scholarly journals Acceptability and Perceptions of Generic Drugs among Patients, Pharmacists, and Physicians

2020 ◽  
pp. 40-47
Author(s):  
Krupali Patel ◽  
Sandul Yasobant ◽  
Jaykaran Charan ◽  
Mayur Chaudhari ◽  
Abhay Gaidhane ◽  
...  
Keyword(s):  
Side Effects ◽  
Thematic Analysis ◽  
Generic Drugs ◽  
Poor People ◽  
Key Informant ◽  
Branded Drugs ◽  
Facilitators And Barriers ◽  
The Cost ◽  
The Impact ◽  
Decision Power

Background: Generic drugs are the painstaking solution to deal with out of pocket expenditure however, the impact has not yet been seen in India. Thus, to understand the facilitators and barriers, this study aimed to gather evidence on the perception of the acceptability of generic drugs among patients, pharmacists, and physicians. Methods: The key informant interviews (KII) were conducted during 2017-2018 in Gujarat, India. A total of 25 (9 patients, 8 pharmacists, 8 physicians) KIIs were included in the thematic analysis. Results: Most of the patients knew about cheaper drugs are available in the market, but they perceived that those meant for poor people. Pharmacists talked about the profit from branded drugs are higher than generics. Pharmacist and doctors expressed concern for the efficacy of generic drugs, as it requires more visits to hospitals. Patients usually report more side effects if using generic drugs, apart from that poor packaging and lack of trust on generic also remained an issue in terms of satisfaction. Pharmacist and patients are both expressed their reliance on doctors suggestion and prescription; however, doctors are really not in favour to prescribe generics. The ethical dilemma remained with the pharmacists in not suggesting generics as an alternative to the branded drugs. Conclusion: The study concludes that cost is the main perception of patients, pharmacists, and physicians, however; the decision power lies with the pharmacist and doctors, which is mainly not in favour to use or promote the generic drugs even if the cost is low because of efficacy and satisfaction issues.

scholarly journals Cost Minimisation Study of the Impact of Generic Drugs on Glaucoma Management: 1-year Indian Experience

1970 ◽  
Vol 12 (4) ◽  
pp. 192-196
Author(s):  
Devindra Sood ◽  
Alka Pandey ◽  
Rajeev Sood ◽  
Nagesh Gupta ◽  
Ravinder Kumar Bajaj ◽  
...  
Keyword(s):  
Generic Drugs ◽  
Open Angle Glaucoma ◽  
Eye Drops ◽  
Brand Name ◽  
Cost Difference ◽  
Medication Costs ◽  
Generic Medications ◽  
The Mean ◽  
The Cost ◽  
The Impact

Aim: To study the medication costs of various topical glaucoma medications using data collected from real world use by patients.Methods: Patients with primary open angle glaucoma treated at glaucoma clinics in 5 hospitals (1 rural and 4 urban) in northern India from 1 January to 30 June 2008 were enrolled. The number of days each bottle of medication lasted was recorded, and the mean cost per day was computed from the maximum retail price and mean number of days each medication lasted.Results: 790 of 801 eligible patients completed the study. The mean number of days that a bottle of medication lasted was found to be highest for Xalatan® and Xalacom® at 35.23 days and 35.00 days, respectively. The brand name prostaglandin analogues all lasted for a mean of more than 30 days: Xalatan, 35.23 days (SD, 4.14 days); Lumigan®, 31.37 days (SD, 5.31 days); and Travatan®, 34.84 days (SD, 6.51 days), while the generic eye drops lasted for about 21 days: latanoprost, 20.69 days (SD, 3.69 days) and bimatoprost, 21.39 days (SD, 4.34 days). The cost of the generic medication was less than the brand name medication in all groups (for example, bimatoprost, Indian rupees 9.76 versus Indian rupees 12.33) except for brimonidine/timolol (Indian rupees 8.73 versus Indian rupees 8.66). Further analysis in 2009 showed that, for latanoprost, brimonidine and brimonidine/timolol, the difference between the brand name and generic medications decreased in 2009 over 2008 (in the latanoprost group, the cost difference over the year reduced from Indian rupees 592 in 2008 to Indian rupees 523 in 2009); the cost difference for bimatoprost increased from 2008 to 2009.Conclusion: When both cost and number of days a bottle lasts were considered over the long term, use of generic medications might not minimise the cost of glaucoma medical management by much when compared with the brand name medication.

