Generic Samples » Health

Detecting host factors involved in virus infection by observing the…

admin — Fri, 10 Sep 2010 02:36:30 +0000

Related Articles Detecting host factors involved in virus infection by observing the clustering of infected cells in siRNA screening images. Bioinformatics. 2010 Sep 15;26(18):i653-i658 Authors: Suratanee A, Rebhan I, Matula P, Kumar A, Kaderali L, Rohr K, Bartenschlager R, Eils R, KÃ¶nig R MOTIVATION: Detecting human proteins that are involved in virus entry and replication is facilitated by modern high-throughput RNAi screening technology. However, hit lists from different laboratories have shown only little consistency. This may be caused by not only experimental discrepancies, but also not fully explored possibilities of the data analysis. We wanted to improve reliability of such screens by combining a population analysis of infected cells with an established dye intensity readout. RESULTS: Viral infection is mainly spread by cell-cell contacts and clustering of infected cells can be observed during spreading of the infection in situ and in vivo. We employed this clustering feature to define knockdowns which harm viral infection efficiency of human Hepatitis C Virus. Images of knocked down cells for 719 human kinase genes were analyzed with an established point pattern analysis method (Ripley’s K-function) to detect knockdowns in which virally infected cells did not show any clustering and therefore were hindered to spread their infection to their neighboring cells. The results were compared with a statistical analysis using a common intensity readout of the GFP-expressing viruses and a luciferase-based secondary screen yielding five promising host factors which may suit as potential targets for drug therapy. Conclusion: We report of an alternative method for high-throughput imaging methods to detect host factors being relevant for the infection efficiency of viruses. The method is generic and has the potential to be used for a large variety of different viruses and treatments being screened by imaging techniques. CONTACT: r.eils@dkfz.de; r.koenig@dkfz.de SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online. PMID: 20823335 [PubMed - in process]

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Quantifying the impoverishing effects of purchasing medicines: a…

admin — Thu, 09 Sep 2010 23:55:40 +0000

Related Articles Quantifying the impoverishing effects of purchasing medicines: a cross-country comparison of the affordability of medicines in the developing world. PLoS Med. 2010;7(8): Authors: NiÃ«ns LM, Cameron A, Van de Poel E, Ewen M, Brouwer WB, Laing R BACKGROUND: Increasing attention is being paid to the affordability of medicines in low- and middle-income countries (LICs and MICs) where medicines are often highly priced in relation to income levels. The impoverishing effect of medicine purchases can be estimated by determining pre- and postpayment incomes, which are then compared to a poverty line. Here we estimate the impoverishing effects of four medicines in 16 LICs and MICs using the impoverishment method as a metric of affordability. METHODS AND FINDINGS: Affordability was assessed in terms of the proportion of the population being pushed below US$1.25 or US$2 per day poverty levels because of the purchase of medicines. The prices of salbutamol 100 mcg/dose inhaler, glibenclamide 5 mg cap/tab, atenolol 50 mg cap/tab, and amoxicillin 250 mg cap/tab were obtained from facility-based surveys undertaken using a standard measurement methodology. The World Bank’s World Development Indicators provided household expenditure data and information on income distributions. In the countries studied, purchasing these medicines would impoverish large portions of the population (up to 86%). Originator brand products were less affordable than the lowest-priced generic equivalents. In the Philippines, for example, originator brand atenolol would push an additional 22% of the population below US$1.25 per day, whereas for the lowest priced generic equivalent this demographic shift is 7%. Given related prevalence figures, substantial numbers of people are affected by the unaffordability of medicines. CONCLUSIONS: Comparing medicine prices to available income in LICs and MICs shows that medicine purchases by individuals in those countries could lead to the impoverishment of large numbers of people. Action is needed to improve medicine affordability, such as promoting the use of quality assured, low-priced generics, and establishing health insurance systems. Please see later in the article for the Editors’ Summary. PMID: 20824175 [PubMed - in process]

