Pharmacoeconomics

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dear sir, i agree with you regrding this. but this is just hypothetical.only 1-5% health professional would agree to this. whatever u suggested should be enforced by STRICT laws only then i think will be the work in right direction. at to add few more suggestion for PE 1. not prescribing unnecessary INVESTIGATIONS. 2.not suggesting CT,S MRI,s and pathological inv. uselessly for the sake of commision. 3. more and more awareness in patients of what is necessary for them and what not. regards dr kumar gaurav jr-1, dpt. of pharmacology, ims-bhuBharat Gajjar <gajjarbm@...> wrote: Dear NetRUMians,In my opinion,Pharmacoeconomics is not a hi-ficoncept.Whatever measures make medical bills lighterand affordable for patients is PE.At ourlevel(physician,pharmacist and pharmacologistlevel),we can do this.-Use of essential drugs only-No fixed dose combinations-Prescribing right drug to right patient,in rightdose,by right route,in right frequency and for rightduration-in short,practising RATIONAL DRUG THERAPY.-Prescribing quality generic product-No over prescribing,no polypharmacy-Not accepting any gift from pharmaceutical companies-Updating our knowledge-Spreading Health Promotional Messages-Believing ourselves real community workersPatients respect us as GOD.We should not break

their FAITH.Dr.Bharat Gajjar. DR. BHARAT GAJJARASSOCIATE PROFESSOR,DEPARTMENT OF PHARMACOLOGY,PRAMUKHSWAMI MEDICAL COLLEGE,KARAMSAD-388325.DIST.-ANAND (GUJARAT) INDIA.MOBILE NO. 09428153344.__________________________________________________________Don't let your dream ride pass you by. Make it a reality with Autos.http://autos./index.htmlDR KUMAR GAURAVJR-1,DPT. OF PHARMACOLOGY,IMS-BHU,VARANASI

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Dear Dr Gaurav, You have really come out with the malpractices which have tarnished the image of doctors. If implemented strictly, they can definitely help our poor patients in terms of costs spent on medical care. Moreover an awareness drive in patients can be brought by volunteers willing to help the poor rather than sucking out from them. There is a need of modern Robin Hoods today. Anupamadr kumar gaurav <shell_dish@...> wrote: dear sir, i agree with you regrding this. but this is just hypothetical.only 1-5% health professional would agree to this. whatever u suggested should be enforced by STRICT laws only then i think will be the work in right direction. at to add few more suggestion for PE 1. not prescribing unnecessary INVESTIGATIONS. 2.not suggesting CT,S MRI,s and pathological inv. uselessly for the sake of commision. 3. more and more awareness in patients of what is necessary for them and what not. regards dr kumar gaurav jr-1, dpt. of pharmacology, ims-bhuBharat Gajjar <gajjarbm > wrote: Dear NetRUMians,In my opinion,Pharmacoeconomics is not a hi-ficoncept.Whatever measures make medical bills

lighterand affordable for patients is PE.At ourlevel(physician,pharmacist and pharmacologistlevel),we can do this.-Use of essential drugs only-No fixed dose combinations-Prescribing right drug to right patient,in rightdose,by right route,in right frequency and for rightduration-in short,practising RATIONAL DRUG THERAPY.-Prescribing quality generic product-No over prescribing,no polypharmacy-Not accepting any gift from pharmaceutical companies-Updating our knowledge-Spreading Health Promotional Messages-Believing ourselves real community workersPatients respect us as GOD.We should not break their FAITH.Dr.Bharat Gajjar. DR. BHARAT GAJJARASSOCIATE PROFESSOR,DEPARTMENT OF PHARMACOLOGY,PRAMUKHSWAMI MEDICAL COLLEGE,KARAMSAD-388325.DIST.-ANAND (GUJARAT) INDIA.MOBILE NO.

09428153344.__________________________________________________________Don't let your dream ride pass you by. Make it a reality with Autos.http://autos./index.htmlDR KUMAR GAURAVJR-1,DPT. OF PHARMACOLOGY,IMS-BHU,VARANASI Now you can chat without downloading messenger. Click here to know how.

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Thanks sir, audit committe which u have suggested should include non-official members sir ,probably from law field too,so that they are not subjected to any bias . MCI has to come forward and bring some strict rules regarding irrational and unnecessary use of expensive drugs. regrds dr kumar gaurav, jr-1, dpt. of pharmacoly, ims-bhuBharat Gajjar <gajjarbm@...> wrote: Dear Anupama,Dr.Kumar has added some of the points to lower

totaltherapy cost.Thank you,Kumar.In UG and PG curriculum,we can include prescriptionaudit exercises where we can include financial aspectsalso.In hospital,we can form 'Prescriptionaudit'committe. Pharmacologists can play active rolein the committee.Bharat Gajjar.DR. BHARAT GAJJARASSOCIATE PROFESSOR,DEPARTMENT OF PHARMACOLOGY,PRAMUKHSWAMI MEDICAL COLLEGE,KARAMSAD-388325.DIST.-ANAND (GUJARAT) INDIA.MOBILE NO. 09428153344.__________________________________________________________Moody friends. Drama queens. Your life? Nope! - their life, your story. Play Sims Stories at Games.http://sims./ DR KUMAR GAURAVJR-1,DPT. OF PHARMACOLOGY,IMS-BHU,VARANASI

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There are very few literatures available on pharmacoeconomics in Indian subcontinent. There are some foreign journals, which deals with such parameters deliberately (Journal of Health Economics, Health economics, Medical Care Inquiry, The American Journal of Public Health, Health Service Research, Health Care Financing Review and Health Affairs).