scholarly journals The impact of visa status and Medicare eligibility on people diagnosed with HIV in Western Australia: a qualitative report

Sexual Health ◽  
2012 ◽  
Vol 9 (5) ◽  
pp. 407 ◽  
Author(s):  
Susan Herrmann ◽  
Joan Wardrop ◽  
Mina John ◽  
Silvana Gaudieri ◽  
Michaela Lucas ◽  
...  
Keyword(s):  
Side Effects ◽  
Generic Drugs ◽  
Health Sector ◽  
Antiretroviral Drugs ◽  
Access To Treatment ◽  
Hiv Serostatus ◽  
Permanent Residency ◽  
The Impact ◽  
Permanent Residents ◽  
Rate Of Response

Background: In Australia, temporary visa holders are ineligible for Medicare and subsidised antiretroviral drugs. Additionally, HIV testing is not mandatory for visas unless applicants seek work in the health sector. We sought to understand the impact of HIV and issues of access and adherence to antiretroviral therapy (ART) in people holding temporary visas and permanent residents. Methods: Data were gathered from interviews with 22 participants. Information concerning medication adherence, side effects, CD4 T-cell count, viral load and rate of response to generic drugs were collected. Results: The mean age was 33.4 years (±s.d. = 6.0), 21 out of 22 were from HIV-prevalent areas in East Africa and Asia, 14 out of 22 were on temporary visas, 12 were ineligible for Medicare, 14 out of 22 were diagnosed during health screening, 19 out of 22 risk exposures were in country of origin, 8 out of 17 were taking generic ART at an average cost of $180 per month, adherence was excellent and self-reported side-effects were relatively infrequent. Participants applying for visa continuations and permanent residency were fearful, believing their HIV serostatus would prejudice their applications. Patients cited belief in ART efficacy, were motivated to maintain therapy and were anxious about lack of access to treatment in their countries of origin. Conclusion: Adherence to antiretroviral drugs in Medicare-ineligible HIV-infected individuals is excellent despite limited access to treatment. The threat of visa non-renewal and the likely failure of applications for permanent residency result in considerable anxiety and confidentiality concerns.

scholarly journals What is the impact of giant cell arteritis on patients’ lives? A UK qualitative study

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e017073 ◽  
Author(s):  
Jennifer Liddle ◽  
Roisin Bartlam ◽  
Christian D Mallen ◽  
Sarah L Mackie ◽  
James A Prior ◽  
...  
Keyword(s):  
Side Effects ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Thematic Analysis ◽  
Treatment Goals ◽  
Telephone Interviews ◽  
Everyday Lives ◽  
Future Loss ◽  
The Impact ◽  
Inductive Thematic Analysis

ObjectivesClinical management of giant cell arteritis (GCA) involves balancing the risks and burdens arising from the disease with those arising from treatment, but there is little research on the nature of those burdens. We aimed to explore the impact of giant cell arteritis (GCA) and its treatment on patients’ lives.MethodsUK patients with GCA participated in semi-structured telephone interviews. Inductive thematic analysis was employed.Results24 participants were recruited (age: 65–92 years, time since diagnosis: 2 months to >6 years). The overarching themes from analysis were: ongoing symptoms of the disease and its treatment; and ‘life-changing’ impacts. The overall impact of GCA on patients’ lives arose from a changing combination of symptoms, side effects, adaptations to everyday life and impacts on sense of normality. Important factors contributing to loss of normality were glucocorticoid-related treatment burdens and fear about possible future loss of vision.ConclusionsThe impact of GCA in patients’ everyday lives can be substantial, multifaceted and ongoing despite apparent control of disease activity. The findings of this study will help doctors better understand patient priorities, legitimise patients’ experiences of GCA and work with patients to set realistic treatment goals and plan adaptations to their everyday lives.