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Quantifying the impoverishing effects of purchasing medicines: a…

‘Not the full Monty’: a qualitative study of seniors’ perceptions of…

admin — Thu, 09 Sep 2010 10:49:30 +0000

Related Articles ‘Not the full Monty’: a qualitative study of seniors’ perceptions of generic medicines in Western Australia. Aust J Prim Health. 2010;16(3):240-5 Authors: Bulsara C, McKenzie A, Sanfilippo F, Holman CD, Emery JE The study explored consumers’ perspectives on generic medicine use in Australia. A qualitative methodology was used to explore the topic, including community participation in the form of forums, focus groups and a panel of seniors. Three consumer forums were held from which a seniors’ panel was formed and a series of focus groups were conducted. Participants demonstrated considerable mistrust of generic medicines. Participants highlighted their uncertainty about the extent of pharmaceutical companies’ influence on health professionals, the mistrust of foreign generic manufacturers and scepticism in their equivalence. In addition, the substitution of generic medicines and variability in packaging added to the overall concern and reported poor compliance. Altering consumers’ beliefs and attitudes about generic medicines might require a more concerted effort to reduce consumer mistrust. Consumers’ beliefs about generic medicines will strongly affect attempts to increase generic prescribing in Australia. Many seniors require multiple medications for a range of chronic conditions. Currently however, the lack of uniformity in information and packaging implies that closer monitoring, greater clarity of information and improved packaging of generic medicines is required. Otherwise, the widespread problems and lower uptake of generic medicines amongst seniors will remain. PMID: 20815994 [PubMed - in process]

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‘Not the full Monty’: a qualitative study of seniors’ perceptions of…

Comparison in purity and antitumor effect of brand and generic paclitaxel…

jos — Thu, 09 Sep 2010 06:46:18 +0000

Comparison in purity and antitumor effect of brand and generic paclitaxel against human ovarian cancer cells by an in vitro experimental model. Drug Dev Ind Pharm. 2010 Oct;36(10):1253-8 Authors: Wang KL, Yang YC, Cheng-Yen Lai J, Tsai TH, Lin CP, Wu YT, Chen YY, Wang SC, Chen YJ Context: The purity and the therapeutic effectiveness of the generic paclitaxel have not yet been examined and compared to the original brand form. Objective: This study aimed to compare the in vitro purity and biological effects of original brand form (Taxol) and a generic drug of paclitaxel. Materials and Methods: Purity was determined by high-performance liquid chromatography analysis, cell viability by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide assay, cell proliferation by clonogenic assay, morphology by Liu’s staining, and cell cycle distribution by DNA histogram. Results: Taxol and generic paclitaxel shared similar high-performance liquid chromatography profiles with a major peak at the same retention time and ultraviolet spectrum. Generic paclitaxel inhibited the cell viability to an extent greater than Taxol. By assessing the IC(50), generic paclitaxel also exhibited a greater inhibitory activity on clonogenicity of human ovarian adenocarcinoma SKOV-3 cells. Although both generic paclitaxel and Taxol arrested SKOV-3 and ES-2 cells at G2/M phase with concurrent development of hypoploid and polyploid cells, Taxol treatment exhibited markedly less extent of these changes. Observation of cellular morphology revealed a greater amount of mitotic catastrophe-like and apoptotic cells in generic paclitaxel-treated cells than Taxol-treated cells. Discussion and Conclusion: The results suggest that generic paclitaxel may possess a greater cell death inducing capacity and clonogenicity inhibitory activity against ovarian cancer cells than the original brand Taxol of the same purity. We conclude that this experimental model for assessing the difference between generic and brand name drugs might be considered as a reference while determining their interchangeability and could be easily established in a hospital-based laboratory. PMID: 20818963 [PubMed - in process]

