Sales practices of patent medicine sellers in Nigeria.
A survey was carried out among patent medicine dealers to evaluate their practices that militate against laws governing prescriptions-only medicines in Nigeria. Questionnaires were distributed to 46 patent medicine dealers and later collected from them on appointment. Analysis of the results showed that all the patent medicine dealers were aware of the law governing the sale of prescription drugs in Nigeria. Seventy-five per cent of them stock such drugs. Patent medicine dealers obtain their drugs largely from sales representative of pharmaceutical companies as well as from industries. Inappropriate use of sales boys and girls in patent medicine stores and defective government policies were all investigated. (+info)
Nuclear pharmacy, Part II: Nuclear pharmacy practice today.
OBJECTIVE: Nuclear pharmacy is a specialty within the profession of pharmacy that focuses on the proper use of radiopharmaceuticals. This article reviews various features of contemporary nuclear pharmacy practice. After reading this article the nuclear medicine technologist should be able to: (a) describe nuclear pharmacy training and certification; (b) discuss nuclear pharmacy practice settings; (c) discuss nuclear pharmacy practice activities; (d) list professional organizations; and (e) describe activities associated with job satisfaction. In addition, the reader should be able to discuss regulatory issues of current concern. (+info)
Comparative approaches to pharmaceutical price regulation in the European Union.
AIM: To review pharmaceutical price regulation methods in countries of the European Union (EU), in terms of the anticipated impact of regulation on pharmaceutical expenditures and evidence of actual outcomes. METHOD: An extensive search was performed of medical and economic studies on regulatory interventions specifically targeting pharmaceutical prices in EU countries, published between January 1990 and April 2002. Both peer-reviewed and "gray" literature were systematically reviewed. RESULTS: Four principle approaches to pharmaceutical price regulation with some methodological differences were identified in EU countries, as follows: fixed pricing, cost-effectiveness pricing, profit controls, and reference pricing. Actual evidence of the impact of price regulation was limited in many of these countries. Cross-country comparisons suggested that limiting the rise of pharmaceutical prices did not equate to controlling the rise of pharmaceutical expenditures because of the volume effect of utilization. CONCLUSIONS: Supply-side regulation without the simultaneous use of demand-side incentives and volume controls does little to control the rise in pharmaceutical expenditures. The types of needed demand-side controls depend on the context of the individual country, on political priorities, and on the type of supply-side regulation in place. (+info)
Opioid "mythstakes": opioid analgesics--current clinical and regulatory perspectives.
Barriers to appropriate prescribing of opioids include the deficit in educating medical students in core curricula. Other barriers include physicians' lack of knowledge of pain management, failure to educate their patients or include them in treatment options, and failure to take adequate medical histories and obtain records of their patients' previous treatment. In addition, physicians often lack the ability to distinguish the patient who is suffering pain from the addict. Patients, too, may fear that opioid therapy may cause addiction. This article provides an overview of guidelines and federal regulations for prescribing opioids, along with some caveats, in the hope that physicians and patients alike will appreciate that pain management is an integral part of treatment. And, that treatment is aimed at decreasing or eradicating pain and maintaining patients' function to the greatest possible degree while monitoring and treating side effects. (+info)
Effects of ambulatory-care pharmacist consultation on mortality and hospitalization.
OBJECTIVE: To determine the effect of 3 alternative models of ambulatory-care pharmacist consultation on patient survival and hospitalization. STUDY DESIGN: Patients were randomly chosen adult Kaiser Permanente (KP) Southern California enrollees with at least 1 prescription in the base year. The demonstration lasted 23 months. Using time-dependent proportional hazards estimation, survival and hospitalization were examined across 5 patient risk groups. INTERVENTIONS: The pharmacy interventions were (1) consultation about new or changed prescriptions as mandated by 1992 state and federal regulations (State model), (2) consultation focused on selected high-risk ambulatory care patients (KP model), and (3) pre-1992 standard care (Control model). RESULTS: In the 6 service areas in which only 1 of the models was implemented, both the KP (relative risk [RR] = 0.295, P < .001) and State (RR = 0.338, P < .001) models significantly reduced emergency hospital admissions over 2 years compared with the Control model when measured across all risk groups. The State model also was associated with fewer urgent and emergency admissions (RR = 0.854, P < .001). In the randomized treatment sample of 5499 patients, the KP model was associated with lower total mortality per new prescription filled (RR = 0.921, P < .01), and significantly lower hospitalization and mortality in high-risk patient groups. CONCLUSIONS: Intensive outpatient pharmacist consultation targeting high-risk patients would improve survival and decrease hospitalization rates. Broader nontargeted consultation would reduce hospitalizations, but was not associated with lower mortality within the 2-year intervention. (+info)
Emergency contraception: lessons learned from the UK.