Abstract 616: The Population Impact and Cost-Effectiveness of Blood Pressure Treatment in U.S. Adults Age 75 and Older

Hypertension ◽  
2013 ◽  
Vol 62 (suppl_1) ◽  
Author(s):  
Michelle C Odden ◽  
Pamela Coxson ◽  
Andrew Moran ◽  
David Guzman ◽  
Lee Goldman ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cost Effectiveness ◽  
Side Effects ◽  
Systolic Blood Pressure ◽  
Blood Pressure Target ◽  
Blood Pressure Treatment ◽  
Artery Disease ◽  
The Cost ◽  
The Impact ◽  
The U.S

Introduction: In the next 30 years, the population of adults 75 years and older will more than double in the U.S., and high blood pressure is the most prevalent cardiovascular risk factor in this population. The impact of strategies for blood pressure control has not been evaluated in this population with special consideration of geriatric conditions that may alter the cost-effectiveness. Methods: Based on the Cardiovascular Disease Policy Model, a Markov model of the U.S. population, we forecasted the population impact of blood pressure treatment over 10 years in adults aged 75-94 years, using the health care system perspective, and assuming an annual discount rate of 3%. Based on epidemiologic and trial data, we projected the impact of four potential negative events on cost-effectiveness in this geriatric population: 1) mild side effects, 2) polypharmacy (use of 5+ medications) associated cognitive impairment, 3) increased risk of falls/fracture, and 4) attenuated effectiveness of therapy in frail older adults Results: We project that treatment to a systolic blood pressure target of 160 mmHg would result in the prevention of 65,000 cases of incident coronary artery disease, and 54,000 cases of incident ischemic stroke in adults 74-95 years. Based on a systolic blood pressure target of 140 mmHg, 191,000 cases of incident coronary artery disease, and 141,000 cases of incident ischemic stroke would be avoided. This would result in 729,000 additional years of life and 992,000 quality-adjusted life years (QALYs). The total health care costs of treating 75-94 year olds to a systolic blood pressure target of 140 mmHg would be $40.5 billion in the U.S., and the cost per QALY would be $40,800. The cost-effectiveness of treatment to a target of 140 mmHg would be worse in the presence of side effects ($ 51,000/QALY), polypharmacy ($ 58,400), fractures ($ 48,400), or frailty ($134,300). Conclusions: Treatment of systolic blood pressure to a target of 140 mmHg would prevent the most cardiovascular events and result in the greatest QALYs gained. The presence of side effects, polypharmacy-related cognitive impairment, fractures, or frailty could substantially offset this benefit. Treatment strategies that are tailored to the health status of older adults are warranted.

Interventions to Reduce the Impact of Client Death on Home Care Aides: Employers’ Perspectives

2021 ◽  
pp. 073346482198985
Author(s):  
Emma K. Tsui ◽  
Emily Franzosa ◽  
Jennifer M. Reckrey ◽  
Marita LaMonica ◽  
Verena R. Cimarolli ◽  
...  
Keyword(s):  
New York ◽  
Home Care ◽  
Job Insecurity ◽  
Future Research ◽  
Supportive Services ◽  
Key Informant ◽  
Care Aides ◽  
Facilitators And Barriers ◽  
The Impact ◽  
Agency Action

For home care agencies and aides, the death of clients has important, yet often unrecognized, workforce implications. While research demonstrates that client death can cause grief and job insecurity for aides, we currently lack home care agencies’ perspectives on this issue and approaches to addressing it. This study uses key informant interviews with leaders from a diverse sample of eight New York City home care agencies to explore facilitators and barriers to agency action. We found that agencies engaged primarily in a range of informal, reactive practices related to client death, and relatively few targeted and proactive efforts to support aides around client death. While leaders generally acknowledged a need for greater aide support, they pointed to a lack of sustainable home care financing and policy resources to fund this. We recommend increased funding to support wages, paid time off, and supportive services, and discuss implications for future research.

