scholarly journals Off-Patent Biological and Biosimilar Medicines in Belgium: A Market Landscape Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Yannick Vandenplas ◽  
Steven Simoens ◽  
Philippe Van Wilder ◽  
Arnold G. Vulto ◽  
Isabelle Huys
Keyword(s):  
Price Competition ◽  
Quality Care ◽  
Added Value ◽  
Stakeholder Perceptions ◽  
Structured Interviews ◽  
Financing System ◽  
Market Data ◽  
Quantitative And Qualitative Research ◽  
Therapeutic Class ◽  
Market Shares

Background and objective: Best-value biological medicines may generate competition in the off-patent biologicals market, resulting in having more resources available to provide patients with access to necessary medicines while maintaining high-quality care. Belgium is a country known to have low biosimilar market shares, suggesting a malfunctioning market for off-patent biologicals. This study aims to gain an in-depth understanding of the Belgian off-patent biologicals market, by looking at the evolution in volumes and costs of the relevant products in the market.Methods: This study included a combination of quantitative and qualitative research methods. The quantitative part of this study consisted of the analysis of market data obtained by the National Institute for Health and Disability Insurance (NIHDI) for all relevant products in the Belgian off-patent biologicals market (i.e. TNF-inhibitors, insulins, granulocyte colony-stimulating factors, epoetins, rituximab, trastuzumab). In addition, for the qualitative part of this study, semi-structured interviews with Belgian stakeholders were conducted between December 2019 and March 2020.Results: Belgian market data and stakeholder perceptions suggest a suboptimal market environment for off-patent biological and biosimilar medicines. Shifts are observed after loss of exclusivities of originator biologicals toward second-generation products or new therapeutic class products, at a higher cost and often limited added value. Moreover, cost reductions for off-patent biologicals after biosimilar market entry are mainly determined by mandatory price reductions applicable to both originator and biosimilar products, and not by lower prices induced by competition. For products used in the retail setting, significant mandatory price reductions for both originator and reference products with low biosimilar volumes were pointed out as the main reasons for the lack of price competition. For products dispensed in hospitals, the hospital financing system is important. First, it does not always encourage the use of lower cost alternatives. Second, competition mainly takes place at the level of confidential discounts in tenders. Most interviewees acknowledged the lack of a competitive environment, which is not supportive of a sustainable Belgian off-patent biologicals market.Conclusion: Market data and stakeholder perceptions indicate that the sustainability of the Belgian market for off-patent biologicals is challenged. A sustainable market ensures access to biological therapies now and in the future.

Understanding the Abortion Experiences of Young People to Inform Quality Care in Argentina, Bangladesh, Ethiopia, and Nigeria

2021 ◽  
pp. 0044118X2110110
Author(s):  
Laura E. Jacobson ◽  
Ana Maria Ramirez ◽  
Chiara Bercu ◽  
Anna Katz ◽  
Caitlin Gerdts ◽  
...  
Keyword(s):  
Young People ◽  
Quality Care ◽  
First Trimester ◽  
Structural Barriers ◽  
Structured Interviews ◽  
Safe Abortion ◽  
Medication Abortion ◽  
Abortion Care ◽  
The Mean ◽  
Reproductive Healthcare

Young people face social and structural barriers when accessing abortions. High-quality, sexual and reproductive healthcare is needed; however, literature on youth-informed abortion services is limited. This study assesses accounts of youth who obtained an abortion in Argentina, Bangladesh, Ethiopia, and Nigeria and provides recommendations to improve person-centered aspects of abortion quality. We analyzed 48 semi-structured interviews with clients recruited from clinics, safe abortion hotlines, and patent and proprietary medicine vendors. We coded transcripts and conducted a thematic analysis. The mean age was 21 years (range 16–24), and the majority had a first trimester, medication abortion. Prominent themes included access to information; privacy; stigma associated with age or marital status; the decision-making process; and comfort and rapport with providers. Youth-centered abortion care should anticipate the distinct needs of younger clients. Supportive providers have an important role in offering a non-judgmental service that makes young clients feel comfortable and prepared.

