Generic Samples http://www.genericsamples.com/wp Thu, 02 Sep 2010 23:26:12 +0000 http://wordpress.org/?v=2.8.5 en hourly 1 Measuring medicine prices in Peru: validation of key aspects of WHO/HAI… http://www.genericsamples.com/wp/measuring-medicine-prices-in-peru-validation-of-key-aspects-of-whohai/ http://www.genericsamples.com/wp/measuring-medicine-prices-in-peru-validation-of-key-aspects-of-whohai/#comments Thu, 02 Sep 2010 23:26:12 +0000 jos http://www.genericsamples.com/wp/measuring-medicine-prices-in-peru-validation-of-key-aspects-of-whohai/ 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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]]> http://www.genericsamples.com/wp/measuring-medicine-prices-in-peru-validation-of-key-aspects-of-whohai/feed/ 0 Saving lives, money and resources: drug and CABG/PCI use after myocardial… http://www.genericsamples.com/wp/saving-lives-money-and-resources-drug-and-cabgpci-use-after-myocardial/ http://www.genericsamples.com/wp/saving-lives-money-and-resources-drug-and-cabgpci-use-after-myocardial/#comments Thu, 02 Sep 2010 09:17:02 +0000 jos http://www.genericsamples.com/wp/saving-lives-money-and-resources-drug-and-cabgpci-use-after-myocardial/ Related Articles Saving lives, money and resources: drug and CABG/PCI use after myocardial infarction in a Swedish record-linkage study. Eur J Health Econ. 2010 Apr;11(2):177-84 Authors: Wilhelmsen L, Welin L, Odén A, Björnberg A BACKGROUND: Drug costs are increasing despite the introduction of cheaper generic drugs. The aim of the present study was to analyse the entire costs of hospital care, out-patient care, and the cost of drugs for 16 months following a myocardial infarction (MI) to see to what extent drug costs contribute to the overall costs of care. METHODS: Diagnoses and costs for care as well as mortality data obtained from the Västra Götaland Region, Sweden, and drug costs from the Swedish Board of Health and Welfare, were merged in a computer file. Patients registered from 1 July 2005 to 30 June 2006 were followed from 28 days after an MI, with follow-up until 31 October 2006. RESULTS: Of 4,725 patients, 711 died before the start of the study and 721 during follow-up. Higher age [hazard ratio (HR, 95%CI) = 1.06 (1.05-1.07)], previous MI [HR = 1.31 (1.13-1.53)] and diabetes mellitus [HR = 1.34 (1.13-1.58)] were associated with increased mortality, which decreased with coronary interventions: CABG/PCI [HR = 0.19 (0.14-0.27)]. In a multivariable analysis, mortality was lower for patients taking simvastatin [HR = 0.62 (0.50-0.76)] and clopidogrel [HR = 0.58 (0.46-0.74)]. CONCLUSION: Costs for out-patient care accounted for 25% and drugs for 5% of total costs. If patients not treated with simvastatin or clopidogrel had received these drugs, an additional 154-306 lives might have been saved. Drug costs would be higher, but total costs lower. Thus, even expensive drugs may reduce overall costs. PMID: 19495819 [PubMed - indexed for MEDLINE]

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]]> http://www.genericsamples.com/wp/saving-lives-money-and-resources-drug-and-cabgpci-use-after-myocardial/feed/ 0 Primary care summary of the British Thoracic Society Guidelines for the… http://www.genericsamples.com/wp/primary-care-summary-of-the-british-thoracic-society-guidelines-for-the/ http://www.genericsamples.com/wp/primary-care-summary-of-the-british-thoracic-society-guidelines-for-the/#comments Thu, 02 Sep 2010 04:15:40 +0000 jos http://www.genericsamples.com/wp/primary-care-summary-of-the-british-thoracic-society-guidelines-for-the/ Related Articles Primary care summary of the British Thoracic Society Guidelines for the management of community acquired pneumonia in adults: 2009 update. Endorsed by the Royal College of General Practitioners and the Primary Care Respiratory Society UK. Prim Care Respir J. 2010 Mar;19(1):21-7 Authors: Levy ML, Le Jeune I, Woodhead MA, Macfarlaned JT, Lim WS, INTRODUCTION: The identification and management of adults presenting with