Impact of Side-Effects of Atypical Antipsychotics on Non-Compliance, Relapse and Cost

2003 ◽  
Vol 31 (3) ◽  
pp. 188-196 ◽  
Author(s):  
A Mortimer ◽  
P Williams ◽  
D Meddis
Keyword(s):  
Side Effects ◽  
Side Effect ◽  
Atypical Antipsychotics ◽  
Antipsychotic Agents ◽  
Conventional Antipsychotics ◽  
State Transition Model ◽  
Cost Implications ◽  
The Cost ◽  
The Impact ◽  
Relapse Rates

Atypical antipsychotics generally have milder side-effects than conventional antipsychotics, but also differ among themselves in this respect. This study aimed to compare the impact of different side-effect profiles of individual atypical antipsychotics on non-compliance, relapse and cost in schizophrenia. A state-transition model was built using literature data supplemented by expert opinion. The model found that quetiapine and ziprasidone were similar in estimated non-compliance and relapse rates. Olanzapine and risperidone had higher estimated non-compliance and relapse rates, and incremental, 1-year, per-patient direct costs, using US-based cost data, of ~$530 (95% confidence interval [CI] ~$275, $800), and ~$485 (95% CI ~$235, $800), respectively, compared with quetiapine. Incremental costs attributable to different side-effect profiles were highly significant. This study shows that differing side-effect profiles of the newer antipsychotic agents are likely to lead to different compliance rates, and consequent variation in relapse rates. The cost implications of these heterogenous clinical outcomes are substantial.

scholarly journals Barriers and facilitators to weight management in overweight and obese women living in Australia with PCOS: a qualitative study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Siew Lim ◽  
Caroline A. Smith ◽  
Michael F. Costello ◽  
Freya MacMillan ◽  
Lisa Moran ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Management ◽  
Thematic Analysis ◽  
Lifestyle Modification ◽  
Lifestyle Changes ◽  
Future Research ◽  
Presenting Symptoms ◽  
Wide Range ◽  
Facilitators And Barriers ◽  
The Impact

Abstract Background Lifestyle modification targeting weight management is the first-line treatment for women with Polycystic Ovary Syndrome (PCOS) regardless of presenting symptoms. Women with PCOS are more likely to gain more weight compared with women without PCOS, which may be related to barriers in engaging in lifestyle modification. The aim of this study is to explore the experience of women with PCOS in weight management and to determine the facilitators and barriers to lifestyle modifications in women with PCOS. Methods Ten women with PCOS participated in focus groups and semi-structured telephone interviews on lifestyle and weight management in PCOS. Discussions were audio-recorded and transcribed verbatim. Thematic analysis of the transcripts was conducted. Thematic analysis of the transcripts were conducted using the method of constant comparison. Results Women in the current study attempted a wide range of weight loss interventions, but had difficulties losing weight and preventing weight regain. Women felt that having PCOS affected their ability to lose weight and to keep it off. Facilitators to lifestyle modification for weight management were reported as structured approaches such as having balanced meals and support by health professionals, peers, friends or family. Barriers to lifestyle changes in women with PCOS included logistical barriers such as time and cost, motivational barriers including tiredness or feeling unrewarded, environmental barriers such as not having access to safe places to exercise, emotional barriers such as having depressive and defeating thoughts, and relational barriers such as having unsupportive partner or prioritising children’s meal preferences. Conclusions Women with PCOS face a number of personal, environmental and social facilitators and barriers to lifestyle modification for weight loss. While many of these are also experienced by women without PCOS, women with PCOS face additional barriers in having low sense of self-confidence and high prevalence of negative thoughts which may impair their ability to maintain efforts in lifestyle modification over the long term. Future research should further explore the impact of the emotional and mental burden of PCOS on the management of weight and other aspects of PCOS. Future lifestyle intervention should also address the psychosocial aspect of PCOS.