scholarly journals Implementation of Person-Centered Care: A Feasibility Study Using the WE-CARE Roadmap

2021 ◽  
Vol 18 (5) ◽  
pp. 2205
Author(s):  
Roman A. Lewandowski ◽  
Jędrzej B. Lewandowski ◽  
Inger Ekman ◽  
Karl Swedberg ◽  
Jan Törnell ◽  
...  
Keyword(s):  
Pilot Study ◽  
Feasibility Study ◽  
Health Care Professionals ◽  
Quality Care ◽  
Structured Interviews ◽  
Rehabilitation Hospital ◽  
Person Centered Care ◽  
Centered Care ◽  
Multi Disciplinary Team

Background: Person-Centered Care (PCC) is a promising approach towards improved quality of care and cost containment within health systems. It has been evaluated in Sweden and England. This feasibility study examines initial PCC implementation in a rehabilitation hospital for children in Poland. Methods: The WE-CARE Roadmap of enablers was used to guide implementation of PCC for patients with moderate scoliosis. A multi-disciplinary team of professionals were trained in the PCC approach and the hospital Information Technology (IT) system was modified to enhance PCC data capture. Semi-structured interviews were conducted with the nine health care professionals involved in the pilot study and three patients/parents receiving care. Transcribed data were analyzed via content analysis. Results: 51 patients and their families were treated via a PCC approach. High proportions of new PCC data fields were completed by the professionals. The professionals were able to implement the three core PCC routines and perceived benefits using the PCC approach. Patients and their families also perceived improved quality care. The WE-CARE framework enablers facilitated PCC implementation in this setting. Conclusions: This feasibility pilot study indicates that the Gothenburg PCC approach can be successfully transferred to a rehabilitation hospital in Poland with favorable perceptions of implementation by both professionals and patients/their families.

scholarly journals Enhancing flood resilience through improved risk communications

2012 ◽  
Vol 12 (7) ◽  
pp. 2271-2282 ◽  
Author(s):  
J. J. O'Sullivan ◽  
R. A. Bradford ◽  
M. Bonaiuto ◽  
S. De Dominicis ◽  
P. Rotko ◽  
...  
Keyword(s):  
Flood Risk ◽  
Structured Interviews ◽  
Deficit Model ◽  
Statistical Correlations ◽  
Quantitative And Qualitative Research ◽  
Flood Warning ◽  
Questionnaire Surveys ◽  
Relationship Of ◽  
Eleven Case ◽  
Conceptual Relationship

Abstract. A framework of guiding recommendations for effective pre-flood and flood warning communications derived from the URFlood project (2nd ERA-Net CRUE Research Funding Initiative) from extensive quantitative and qualitative research in Finland, Ireland, Italy and Scotland is presented. Eleven case studies in fluvial, pluvial, coastal, residual and "new" flood risk locations were undertaken. The recommendations were developed from questionnaire surveys by exploring statistical correlations of actions and understandings of individuals in flood risk situations to low, moderate and high resilience groupings. Groupings were based on a conceptual relationship of self-assessed levels of awareness, preparedness and worry. Focus groups and structured interviews were used to discuss barriers in flood communications, explore implementation of the recommendations and to rank the recommendations in order of perceived importance. Results indicate that the information deficit model for flood communications that relies on the provision of more and better information to mitigate risk in flood-prone areas is insufficient, and that the communications process is very much multi-dimensional. The recommendations are aimed at addressing this complexity and their careful implementation is likely to improve the penetration of flood communications. The recommendations are applicable to other risks and are transferrable to jurisdictions beyond the project countries.