pneumonia is a major challenge for primary care health professionals. This paper summarises the key recommendations of the British Thoracic Society (BTS) Guidelines for the management of Community Acquired Pneumonia (CAP) in adults. METHOD: Systematic electronic database searches were conducted in order to identify potentially relevant studies that might inform guideline recommendations. Generic study appraisal checklists and an evidence grading from A+ to D were used to indicate the strength of the evidence upon which recommendations were made. CONCLUSIONS: This paper provides definitions, key messages, and recommendations for handling the uncertainty surrounding the clinical diagnosis, assessing severity, management, and follow-up of patients with CAP in the community setting. Diagnosis and decision on hospital referral in primary care is based on clinical judgement and the CRB-65 score. Unlike some other respiratory infections (e.g. acute bronchitis) an antibiotic is always indicated when a clinical diagnosis of pneumonia is made. Timing of initial review will be determined by disease severity. When there is a delay in symptom or radiographic resolution beyond six weeks, the main concern is whether the CAP was a complication of an underlying condition such as lung cancer. PMID: 20157684 [PubMed - indexed for MEDLINE]

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]]> http://www.genericsamples.com/wp/primary-care-summary-of-the-british-thoracic-society-guidelines-for-the/feed/ 0 Indicators of rational drug use and health services in Hadramout, Yemen. http://www.genericsamples.com/wp/indicators-of-rational-drug-use-and-health-services-in-hadramout-yemen/ http://www.genericsamples.com/wp/indicators-of-rational-drug-use-and-health-services-in-hadramout-yemen/#comments Thu, 02 Sep 2010 01:16:19 +0000 admin http://www.genericsamples.com/wp/indicators-of-rational-drug-use-and-health-services-in-hadramout-yemen/ Related Articles Indicators of rational drug use and health services in Hadramout, Yemen. East Mediterr Health J. 2010 Feb;16(2):151-5 Authors: Bashrahil KA WHO standard indicators of rational drug use, this study analysed 550 prescriptions from 20 health facilities at different levels throughout Hadramout governorate, Yemen. A mean of 2.8 (SD 0.2) drugs were prescribed per prescription, with a low rate of prescribing drugs by generic name (39.2%). The proportion of prescriptions for antibiotics was 66.2%, for injectable drugs 46.0% and for vitamins/tonics 23.6%. The essential drugs list was available in 78.9% of facilities and a high percentage of drugs were prescribed from the list (81.2%). Other official sources of local drug information were less available. PMID: 20799566 [PubMed - in process]

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]]> http://www.genericsamples.com/wp/indicators-of-rational-drug-use-and-health-services-in-hadramout-yemen/feed/ 0 A generic static headspace gas chromatography method for determination of… http://www.genericsamples.com/wp/a-generic-static-headspace-gas-chromatography-method-for-determination-of/ http://www.genericsamples.com/wp/a-generic-static-headspace-gas-chromatography-method-for-determination-of/#comments Wed, 01 Sep 2010 20:14:17 +0000 admin http://www.genericsamples.com/wp/a-generic-static-headspace-gas-chromatography-method-for-determination-of/ Related Articles A generic static headspace gas chromatography method for determination of residual solvents in drug substance. J Chromatogr A. 2010 Aug 13; Authors: Cheng C, Liu S, Mueller BJ, Yan Z In order to increase productivity of drug analysis in the pharmaceutical industry, an efficient and sensitive generic static headspace gas chromatography (HSGC) method was successfully developed and validated for the determination of 44 classes 2 and 3 solvents of International Conference of Harmonization (ICH) guideline Q3C, as residual solvents in drug substance. In order to increase the method sensitivity and efficiency in sample equilibration, dimethylsulfoxide (DMSO) was selected as the sample diluent based on its high capacity of dissolving drug substance, stability and high boiling point. The HS sample equilibration temperature and equilibration time are assessed in ranges of 125-150 degrees C and 8-15min, respectively. The results indicate that the residual solvents in 200mg of drug substance can be equilibrated efficiently in HS sampler at 140 degrees C for 10min. The GC parameters, e.g. sample split ratio, carrier flow rate and oven temperature gradient are manipulated to enhance the method sensitivity and separation efficiency. The two-stage gradient GC run from 35 to 240 degrees C, using an Agilent DB-624 capillary column (30m long, 0.32mm I.D., 1.8mum film thickness), is suitable to determine 44 ICH classes 2 and 3 solvents in 30min. The method validation results indicate that the method is accurate, precise, linear and sensitive for solvents assessed. The recoveries of most of these solvents from four drug substances are greater than 80% within the method determination ranges. However, this method is not suitable for the 10 remaining ICH classes 2 and 3 solvents, because they are too polar (e.g. formic acid and acidic acid), or have boiling points higher than 150 degrees C, (e.g. anisol and cumene). In comparison with the previous published methods, this method has a much shorter sample equilibration time, a better separation for many solvents, a higher sensitivity and a broader concentration range. PMID: 20801455 [PubMed - as supplied by publisher]

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]]> http://www.genericsamples.com/wp/a-generic-static-headspace-gas-chromatography-method-for-determination-of/feed/ 0 Cardiovascular and Economic Outcomes After Initiation of Atorvastatin… http://www.genericsamples.com/wp/cardiovascular-and-economic-outcomes-after-initiation-of-atorvastatin/ http://www.genericsamples.com/wp/cardiovascular-and-economic-outcomes-after-initiation-of-atorvastatin/#comments Wed, 01 Sep 2010 16:43:42 +0000 admin http://www.genericsamples.com/wp/cardiovascular-and-economic-outcomes-after-initiation-of-atorvastatin/ Related Articles Cardiovascular and Economic Outcomes After Initiation of Atorvastatin versus Simvastatin in an Employed Population Stratified by Cardiovascular Risk. Am J Ther. 2010 Aug 27; Authors: Simpson RJ, Signorovitch J, Ramakrishnan K, Ivanova J, Birnbaum H, Kuznik A The relative effects of atorvastatin and simvastatin among higher- and lower-risk patients are not well characterized. This study compared cardiovascular (CV) risk and direct and indirect costs among higher- and lower-risk employees initiating atorvastatin vs. simvastatin. Using a large employer claims database (1999-2006), employees were stratified as 1) high-risk employees with prior CV events, diabetes, or renal disorders; and 2) low- to intermediate-risk employees without these conditions. Propensity score matching was used, and 2-year outcomes were compared between matched cohorts. Indirect costs included disability payments and medically related absenteeism. Drug costs were imputed with recent prices to account for availability of generic simvastatin. Among 4167 matched pairs of high-risk employees, atorvastatin use was associated with a numerically lower risk of CV events (17.6 versus 18.4%, P = 0.37), higher direct medical costs ($17,590 versus $17,377, P = 0.002), numerically lower indirect costs ($4830 versus $4989, P = 0.29), and higher total costs by $54 ($22,420 versus $22,366, P = 0.034). The majority of high-risk employees (62%) received low initial statin doses (atorvastatin = 10 mg or simvastatin = 20 mg). Among 9326 matched pairs of low- to intermediate-risk employees, atorvastatin use was associated with a lower risk of CV events (3.1% versus 3.7%, P = 0.030), lower direct medical costs ($8400 versus $8436, P < 0.001), numerically lower indirect costs ($2781 versus $2807; P = 0.12), and lower total costs by $61 ($11,181 versus $11,243, P < 0.001). These results suggest that formulary policies reserving atorvastatin for higher-risk patients may not be cost-saving from the employer perspective. PMID: 20802306 [PubMed - as supplied by publisher]