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Comparison of generic tacrolimus and Prograf drug levels in a pediatric…

jos — Thu, 09 Sep 2010 03:26:04 +0000

Comparison of generic tacrolimus and Prograf drug levels in a pediatric kidney transplant program: Brief communication. Pediatr Transplant. 2010 Aug 31; Authors: Abdulnour HA, Araya CE, Dharnidharka VR Abdulnour HA, Araya CE, Dharnidharka VR. Comparison of generic tacrolimus and Prograf drug levels in a pediatric kidney transplant program: Brief communication. Pediatr Transplantation 2010. (c) 2010 John Wiley & Sons A/S. Abstract: A generic version of tacrolimus was approved for use in the USA in August 2009. These narrow therapeutic index generics are tested for bioequivalence only in adults. No data are available on generic tacrolimus levels in children with allografts. Four patients with stable renal allografts in our pediatric program were inadvertently switched to generic tacrolimus. We retrospectively analyzed pre- and post-switch trough tacrolimus and serum creatinine levels. Twelve-h trough tacrolimus levels (mean +/- s.e.) were (i) patient 1 (12-yr-old girl): 7.0 +/- 0.69 and 9.7 +/- 3.5 (p = NS); (ii) patient 2 (eight-yr-old boy): 4.7 +/- 0.68 and 3.4 +/- 0.84 (p = 0.04); (iii) patient 3 (22-yr-old woman): 6.8 +/- 0.17 and 6.6 +/- 0.4 (p = NS); (iv) patient 4 (20-yr-old woman): 5.4 +/- 0.25 and 4.9 +/- 1.4 (p = NS). Creatinine levels were similar pre- and post-switch (eGFR > 75 mL/min/1.73 m(2)) in the first three. Patient 4 experienced a biopsy proven acute rejection immediately after switching. Mean creatinine rose from 1.15 +/- 0.05 to 2.168 +/- 0.07 after switch (p < 0.001). Given our mixed picture with the early data, we suggest careful monitoring of pediatric patients who get switched to generic tacrolimus. PMID: 20819180 [PubMed - as supplied by publisher]

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Comparison of generic tacrolimus and Prograf drug levels in a pediatric…

An integrated phosphoproteomics work flow reveals extensive network…

jos — Mon, 06 Sep 2010 02:27:29 +0000

Related Articles An integrated phosphoproteomics work flow reveals extensive network regulation in early lysophosphatidic acid signaling. Mol Cell Proteomics. 2010 Jun;9(6):1047-62 Authors: Schreiber TB, MÃ¤usbacher N, KÃ©ri G, Cox J, Daub H Lysophosphatidic acid (LPA) induces a variety of cellular signaling pathways through the activation of its cognate G protein-coupled receptors. To investigate early LPA responses and assess the contribution of epidermal growth factor (EGF) receptor transactivation in LPA signaling, we performed phosphoproteomics analyses of both total cell lysate and protein kinase-enriched fractions as complementary strategies to monitor phosphorylation changes in A498 kidney carcinoma cells. Our integrated work flow enabled the identification and quantification of more than 5,300 phosphorylation sites of which 224 were consistently regulated by LPA. In addition to induced phosphorylation events, we also obtained evidence for early dephosphorylation reactions due to rapid phosphatase regulation upon LPA treatment. Phosphorylation changes induced by direct heparin-binding EGF-like growth factor-mediated EGF receptor activation were typically weaker and only detected on a subset of LPA-regulated sites, indicating signal integration among EGF receptor transactivation and other LPA-triggered pathways. Our results reveal rapid phosphoregulation of many proteins not yet implicated in G protein-coupled receptor signaling and point to various additional mechanisms by which LPA might regulate cell survival and migration as well as gene transcription on the molecular level. Moreover, our phosphoproteomics analysis of both total lysate and kinase-enriched fractions provided highly complementary parts of the LPA-regulated signaling network and thus represents a useful and generic strategy toward comprehensive signaling studies on a system-wide level. PMID: 20071362 [PubMed - indexed for MEDLINE]