Velosatiksmes pārvaldība Valmieras pašvaldībā: sistēmpieejas izpratnes un pārvaldības attīstība

2021 ◽  
pp. 208-221
Author(s):  
Roberts Pūgulis ◽  
◽  
Līga Bieziņa ◽  
Raimonds Ernšteins ◽  
◽  
...  
Keyword(s):  
Urban Transport ◽  
Transport Infrastructure ◽  
Medium Size ◽  
Infrastructure Development ◽  
Structured Interviews ◽  
Sustainable Mobility ◽  
Quantitative And Qualitative Research ◽  
Mobility System ◽  
Working Groups ◽  
Systemic Governance

Cycling and general sustainable mobility has become a topical issue around Europe, and gradually also in Latvia, including Valmiera – a medium size town, which is a research-base for this study where the governance and development of the municipal cycling infrastructure is analysed. The rapid growth of cycling in Valmiera not only highlights some deficiencies in urban infrastructure developments, but also reveals the management problems: the expectations and needs of users of different means of transportation and also pedestrians are not met. Looking towards solving various cycling development issues, it is necessary, first of all, to develop an understanding of system’s approach and the systemic governance of the cycling infrastructure. The urban transport/mobility system must be developed as a whole, integrating cycling mobility in it as an independently and continuously developing component, promoting a process of cooperation between all parties involved. Thus, to facilitate the cycling mobility of inhabitants in Valmiera, the involvement/participation of all the interested parties shall be pro-actively communicated – informed, educated/trained, pro-cycling behaviour encouraged. During this integrative case study, both quantitative and qualitative research methods were applied complementary: analysis of documents, infrastructure observations in the town with photo documentation, survey of inhabitants, also in-depth semi-structured interviews with open-ended questions. Additionally, a participatory observation was conducted through participation in cycling activities, forums, working groups, etc., elaborating suggestions for the municipal planning document - Transport Infrastructure Development Concept of Valmiera.

A Tsunami of Love: Overcoming the Violence of Curiosity—The Lived Experiences of Young Adults Born with Variations of Sex Characteristics

2021 ◽  
Vol 14 (2) ◽  
pp. 11-35
Author(s):  
Eva De Clercq
Keyword(s):  
Young Adults ◽  
Interpretative Phenomenological Analysis ◽  
Quality Care ◽  
Phenomenological Analysis ◽  
Sex Characteristics ◽  
Health Providers ◽  
Structured Interviews ◽  
Patient Centered ◽  
Medical Settings ◽  
Insight Into

This study provides insight into the experiences of young adults born with variations of sex characteristics to identify aspects of care and social support that need improvement. Semi-structured interviews with intersex youths in Switzerland were analyzed using interpretative, phenomenological analysis. Young adults desire timely, patient-centered information about their diagnoses. Peer support is key to delivering high-quality care but rarely systematically implemented. Intersex youth often face misrepresentation, stigma, and discrimination in medical settings and in society. Increased visibility alone cannot tackle these issues, but a feminist curiosity of care will enable health providers and society to overcome preconceptions of body normativity.

scholarly journals Does the New Industrial Strategy for Europe Follow the Path of the Concept of Industry 4.0?

2021 ◽  
Vol 25 (1) ◽  
pp. 85-102
Author(s):  
Aleksandra Borowicz
Keyword(s):  
European Union ◽  
European Commission ◽  
Industry 4.0 ◽  
Added Value ◽  
The European Union ◽  
Review Of The Literature ◽  
Digital Revolution ◽  
Quantitative And Qualitative Research ◽  
New Strategy ◽  
European Industry

The concept of Industry 4.0 turns 10 years old in 2021. This milestone calls for renewed inquiries to review the current efforts of the European Union (EU) and its Member States towards the modernisation of European industry. In 2018, the European Commission published the Digital Transformation Scoreboard 2018: EU businesses go digital: Opportunities, outcomes and uptake, which reports on the readiness for the digital revolution focused on building an economy in line with the concept of Industry 4.0 at three levels: European, national, and business. This study shows how much still remains to be done. At the same time, it identifies some of the key elements contributing to the success in this area, i.e., the digitisation of machines, Big Data, robotics and artificial intelligence, which represent the very essence of the idea of revolution 4.0. The aim of the paper is to determine the extent to which the new strategy for industry proposed by the European Commission in 2020 follows the concept of Industry 4.0. Quantitative and qualitative research methods were used. Statistical analysis was used to demonstrate the importance of industry in the economy of the European Union between 1998 and 2019 in terms of the share in the added value created and the significance for the labour market. The descriptive methods used include a review of the literature and research on the concept of Industry 4.0 and an analysis of the latest strategic documents of the European Commission (EC) in relation to industrial policy.