There are some salient features of pharmacoeconomics.

1) Extent of government involvement

Doctors, Drug Producers, Price Control, Capital construction, Provision for Insurance, Research & Development, Professional Education.

2) Presence of uncertainty in all level

Random illness striking individuals, Random outcome from medical intervention, Professional uncertainty about efficacy of treatment.

3) The large difference in knowledge between doctors, patients, consumers of health care.

Health professionals know more than patients about healing process, Common patients know more about their conditions than insurance provider.

4) Externalis

Behavior of individuals.

As numerous studies have demonstrated, the medical profession as a whole harbours considerable uncertainty about the average interventions raging from balloon angioplasty to ocular infections. In similar situations doctors often recommend treatment at vastly different rates and often diverge greatly on which treatment they recommend. Therapies of choice change through time, often with little or no scientific basis for the decisions. How can such medical confusion persist in a modern, scientific society?

The contrast between our approaches to uncertainty in some areas of new drug applications. In one case we regulate the market intensively. In other we license the providers broadly and then entrust them to make appropriate decisions. The new therapies may sweep the country with not so much as a single case-control study, let alone a true randomized controlled trial such as would be required for new drugs. Why do we behave so differently in these areas of uncertainty?

Aspirin has been replaced for many people by one of the new COX2 inhibitors. But the price is 100 times than the aspirin for better analgesic properties and fewer side effects.

In private practice a hypertensive patient can attend physician four times yearly but in government sponsored practice employee visit clinic every month.

In non-surgical intervention the problem is more subtle. Some doctors now advocate the use of very frequent, very small dose of soluble insulin. Other advises of long acting Glargine insulin

Professional duty, ethics and personal responsibility make the doctor to be open and honest. Conflicting with this however, the simple profit motive can lead to doctor into different choices. If so desired the doctor might be able to deceive the patient and make more money in doing so.

Amit Pachal

Pharmacist

central Hospital

South Eastern Railway

Gardenreach

Kolkata-700043

pharma691@...

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Dear Amit

Could you please elaborate what is "Capital Construction" in relation to PE.

S. Ziaur Rahman

Pharmacoeconomics

There are very few literatures available on pharmacoeconomics in Indian subcontinent. There are some foreign journals, which deals with such parameters deliberately (Journal of Health Economics, Health economics, Medical Care Inquiry, The American Journal of Public Health, Health Service Research, Health Care Financing Review and Health Affairs).There are some salient features of pharmacoeconomics.1) Extent of government involvementDoctors, Drug Producers, Price Control, Capital construction, Provision for Insurance, Research & Development, Professional Education.2) Presence of uncertainty in all levelRandom illness striking individuals, Random outcome from medical intervention, Professional uncertainty about efficacy of treatment.3) The large difference in knowledge between doctors, patients, consumers of health care.Health professionals know more than patients about healing process, Common patients know more about their conditions than insurance provider.4) ExternalisBehavior of individuals.As numerous studies have demonstrated, the medical profession as a whole harbours considerable uncertainty about the average interventions raging from balloon angioplasty to ocular infections. In similar situations doctors often recommend treatment at vastly different rates and often diverge greatly on which treatment they recommend. Therapies of choice change through time, often with little or no scientific basis for the decisions. How can such medical confusion persist in a modern, scientific society?The contrast between our approaches to uncertainty in some areas of new drug applications. In one case we regulate the market intensively. In other we license the providers broadly and then entrust them to make appropriate decisions. The new therapies may sweep the country with not so much as a single case-control study, let alone a true randomized controlled trial such as would be required for new drugs. Why do we behave so differently in these areas of uncertainty?Aspirin has been replaced for many people by one of the new COX2 inhibitors. But the price is 100 times than the aspirin for better analgesic properties and fewer side effects.In private practice a hypertensive patient can attend physician four times yearly but in government sponsored practice employee visit clinic every month.In non-surgical intervention the problem is more subtle. Some doctors now advocate the use of very frequent, very small dose of soluble insulin. Other advises of long acting Glargine insulinProfessional duty, ethics and personal responsibility make the doctor to be open and honest. Conflicting with this however, the simple profit motive can lead to doctor into different choices. If so desired the doctor might be able to deceive the patient and make more money in doing so.Amit PachalPharmacistcentral HospitalSouth Eastern RailwayGardenreachKolkata-700043pharma691gmail

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Dear members

Thank you sir for your valuable inputs. As sir mentioned correctly, willingness to pay is one of the most imp parameter we need to consider while making decisions for chosing therapeutic intervention for the disease management. e.g. thrombolytic therapy for acute myocardial infarction patients. few patients may prefer streptokinase (SK) or few may choose alteplase or tenecteplase based on affordability. Both are effective in terms of efficacy and safety but newer thrombolytic offers significant reduction in mortality compared to SK if administered within recommended time period (door to needle time< 30 min). Therefore, we need to consider what patients are willing to pay for getting maximum benefit.