CONTEXT: Since January 2001, women aged over 16 years in the UK have been able to purchase progestogen-only emergency hormonal contraception from pharmacists without prescription. This paper outlines the context in which these changes took place, including contraceptive choices in the UK, changes within the pharmacy profession and political pressures. OBSERVATIONS: We chart the multisectoral developments required to make emergency contraception (EC) available without prescription in the UK, from clinical research findings and results on the views and behaviour of health care professionals and users of EC, through to professional and policy developments, including challenges during and after this process. DISCUSSION: Lessons learnt from the innovative experience of the deregulation of EC in the UK apply to other regions currently considering similar change. We extrapolate internationally applicable lessons including the importance of stakeholder partnership, transparency and cautious pace of change, and the vital role of professional groups. CONCLUSION: Although this change brought a new element of reproductive choice to some women, significant barriers to access to EC still remain for young women and women unable to afford the high price ( 24/euro;37/$39) of pharmacy purchase in the UK. (+info)
Allowing central fill pharmacies and retail pharmacies to fill prescriptions for controlled substances on behalf of retail pharmacies. Final rule.
DEA is finalizing a Notice of Proposed Rulemaking (NPRM) defining central fill pharmacy activities and permitting central fill pharmacies to prepare controlled substances prescriptions on behalf of retail pharmacies with which the central fill pharmacies have a contractual agreement to provide such services or with which the pharmacies share a common owner. When one retail pharmacy receives a prescription and a second pharmacy prepares and subsequently delivers the controlled substance medication to the first retail pharmacy for dispensing to the patient, the second pharmacy is engaging in a "central fill activity". Records must be maintained by both the central fill pharmacy and the retail pharmacy that completely and accurately reflect the disposition of all controlled substance prescriptions dispensed. With respect to security, central fill pharmacies would be required to comply with the same security requirements applicable to retail pharmacies including the general requirement to maintain effective controls and procedures to guard against theft and diversion of controlled substances. DEA is creating an allowance for retail pharmacies that also perform central fill activities to do so without separate DEA registration, separate inventories, or separate records. This rulemaking is sought by the regulated industry and will allow for more efficient delivery of controlled substance prescriptions to patients. (+info)
Dangerous and Hypnotic Drug Act.
It is unprofessional conduct within the meaning of the Medical Practice Act to prescribe a dangerous drug without either a medical examination by a physician or other medical indications. Dangerous and hypnotic drugs are specifically defined by both state and federal law and distribution is strictly regulated.A physician may administer to his own patients such amounts of dangerous drugs as are necessary for the immediate needs of the patient. The physician may obtain such needed amounts of these drugs by an order placed with a pharmacist marked "for administration to immediate needs of patients." A licensed physician may also prescribe dangerous and hypnotic drugs for patients and such prescriptions may be refilled on the specific authorization of the physician.A physician who dispenses dangerous and hypnotic drugs to patients must obtain a hypnotic drug license; he must use specific purchase orders when purchasing; the drugs must be labeled in the manner provided by law; and all records of sale shall be open to inspection by authorized officers of the law and kept for three years. By the Principles of Medical Ethics physicians are bound to limit the source of their professional income to medical services actually rendered. Recent decisions of the Judicial Council answer questions concerning a physician's interest in a corporation which purchases, packages and sells medicines under a corporate name. Also answered are questions as to the measures that exist to prevent physicians from abusing the privilege of owning a pharmacy, and whether a physician can ethically rent space in a building owned by him to a pharmacist with a percentage of the income of the pharmacy as rental. The public welfare of California and the nation as determined by legislation strictly regulates the distribution of dangerous drugs. It is in the best interest of the medical profession and its patients that these laws be understood and carefully observed. (+info)