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Impact of Medicare Part D on independent and chain community pharmacies in…

jos — Sun, 05 Sep 2010 22:14:52 +0000

Related Articles Impact of Medicare Part D on independent and chain community pharmacies in rural Illinois–A qualitative study. Res Social Adm Pharm. 2010 Jun;6(2):110-20 Authors: Bono JD, Crawford SY BACKGROUND: Although the sustainability of rural pharmacy services is a concern of long standing, the rural marketplace is not monolithic. Enhanced understanding of different experiences, strengths, and potential weaknesses of rural chain and independent pharmacies could help inform health policy debates, legislation, and consideration of disparities and access. This study compared and contrasted experiences by pharmacists in chain and independent community pharmacies during Medicare Part D implementation. OBJECTIVE: The objective was to obtain and describe experiential narratives from rural Illinois pharmacists regarding the implementation of Medicare Part D. Similarities and differences experienced in chain and independent community pharmacies were examined, as well as pharmacists’ perceptions about potential implications of the newly implemented Act on the accessibility of rural pharmacy care and services. METHODS: A semistructured qualitative research approach was used, involving focus groups and telephone interviews, to elicit the subjective experiences of rural Illinois pharmacists. Participants were selected through purposive sampling to include representative perspectives of independent and chain community pharmacists in rural areas across the state. Using a systematic, iterative coding process, recurrent themes were identified in 8 substantive categories. RESULTS: Areas of similarity between the 2 groups included universal criticism of the initial implementation processes, but consensus belief that Medicare patients ultimately benefited if they did not have previous prescription drug coverage. Pharmacists in independent drugstores expressed more concern about their future viability. Corporate communications and infrastructure support were available in chain pharmacies and believed to present them with competitive advantages and a stronger long-term financial position. CONCLUSIONS: The findings showed a disparate impact of Medicare Part D on the initial experiences and perceived viability of independent community pharmacies, in comparison with their chain pharmacy counterparts. The long-term implications of changing regulatory environments and customers’ pharmacy needs in underserved communities should be carefully considered and monitored. PMID: 20511110 [PubMed - indexed for MEDLINE]

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PDP or MA-PD? Medicare part D enrollment decisions in CMS Region 25.

admin — Sun, 05 Sep 2010 19:16:01 +0000

Related Articles PDP or MA-PD? Medicare part D enrollment decisions in CMS Region 25. Res Social Adm Pharm. 2010 Jun;6(2):130-42 Authors: Cline RR, Worley MM, Schondelmeyer SW, Schommer JC, Larson TA, Uden DL, Hadsall RS BACKGROUND: The Medicare Prescription Drug Improvement and Modernization Act of 2003 provides outpatient prescription drug coverage for Medicare beneficiaries through private insurers. This coverage is available through 2 primary venues: stand-alone prescription drug plans (PDPs) and integrated managed care (or Medicare Advantage) plans that also provide prescription drug coverage (MA-PDs). OBJECTIVES: The first objective was to describe factors associated with Medicare beneficiaries choosing to enroll in any Medicare part D PDP. The second objective was to describe factors associated with the choice of an MA-PD, given enrollment in the part D program. METHODS: The study used a cross-sectional, survey design. Data were collected from a stratified random sample of 5000 community-dwelling adults, aged 65 years and older in the Center for Medicaid and Medicare Services Region 25. Data were collected by means of a mailed questionnaire. Data analyses included univariate and bivariate descriptive statistics and multivariate probit modeling. RESULTS: The overall adjusted response rate was 50.2% (2309 of 4603). Data from 1490 respondents (32.4% of those attempted) were analyzed in this study. Nearly 75% of sample members elected to enroll in one of the Medicare part D coverage options in 2007, with more than 3 times as many choosing a PDP compared with a MA-PD option (57.2% vs 17.8%). A variety of variables including rurality, plan price, perceived future need for medications, and preferences emerged as important predictors of choosing to enroll in any Medicare part D drug plan, whereas rurality, state of residence, and number of diagnosed medical conditions were associated with the decision to enroll in a MA-PD. CONCLUSIONS: Models of health insurance demand and plan choice applied in this context appear to be modestly effective. Rurality and state of residence were particularly important contributors to both of these decisions, as were a variety of individual characteristics. PMID: 20511112 [PubMed - indexed for MEDLINE]

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PDP or MA-PD? Medicare part D enrollment decisions in CMS Region 25.