Tarun Wadhwa

Tarun Wadhwa

M.Pharm (MCOPS, Manipal Univ.), Research Scholar, Department of Pharmacology; Guest Faculty, Department of Clinical Pharmacy, J N Medical College, Nehrunagar, Belgaum- 590010, Karnataka, INDIA.

From: Vijay <drvijaythawani@ .co. in>Subject: Re: introduction to pharmacoeconomicsnetrumgroups (DOT) comDate: Friday, 7 May, 2010, 6:36 AM

Hi,Any economics must be humane. It must subserve the basic purpose of making an effective, quality product available without any discrimination at affordable price to the needy.It is only when the politicians use the principles of economy to suit their own interest or political theory, it becomes political economy.In a democrarcy because of the unchecked powers given to the elected representatives we see more of political economy rather than pure economics. We have the experience that in spite of having the top economist being at the helm of affairs, medicine prices have been spiralling up. Profeetering has replaced profits. And the common patient continues to be exploited.Dr Vijay Thawani >> Dear members> > What

is health economics?> Health economics analyses the supply and demand for healthcare and provides a structure for understanding the choices made therein.> What is pharmacoeconomics?> Pharmacoeconomics adopts and applies the principles and methodologies of health economics to the field of pharmaceutical policy (supply and demand for medicines).> > Regards> > Tarun Wadhwa>

-- Dr SathyanarayanaFaculty,Public Health Foundation of IndiaOpposite Nalanda Junior CollegeVengalrao NagarHyderabad. 500038Ph:91-9490126043Email:drsathya1@ gmail.comwww.phfi.org

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Respected Sir,The ‘first generation’ thrombolytics had clinical disadvantages

such as low specificity for fibrin, increased risk of allergic reactions (

Specially Streptokinase is a bacterial

product, the body has the ability to build up an immunity to it. Therefore, it

is recommended that this medication should not be used again after four days

from the first administration, as it may not be as effective and can also cause

an allergic reactio) and short half-life. Newer thrombolytic agents such as reteplase and

tenecteplase have been developed with potential advantages that

include: prolonged half-life, increased fibrin specificity and

increased resistance to inhibition by plasminogen activators. However,

these laboratory-measured advantages may not translate into measurable clinical benefits. For instance, the new thrombolytic drug

lanoteplase was withdrawn from development as a result of in

an increased incidence of intracranial haemorrhage.Amit PachalPharmacistCentral HospitalSouth Eastern RailwayKolkata-700043On Tue, 11 May 2010 23:43:44 +0530 wrote> Dear membersThank you sir for your valuable inputs. As sir mentioned correctly, willingness to pay is one of the most imp parameter we need to consider while making decisions for chosing therapeutic intervention for the disease management. e.g. thrombolytic therapy for acute myocardial infarction patients. few patients may prefer streptokinase (SK)or few may choose alteplase or tenecteplase based on affordability. Both are effective in terms of efficacy and safety but newer thrombolytic offers significant reduction in mortality compared to SK if administered within recommended time period (door to needle time< 30 min). Therefore, we need to consider what patients are willing to pay for getting maximum benefit.Tarun Wadhwa>>Tarun WadhwaM.Pharm (MCOPS, Manipal Univ.), Research Scholar, Department of Pharmacology; Guest Faculty, Department of Clinical Pharmacy, J N Medical College, Nehrunagar, Belgaum- 590010, Karnataka, INDIA.>>>>From: Vijay <drvijaythawani@ .co. in>>Subject: Re: introduction to pharmacoeconomics>netrumgroups (DOT) com>Date: Friday, 7 May, 2010, 6:36 AM>> Hi,>>Any economics must be humane. It must subserve the basic purpose of making an effective, quality product available without any discrimination at affordable price to the needy.>>It is only when the politicians use the principles of economy to suit their own interest or political theory, it becomes political economy.>>In a democrarcy because of the unchecked powers given to the elected representatives we see more of political economy rather than pure economics. We have the experience that in spite of having the top economist being at the helm of affairs, medicine prices have been spiralling up. Profeetering has replaced profits. And the common patient continues to be exploited.>>Dr Vijay Thawani >>>>>> Dear members>> >> What is health economics?>> Health economics analyses the supply and demand for healthcare and provides a structure for understanding the choices made therein.>> What is pharmacoeconomics?>> Pharmacoeconomics adopts and applies the principles and methodologies of health economics to the field of pharmaceutical policy (supply and demand for medicines).>> >> Regards>> >> Tarun Wadhwa>>>>>>>-- >Dr Sathyanarayana>Faculty,>Public Health Foundation of India>Opposite Nalanda Junior College>Vengalrao Nagar>Hyderabad. 500038>Ph:91-9490126043>Email:drsathya1@ gmail.com>www.phfi.org>>>>