scholarly journals Off to a good start after a cancer diagnosis: implementation of a time out consultation in primary care before cancer treatment decision

2019 ◽  
Vol 14 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Eveline A. Noteboom ◽  
Niek J. de Wit ◽  
Ingrid J. E. M. van Asseldonk ◽  
Monique C. A. M. Janssen ◽  
Wai Yee Lam-Wong ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Treatment ◽  
Cancer Diagnosis ◽  
Family Physicians ◽  
Treatment Decision ◽  
Added Value ◽  
Structured Interviews ◽  
Time Out ◽  
Almost All ◽  
Care Path

Abstract Purpose Supportive care for cancer patients may benefit from improving treatment decisions and optimal use of the family physicians’ and specialists’ strengths. To improve shared decision-making (SDM) and facilitate continuity of primary care during treatment, a cancer care path including a “time out consultation” (TOC) in primary care before treatment decision, was implemented. This study assesses the uptake of a TOC and the added value for SDM. Methods For patients with metastatic lung or gastro-intestinal cancer, a TOC was introduced in their care path in a southern region of The Netherlands, from April until October 2016. Uptake of a TOC was measured to reflect on facilitation of continuity of primary care. The added value for SDM and overall experiences were evaluated with questionnaires and semi-structured interviews among patients, family physicians, and specialists. Results Of the 40 patients who were offered a TOC, 31 (78%) had a TOC. Almost all patients, family physicians, and specialists expressed that they experienced added value for SDM. This includes a stimulating effect on reflection on choice (expressed by 83% of patients) and improved preparation for treatment decision (75% of patients). Overall added value of a TOC for SDM, only evaluated among family physicians and specialists, was experienced by 71% and 86% of these physicians, respectively. Conclusion and Implications for Cancer Survivors The first experiences with a TOC in primary care before cancer treatment decision suggest that it may help to keep the GP “in the loop” after a cancer diagnosis and that it may contribute to the SDM process, according to patients, family physicians, and specialists.

Limited engagement in, yet clear preferences for advance care planning in young-onset dementia: An exploratory interview-study with family caregivers

2019 ◽  
Vol 33 (9) ◽  
pp. 1166-1175 ◽  
Author(s):  
Romy Van Rickstal ◽  
Aline De Vleminck ◽  
Melissa D Aldridge ◽  
Sean R Morrison ◽  
Raymond T Koopmans ◽  
...  
Keyword(s):  
Family Caregivers ◽  
Advance Care Planning ◽  
Quality Care ◽  
Third Party ◽  
Care Planning ◽  
Structured Interviews ◽  
Young Onset ◽  
People With Dementia ◽  
Advance Care ◽  
Young Onset Dementia

Background: The significance of advance care planning in dementia is widely acknowledged. Despite the suggestion that younger people with dementia and their family might have distinct needs and preferences in this area, studies on advance care planning in young-onset dementia are absent. Aim: We aim to explore (1) whether family caregivers had already engaged in advance care planning with patients and/ or professionals and the accompanying reasons and (2) family caregivers’ preferences for how to ideally engage in the process with patients, family and professionals. Design: A qualitative study was conducted: we analysed semi-structured interviews ( n = 15) through the method of constant comparative analysis. Setting/participants: We included Flemish family caregivers of persons with young-onset dementia. Results: Plans for the future typically concerned non-medical affairs. Participants’ limited engagement in advance care planning was clarified through several reasons: not considering it useful, hindering patient behaviour, adopting a day-to-day attitude, caregivers emotionally protecting themselves and uncertainty about patients’ cognitive competence. However, endorsement for advance care planning showed from respondents’ preferences that it should be initiated timely, by a third party, and emphasize patients’ remaining capacities. Finally, the need for information and high-quality care emerged. Conclusion: A gap of knowledge, of information and in care intertwiningly hinder advance care planning. In young-onset dementia, engaging in advance care planning is not an option equally accessible as not doing so. Policy makers, institutions and professionals could reflect on their responsibility in providing these patients and caregivers an actual choice to engage in advance care planning or not.