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]]> http://www.genericsamples.com/wp/cardiovascular-and-economic-outcomes-after-initiation-of-atorvastatin/feed/ 0 Drug prescription habits in public and private health facilities in 2… http://www.genericsamples.com/wp/drug-prescription-habits-in-public-and-private-health-facilities-in-2/ http://www.genericsamples.com/wp/drug-prescription-habits-in-public-and-private-health-facilities-in-2/#comments Sun, 29 Aug 2010 18:21:33 +0000 admin http://www.genericsamples.com/wp/drug-prescription-habits-in-public-and-private-health-facilities-in-2/ Related Articles Drug prescription habits in public and private health facilities in 2 provinces in South Africa. East Mediterr Health J. 2010 Mar;16(3):324-8 Authors: Mohlala G, Peltzer K, Phaswana-Mafuya N, Ramlagan S The aim of this study was to explore drug prescription habits using WHO standard indicators in public hospitals and 36 private surgeries in 2 provinces in South Africa. A high mean number of drugs were prescribed per patient (3.2 versus 2.8) in public hospitals and by general practitioners (GPs) respectively andc generic prescribing rates were low (45.2% versus 24.5%). The rates of prescribing in public hospitals and by GPsa were 8.3% versus 23.3% for injections, 68.1% versus 31.9% for antibiotics and 92.6% versus 68.5% for drugs from the essential drugs list. Drug prescribing in both sectors needs to be regulated, especially the use of antibiotics, essential drugs and generic prescribing. PMID: 20795449 [PubMed - in process]

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]]> http://www.genericsamples.com/wp/drug-prescription-habits-in-public-and-private-health-facilities-in-2/feed/ 0 Influence of patient race on physician prescribing decisions: a randomized… http://www.genericsamples.com/wp/influence-of-patient-race-on-physician-prescribing-decisions-a-randomized/ http://www.genericsamples.com/wp/influence-of-patient-race-on-physician-prescribing-decisions-a-randomized/#comments Fri, 27 Aug 2010 23:31:14 +0000 admin http://www.genericsamples.com/wp/influence-of-patient-race-on-physician-prescribing-decisions-a-randomized/ Related Articles Influence of patient race on physician prescribing decisions: a randomized on-line experiment. J Gen Intern Med. 2009 Nov;24(11):1183-91 Authors: Rathore SS, Ketcham JD, Alexander GC, Epstein AJ BACKGROUND: Prior research reports black patients have lower medication use for hypercholesterolemia, hypertension, and diabetes. OBJECTIVE: To assess whether patient race influences physicians’ prescribing. DESIGN: Web-based survey including three clinical vignettes (hypercholesterolemia, hypertension, diabetes), with patient race (black, white) randomized across vignettes. SUBJECTS: A total of 716 respondents from 5,141 eligible sampled primary care physicians (14% response rate). INTERVENTIONS: None MEASUREMENTS: Medication recommendation (any medication vs none, on-patent branded vs generic, and therapeutic class) and physicians’ treatment adherence forecast (10-point Likert scale, 1-definitely not adhere, 10-definitely adhere). RESULTS: Respondents randomized to view black patients (n = 371) and white patients (n = 345) recommend any medications at comparable rates for hypercholesterolemia (100.0% white vs 99.5% black, P = 0.50), hypertension (99.7% white vs 99.5% black, P = 1.00), and diabetes (99.7% white vs 99.7% black, P = 1.00). Patient race influenced medication class chosen in the hypertension vignette; respondents randomized to view black patients recommended calcium channel blockers more often (20.8% black vs 3.2% white) and angiotensin-converting enzyme inhibitors less often (47.4% black vs 62.6% white) (P < 0.001). Patient race did not influence medication class for hypercholesterolemia or diabetes. Respondents randomized to view black patients reported lower forecasted patient adherence for hypertension (P < 0.001, mean: 7.3 black vs 7.7 white) and diabetes (P = 0.05 mean: 7.4 black vs 7.6 white), but race had no meaningful influence on forecasted adherence for hypercholesterolemia (P = 0.15, mean: 7.2 black vs 7.3 white). CONCLUSION: Racial differences in outpatient prescribing patterns for hypertension, hypercholesterolemia, and diabetes are likely attributable to factors other than prescribing decisions based on patient race. PMID: 19705205 [PubMed - indexed for MEDLINE]

