration, the Microsprayer® Aerosolizer, and the BioLite Intubation System, three-widely reported preclinical inhalation techniques...
July 10, 2018: Vaccines
Onur Atan, Cem Tekin, Mihaela van der Schaar
Multiarmed bandits (MABs) model sequential decision-making problems, in which a learner sequentially chooses arms with unknown reward distributions in order to maximize its cumulative reward. Most of the prior works on MAB assume that the reward distributions of each arm are independent. But in a wide variety of decision problems--from drug dosage to dynamic pricing--the expected rewards of different arms are correlated, so that selecting one arm provides information about the expected rewards of other arms as well...
April 12, 2018: IEEE Transactions on Neural Networks and Learning Systems
Henry Waxman, Bill Corr, Kristi Martin, Sophia Duong
Issue: Prescription drug prices have been climbing, creating significant barriers for patients. Since becoming U.S. Food and Drug Administration (FDA) Commissioner, Scott Gottlieb announced an action plan and several policy changes to increase generic drug competition and transparency to address high prescription drug prices. Goal: This issue brief aims to explain the FDA's plan of action and assess its implementation to date. It also aims to assess whether FDA actions, if implemented, address the known problems leading to high drug pricing...
April 1, 2018: Issue Brief of the Commonwealth Fund
Robert Calandra
The PBM industry is under fire these days for what critics call its lack of transparency and its knotty contract language, secretive pricing schemes, and an inscrutable assortment of rebates, discounts, side deals, and administrative fees. Some see partnerships with insurers and retailers as a possible solution. Opponents see a risk of even higher drug prices.
June 2018: Managed Care
Ed Silverman
A state senator who describes insulin prices as "outrageous" introduced a transparency bill that requires drugmakers to report pricing, costs, and rebates. Other states might make similar moves, and the pharmaceutical industry is suddenly on edge, with PhRMA and BIO fighting the law in court.
June 2018: Managed Care
Timothy Kelley
Even the most effective drug is useless if its cost prevents people from using it. Today's high drug prices are pushing more patients into nonadherence. This can impair or shorten life, and that's toxic for a system that has trouble controlling costs as it is.
June 2018: Managed Care
Richard Mark Kirkner
The pipeline for gene therapies is flush. lists 721 gene therapy trials. Last year, the FDA received 106 new drug applications for gene therapies, up 34% from 2016. There is no shortage of diseases for gene therapies to target. But the costs of these therapies will break the bank.
July 2018: Managed Care
Jianwei Deng, Huilin Tian, Yilun Guo, Tengyang Ma, Yangjie Sun, Shiyang Zhang, Tianan Yang, Xu Tian
The zero-markup drug policy is an important component of the new round of Chinese health care reform that began in 2009 to promote the separation between medical and pharmaceutical services, reduce patients' medical burden, and improve the medical supply security system. Over the past 8 years, the zero-markup drug reform policy has been carried out in 4 pilot rounds (a policy diffusion model with Chinese characteristics) and has been promoted throughout the mainland China. At this critical point, it is necessary to review this policy systematically...
July 10, 2018: International Journal of Health Planning and Management
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