scholarly journals Professional Development of Code and Robotics Teachers Through Small Private Online Course (SPOC): Teacher Centrality and Pedagogical Strategies for Developing Computational Thinking of Students

2020 ◽  
pp. 073563312097343
Author(s):  
Shlomit Hadad ◽  
Tamar Shamir-Inbal ◽  
Ina Blau ◽  
Eynat Leykin
Keyword(s):  
Professional Development ◽  
Computational Thinking ◽  
Added Value ◽  
Independent Learning ◽  
Online Course ◽  
Structured Interviews ◽  
Pedagogical Strategies ◽  
Teacher Professional ◽  
One Year ◽  
And Robotics

This study explored (1) pedagogical strategies in Educational Coding and Robotics (ECR) learning which can develop computational thinking of students and (2) the degree of teacher centrality in the ECR classroom. In addition, we investigated (3) the added value of the Small Private Online Course (SPOC) to teacher professional development (TPD). We analyzed reflections of 80 in-service teachers on TPD through the SPOC (1,091 statements) and conducted semi-structured interviews with 13 of them one year after completing the course and teaching ECR in the classroom (328 statements). The most prominent strategies immediately after the TPD were constructing learning experiences, tinkering & debugging, and interdisciplinary learning, while one year later, experiential learning and collaborative learning were more common. Regarding the degree of teacher centrality, a year after teaching ECR curriculum the teachers had a significantly higher percentage of statements reflecting their role as a guide-on-the-side and as a partner of students in the learning process. Regarding the contribution of the SPOC for TPD, teacher statements revealed significantly more benefits than challenges in both points of time. Interestingly, the same categories emerged bottom-up as benefits and challenges: a variety of control dimensions, independent learning, learning and knowledge management and collaboration. Implications for educational theory and ECR practice are discussed.

scholarly journals Patients’ experiences with the advanced practice nurse role in Swiss family practices: a qualitative study

BMC Nursing ◽  
2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Nicole Schönenberger ◽  
Beat Sottas ◽  
Christoph Merlo ◽  
Stefan Essig ◽  
Stefan Gysin
Keyword(s):  
Patient Perspective ◽  
Qualitative Content Analysis ◽  
Core Competencies ◽  
Holistic Approach ◽  
Well Being ◽  
Added Value ◽  
Advanced Practice ◽  
Structured Interviews ◽  
Practice Nurses ◽  
Family Practices

Abstract Background Considering shortages of general practitioners (GP) and strategies for improving the quality of health care provision, many countries have implemented interprofessional care models with advanced practice nurses (APN). International evidence suggests that APN care results in high patient satisfaction. In Switzerland, the role is still new, and the patient perspective has not yet been researched. Our aim was therefore to explore patients’ experiences with the APN role in Swiss family practices. Methods We conducted 22 semi-structured interviews in four different family practices with patients aged 18 to 97 suffering from minor acute to multiple chronic diseases, and who had at least one consultation with an APN. All interviews were audiotaped, transcribed verbatim, and analysed using qualitative content analysis. Results The analysis resulted in five themes: Despite the unfamiliarity, all patients were willing to be consulted by an APN because it was recommended by their GP (1); after several encounters, most participants perceived differences between the APN and the GP consultation in terms of the length and style of the consultations as well as the complexity of their tasks (2); the interviewees emphasised coaching, guidance, care coordination, and GP-assisting tasks as APN core competencies and attributed the characteristics empathetic, trustworthy, and competent to the APN role (3); most patients especially valued home visits and the holistic approach of the APNs, but they also noticed that in certain cases GP supervision was required (4); and due to the close collaboration between the APN and the GP, patients felt safe, well cared for and experienced improvements in physical and psychological well-being as well as in daily activities (5). Conclusion Our results suggested that patients value the APNs’ competencies, despite their initial lack of role knowledge. Trust in the GP seemed to be the most important factor for patients’ receptiveness toward the APN role. Overall, patients perceived an added value due to the enlargement of the scope of practice offered by APNs. The patient perspective might provide valuable insights for further APN role implementation in Swiss family practices.

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