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]]> http://www.genericsamples.com/wp/influence-of-patient-race-on-physician-prescribing-decisions-a-randomized/feed/ 0 The mitochondrial ribosomal protein of the large subunit, Afo1p, determines… http://www.genericsamples.com/wp/the-mitochondrial-ribosomal-protein-of-the-large-subunit-afo1p-determines/ http://www.genericsamples.com/wp/the-mitochondrial-ribosomal-protein-of-the-large-subunit-afo1p-determines/#comments Fri, 27 Aug 2010 18:46:14 +0000 jos http://www.genericsamples.com/wp/the-mitochondrial-ribosomal-protein-of-the-large-subunit-afo1p-determines/ Related Articles The mitochondrial ribosomal protein of the large subunit, Afo1p, determines cellular longevity through mitochondrial back-signaling via TOR1. Aging (Albany NY). 2009 Jul;1(7):622-36 Authors: Heeren G, Rinnerthaler M, Laun P, von Seyerl P, Kössler S, Klinger H, Hager M, Bogengruber E, Jarolim S, Simon-Nobbe B, Schüller C, Carmona-Gutierrez D, Breitenbach-Koller L, Mück C, Jansen-Dürr P, Criollo A, Kroemer G, Madeo F, Breitenbach M Yeast mother cell-specific aging constitutes a model of replicative aging as it occurs in stem cell populations of higher eukaryotes. Here, we present a new long-lived yeast deletion mutation,afo1 (for aging factor one), that confers a 60% increase in replicative lifespan. AFO1/MRPL25 codes for a protein that is contained in the large subunit of the mitochondrial ribosome. Double mutant experiments indicate that the longevity-increasing action of the afo1 mutation is independent of mitochondrial translation, yet involves the cytoplasmic Tor1p as well as the growth-controlling transcription factor Sfp1p. In their final cell cycle, the long-lived mutant cells do show the phenotypes of yeast apoptosis indicating that the longevity of the mutant is not caused by an inability to undergo programmed cell death. Furthermore, the afo1 mutation displays high resistance against oxidants. Despite the respiratory deficiency the mutant has paradoxical increase in growth rate compared to generic petite mutants. A comparison of the single and double mutant strains for afo1 and fob1 shows that the longevity phenotype of afo1 is independent of the formation of ERCs (ribosomal DNA minicircles). AFO1/MRPL25 function establishes a new connection between mitochondria, metabolism and aging. PMID: 20157544 [PubMed - indexed for MEDLINE]

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]]> http://www.genericsamples.com/wp/the-mitochondrial-ribosomal-protein-of-the-large-subunit-afo1p-determines/feed/ 0 Systematic review and economic modelling of the effectiveness and… http://www.genericsamples.com/wp/systematic-review-and-economic-modelling-of-the-effectiveness-and/ http://www.genericsamples.com/wp/systematic-review-and-economic-modelling-of-the-effectiveness-and/#comments Fri, 27 Aug 2010 15:22:26 +0000 admin http://www.genericsamples.com/wp/systematic-review-and-economic-modelling-of-the-effectiveness-and/ Systematic review and economic modelling of the effectiveness and cost-effectiveness of non-surgical treatments for women with stress urinary incontinence. Health Technol Assess. 