Targeting of Asian Americans and Pacific Islanders by the tobacco industry: results from the Minnesota Tobacco Document Depository.
OBJECTIVE: The study objective was to review internal tobacco industry documents written between 1985 and 1995 regarding the Asian American and Pacific Islander (AAPI) population in the USA. These documents detail opportunities and barriers to promotion of tobacco products, as viewed by the tobacco industry and its market research firms. DATA SOURCES: /methods: Researchers reviewed tobacco industry documents from the document depository in Minneapolis, Minnesota and the tobacco industry's website, The Tobacco Archive, in a systematic fashion. A combined technique was employed using title keywords, dates, and names to search the 4(b) index. FINDINGS: A review of internal tobacco company documents reveal that during the late 1980s, the industry and its market research firms recognised the importance of the AAPI community as a potential business market. Documents describe the population growth in this community, the high prevalence of smoking in countries of origin, high purchasing power of AAPI immigrants, cultural predisposition to smoking, opportunities afforded by the high proportion of retail businesses under AAPI ownership, barriers to developing the AAPI market, comprehensive campaigns, and political and lobbying efforts. Comprehensive campaigns were designed to integrate promotion efforts in AAPI consumer, retail, and business communities. CONCLUSIONS: The documents show that the tobacco industry developed specific promotion strategies to target the AAPI population. Tobacco control initiatives in the AAPI group have been slower to develop than in other targeted ethnic groups, and may benefit by increased awareness of industry methods to promote tobacco use. (+info)
Influence of commercial information on prescription quantity in primary care.
BACKGROUND: In the last few years we have witnessed many publicly-financed health services reaching a crisis point. Thus, drug expenditure is nowadays one of the main concerns of health managers, and its containment one of the first goals of health authorities in western countries. The objective of this study is to identify the effect of the perceived quality stated in commercial information, its uses, and how physicians perceive the influence it has on prescription amounts. METHODS: A cross-sectional study of 405 primary care physicians was conducted in Galicia (north-west Spain). The independent variables physician's education and speciality, physician's perception of the quality of available drug information sources, type of practice, and number of patients were collected, through a postal questionnaire. Environmental characteristics of the practice were obtained from secondary sources. Multiple regression models were constructed using as dependent variables two indicators of prescription volume. RESULTS: The response rate was 75.2%. Prescription amounts was found to be associated with perceived credibility of information provided by medical visitors, regulated physician training, and environmental characteristics of the practice (primary care team practice, urban environment). CONCLUSIONS: The study results suggest that in order to decrease prescription amounts it is necessary to limit the role of pharmaceutical companies in physician training, improve physician education and training, and emphasize more objective sources of information. (+info)
Review article: gastroenterology and the pharmaceutical industry.
Physicians' relationships with industry derive from the moral imperative to advocate and work for the best interests of patients. Private industry generally operates to satisfy the best interests of the stockholders or owners. Conflicts arise between these interests and are magnified by the inequality of the financial positions of physicians and industry. Because the ultimate consumer of the products (drugs, medical devices, etc.) of the biomedical industry must enlist a physician as an intermediary, the physician has become the target of industry in a sophisticated marketing effort that includes the offering of financial and other incentives. These conflicts and incentives are pervasive throughout clinical and research endeavors. Standards for resolution, if not elimination, of these conflicts have been proposed by various respected organizations. Individual physicians and medical organizations should evaluate these standards and, if pertinent and appropriate, endorse and follow them. (+info)
Testing neoclassical competitive market theory in the field.
This study presents results from a pilot field experiment that tests predictions of competitive market theory. A major advantage of this particular field experimental design is that my laboratory is the marketplace: subjects are engaged in buying, selling, and trading activities whether I run an exchange experiment or am a passive observer. In this sense, I am gathering data in a natural environment while still maintaining the necessary control to execute a clean comparison between treatments. The main results of the study fall into two categories. First, the competitive model predicts reasonably well in some market treatments: the expected price and quantity levels are approximated in many market rounds. Second, the data suggest that market composition is important: buyer and seller experience levels impact not only the distribution of rents but also the overall level of rents captured. An unexpected result in this regard is that average market efficiency is lowest in markets that match experienced buyers and experienced sellers and highest when experienced buyers engage in bargaining with inexperienced sellers. Together, these results suggest that both market experience and market composition play an important role in the equilibrium discovery process. (+info)
How will the reduction of tariffs and taxes on insecticide- treated bednets affect household purchases?