The Effect of Medication Samples on Self-Reported Prescribing Practices: A…

jos — Sun, 05 Sep 2010 15:21:34 +0000

Related Articles The Effect of Medication Samples on Self-Reported Prescribing Practices: A Statewide, Cross-Sectional Survey. J Gen Intern Med. 2010 Aug 31; Authors: Pinckney RG, Helminski AS, Kennedy AG, Maclean CD, Hurowitz L, Cote E BACKGROUND: The pharmaceutical industry spends billions of dollars annually to encourage clinicians to prescribe their medications. Small studies have demonstrated that one of the marketing strategies, the distribution of free sample medications, is associated with increased use of brand name medication over generic medication. OBJECTIVES: To determine the relationship between the presence of drug samples in primary care clinics and prescription of preferred drug treatments. DESIGN: Cross-sectional survey. PARTICIPANTS: Primary care prescribers in the state of Vermont. MAIN MEASUREMENT: Prescribers were presented with two clinical vignettes and asked to provide the name of the medication they would prescribe in each case. We compared the responses of prescribers with and without samples in their clinics. KEY RESULTS: Two hundred six prescribers out of the total population of 631 returned the survey and met the eligibility criteria. Seventy-two percent of prescribers had sample closets in their clinics. Seventy percent of clinicians with samples would prescribe a thiazide diuretic for hypertension compared to 91% in those without samples (P < 0.01). For managing depression 91% of prescribers with samples would have provided a generic medication in a patient with no health insurance, compared to 100% of those without samples in their clinic (P = 0.02). CONCLUSIONS: Clinicians with samples in their clinics were less likely to prescribe preferred medications for hypertension and depression. PMID: 20809157 [PubMed - as supplied by publisher]

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Measuring medicine prices in Peru: validation of key aspects of WHO/HAI…

jos — Thu, 02 Sep 2010 23:26:12 +0000

Related Articles Measuring medicine prices in Peru: validation of key aspects of WHO/HAI survey methodology. Rev Panam Salud Publica. 2010 Apr;27(4):291-9 Authors: Madden JM, Meza E, Ewen M, Laing RO, Stephens P, Ross-Degnan D OBJECTIVES: To assess the possibility of bias due to the limited target list and geographic sampling of the World Health Organization (WHO)/Health Action International (HAI) Medicine Prices and Availability survey used in more than 70 rapid sample surveys since 2001. METHODS: A survey was conducted in Peru in 2005 using an expanded sample of medicine outlets, including remote areas. Comprehensive data were gathered on medicines in three therapeutic classes to assess the adequacy of WHO/HAI’s target medicines list and the focus on only two product versions. WHO/HAI median retail prices were compared with average wholesale prices from global pharmaceutical sales data supplier IMS Health. RESULTS: No significant differences were found in overall availability or prices of target list medicines by retail location. The comprehensive survey of angiotensin-converting enzyme inhibitor, anti-diabetic, and anti-ulcer products revealed that some treatments not on the target list were costlier for patients and more likely to be unavailable, particularly in remote areas. WHO/HAI retail prices and IMS wholesale prices were strongly correlated for higher priced products, and weakly correlated for lower priced products (which had higher estimated retailer markups). CONCLUSIONS: The WHO/HAI survey approach strikes an appropriate balance between modest research costs and optimal information for policy. Focusing on commonly used medicines yields sufficient and valid results. Surveyors elsewhere should consider the limits of the survey data as well as any local circumstances, such as scarcity, that may call for extra field efforts. PMID: 20512232 [PubMed - indexed for MEDLINE]

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Measuring medicine prices in Peru: validation of key aspects of WHO/HAI…