2010 Aug;14(40):1-506 Authors: Imamura M, Abrams P, Bain C, Buckley B, Cardozo L, Cody J, Cook J, Eustice S, Glazener C, Grant A, Hay-Smith J, Hislop J, Jenkinson D, Kilonzo M, Nabi G, N’dow J, Pickard R, Ternent L, Wallace S, Wardle J, Zhu S, Vale L OBJECTIVES: To assess the clinical effectiveness and cost-effectiveness of non-surgical treatments for women with stress urinary incontinence (SUI) through systematic review and economic modelling. DATA SOURCES: The Cochrane Incontinence Group Specialised Register, electronic databases and the websites of relevant professional organisations and manufacturers, and the following databases: CINAHL, EMBASE, BIOSIS, Science Citation Index and Social Science Citation Index, Current Controlled Trials, ClinicalTrials.gov and the UKCRN Portfolio Database. STUDY SELECTION: The study comprised three distinct elements. (1) A survey of 188 women with SUI to identify outcomes of importance to them (activities of daily living; sex, hygiene and lifestyle issues; emotional health; and the availability of services). (2) A systematic review and meta-analysis of non-surgical treatments for SUI to find out which are most effective by comparing results of trials (direct pairwise comparisons) and by modelling results (mixed-treatment comparisons – MTCs). A total of 88 randomised controlled trials (RCTs) and quasi-RCTs reporting data from 9721 women were identified, considering five generic interventions [pelvic floor muscle training (PFMT), electrical stimulation (ES), vaginal cones (VCs), bladder training (BT) and serotonin-noradrenaline reuptake inhibitor (SNRI) medications], in many variations and combinations. Data were available for 37 interventions and 68 treatment comparisons by direct pairwise assessment. Mixed-treatment comparison models compared 14 interventions, using data from 55 trials (6608 women). (3) Economic modelling, using a Markov model, to find out which combinations of treatments (treatment pathways) are most cost-effective for SUI. DATA EXTRACTION: Titles and abstracts identified were assessed by one reviewer and full-text copies of all potentially relevant reports independently assessed by two reviewers. Any disagreements were resolved by consensus or arbitration by a third person. RESULTS: Direct pairwise comparison and MTC analysis showed that the treatments were more effective than no treatment. Delivering PFMT in a more intense fashion, either through extra sessions or with biofeedback (BF), appeared to be the most effective treatment [PFMT extra sessions vs no treatment (NT) odds ratio (OR) 10.7, 95% credible interval (CrI) 5.03 to 26.2; PFMT + BF vs NT OR 12.3, 95% CrI 5.35 to 32.7]. Only when success was measured in terms of improvement was there evidence that basic PFMT was better than no treatment (PFMT basic vs NT OR 4.47, 95% CrI 2.03 to 11.9). Analysis of cost-effectiveness showed that for cure rates, the strategy using lifestyle changes and PFMT with extra sessions followed by tension-free vaginal tape (TVT) (lifestyle advice-PFMT extra sessions-TVT) had a probability of greater than 70% of being considered cost-effective for all threshold values for willingness to pay for a QALY up to 50,000 pounds. For improvement rates, lifestyle advice-PFMT extra sessions-TVT had a probability of greater than 50% of being considered cost-effective when society’s willingness to pay for an additional QALY was more than 10,000 pounds. The results were most sensitive to changes in the long-term performance of PFMT and also in the relative effectiveness of basic PFMT and PFMT with extra sessions. LIMITATIONS: Although a large number of studies were identified, few data were available for most comparisons and long-term data were sparse. Challenges for evidence synthesis were the lack of consensus on the most appropriate method for assessing incontinence and intervention protocols that were complex and varied considerably across studies. CONCLUSIONS: More intensive forms of PFMT appear worthwhile, but further research is required to define an optimal form of more intensive therapy that is feasible and efficient for the NHS to provide, along with further definitive evidence from large, well-designed studies. PMID: 20738930 [PubMed - in process]

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