One of the steps called for in the fight against malaria is the removal of tariffs and taxes on insecticide-treated bednets (ITNs), netting materials, and insecticides, with a view to reducing the retail prices of ITNs and thus increasing utilization. In this paper we develop an approach for analysing the extent to which reform of tariff and tax policy can be expected to increase ITN purchases. We consider the following questions: (1). How much does the retail price of ITNs change if tariffs and taxes are reduced or eliminated? (2). How responsive is consumer demand to changes in the retail price of ITNs? Data on the price elasticity of demand for ITNs are very limited. Nevertheless, they suggest that ITN demand is not highly responsive to lower prices if household preferences are held constant. The reduction in retail prices associated with the removal of tariffs and taxes depends on the structure of the market in individual countries. In Nigeria, reducing the tariff on insecticides from 42% to zero and the tariff on netting materials from 40% to 5% is expected to increase ITN purchases by 9-27%, depending on the elasticity used. Country-specific information about market structure and cost conditions is needed if predictions are to be made as to how a specific policy change will affect ITN purchases. (+info)
Restrictions on import of drugs for personal use within the European single market.
BACKGROUND: The European Union (EU) has harmonized legislation on pharmaceutical products to implement the single market in this field. European consumers are offered with high quality and safe products that have been brought onto the market through harmonized procedures. The aim of the study was to find out if there still were legislative restrictions to purchasing prescription only medicines (POMs) for personal use from another EU member state. METHODS: The medicines authorities in the EU were inquired about the possibilities of a citizen to obtain POMs for personal use from another EU country. The method used was a questionnaire covering both the delivery of foreign prescriptions and import of prescription-only medicines. The questionnaire was mailed, e-mailed or faxed to the national medicines authorities. RESULTS: An answer was obtained from 11 of the 15 member states. The results showed that the delivery of foreign prescriptions was regulated only in the Nordic countries. All the countries reported prohibitions on delivering prescriptions for drugs that act on the central nervous system and prescriptions that were suspicious. The personal import of drugs was restricted as to the amounts and reimbursement policy. CONCLUSIONS: The import of drugs for personal use is not yet comparable to other consumables in the EU. The prevailing restrictions contravene the community legislation and this problem has not yet been solved. It is probable that problems will arise in the near future when information technology is likely to be used increasingly in the delivery of drugs. (+info)
Monitoring compliance with the International Code of Marketing of Breastmilk Substitutes in west Africa: multisite cross sectional survey in Togo and Burkina Faso.
OBJECTIVES: To monitor compliance with the International Code of Marketing of Breastmilk Substitutes in health systems, sales outlets, distribution points, and the news media in Togo and Burkina Faso, west Africa. DESIGN: Multisite cross sectional survey. PARTICIPANTS: Staff at 43 health facilities and 66 sales outlets and distribution points, 186 health providers, and 105 mothers of infants aged < or =5 months in 16 cities. RESULTS: Six (14%) health facilities had received donations of breast milk substitutes. All donations were being given to mothers free of charge. Health providers in five (12%) health facilities had received free samples of breast milk substitutes for purposes other than professional research or evaluation. Health professionals in five (12%) health facilities had received promotional gifts from manufacturers. Promotional materials of commercial breast milk substitutes were found in seven (16%) health facilities. Special displays to market commercial breast milk substitutes were found in 29 (44%) sales and distribution points. Forty commercial breast milk substitutes violated the labelling standards of the code: 21 were manufactured by Danone, 11 by Nestle, and eight by other national and international manufacturers. Most (148, 90%) health providers had never heard of the code, and 66 mothers (63%) had never received any counselling on breast feeding by their health providers. CONCLUSION: In west Africa manufacturers are violating the code of marketing of breast milk substitutes. Comparable levels of code violations are observed with (Burkina Faso) or without (Togo) regulating legislation. Legislation must be accompanied by effective information, training, and monitoring systems to ensure that healthcare providers and manufacturers comply with evidence based practice and the code. (+info)
Views of older people on cataract surgery options: an assessment of preferences by conjoint analysis.
BACKGROUND: Key issues in the quality of care for people with cataracts in the UK include hospital waiting lists, complication rates from surgery, and the use of junior surgeons. The main objective of this study was to investigate the relative importance that older people attach to these factors when given theoretical choices over options for cataract surgery. METHOD: A systematic sample of 194 individuals aged 60-84 years on a general practice register in Nottingham were invited to take part in an interview based survey. Respondents ranked 11 "cataract surgery packages" containing different waiting list lengths, complication risks, and surgeon grades. Conjoint analysis was performed to determine the relative importance of these factors for individuals and for the group as a whole. RESULTS: Of the 194 subjects invited to participate, 146 (72%) completed the interview. For the group as a whole the "averaged importance" of the factors was: complication risk 45.8%; waiting time 41.1%, surgeon grade 13.1%. Analysis of importance scores for individuals showed that some were particularly concerned about complication risk while others were more concerned about waiting times. There was a strong negative correlation between importance scores for these factors (Spearman's rho -0.78, p<0.001). CONCLUSIONS: Most respondents thought that either risk of damage to sight and/or waiting time were important, while surgeon grade was relatively unimportant. The findings show that some potential cataract patients prefer a greater risk of complication combined with a short wait than a low complication rate and a longer wait. (+info)