The impact of generic drugs on the cost of transplantation medical care

1999 ◽  
Vol 31 (3) ◽  
pp. 31S-34S ◽  
Author(s):  
A.J Olyaei ◽  
A.M deMattos ◽  
W.M Bennett
Keyword(s):  
Medical Care ◽  
Generic Drugs ◽  
The Cost ◽  
The Impact

Demonstrating Nutrient Cost Gradients: A Brooklyn Case Study

2014 ◽  
Vol 84 (5-6) ◽  
pp. 244-251 ◽  
Author(s):  
Robert J. Karp ◽  
Gary Wong ◽  
Marguerite Orsi
Keyword(s):  
Low Income ◽  
Energy Content ◽  
Food Selection ◽  
The United States ◽  
United States Department ◽  
Micronutrient Deficiencies ◽  
Caloric Density ◽  
Low Income Families ◽  
The Cost ◽  
The Impact

Abstract. Introduction: Foods dense in micronutrients are generally more expensive than those with higher energy content. These cost-differentials may put low-income families at risk of diminished micronutrient intake. Objectives: We sought to determine differences in the cost for iron, folate, and choline in foods available for purchase in a low-income community when assessed for energy content and serving size. Methods: Sixty-nine foods listed in the menu plans provided by the United States Department of Agriculture (USDA) for low-income families were considered, in 10 domains. The cost and micronutrient content for-energy and per-serving of these foods were determined for the three micronutrients. Exact Kruskal-Wallis tests were used for comparisons of energy costs; Spearman rho tests for comparisons of micronutrient content. Ninety families were interviewed in a pediatric clinic to assess the impact of food cost on food selection. Results: Significant differences between domains were shown for energy density with both cost-for-energy (p < 0.001) and cost-per-serving (p < 0.05) comparisons. All three micronutrient contents were significantly correlated with cost-for-energy (p < 0.01). Both iron and choline contents were significantly correlated with cost-per-serving (p < 0.05). Of the 90 families, 38 (42 %) worried about food costs; 40 (44 %) had chosen foods of high caloric density in response to that fear, and 29 of 40 families experiencing both worry and making such food selection. Conclusion: Adjustments to USDA meal plans using cost-for-energy analysis showed differentials for both energy and micronutrients. These differentials were reduced using cost-per-serving analysis, but were not eliminated. A substantial proportion of low-income families are vulnerable to micronutrient deficiencies.

The Perspective of Older Men With Depression on Suicide and Its Prevention in Primary Care

Crisis ◽  
2018 ◽  
Vol 39 (5) ◽  
pp. 397-405 ◽  
Author(s):  
Steven Vannoy ◽  
Mijung Park ◽  
Meredith R. Maroney ◽  
Jürgen Unützer ◽  
Ester Carolina Apesoa-Varano ◽  
...  
Keyword(s):  
Primary Care ◽  
Low Socioeconomic Status ◽  
Thematic Analysis ◽  
Older Men ◽  
Primary Care Providers ◽  
Depression Treatment ◽  
Care Providers ◽  
Low Socioeconomic ◽  
Self Image ◽  
The Impact

Abstract. Background: Suicide rates in older men are higher than in the general population, yet their utilization of mental health services is lower. Aims: This study aimed to describe: (a) what primary care providers (PCPs) can do to prevent late-life suicide, and (b) older men's attitudes toward discussing suicide with a PCP. Method: Thematic analysis of interviews focused on depression and suicide with 77 depressed, low-socioeconomic status, older men of Mexican origin, or US-born non-Hispanic whites recruited from primary care. Results: Several themes inhibiting suicide emerged: it is a problematic solution, due to religious prohibition, conflicts with self-image, the impact on others; and, lack of means/capacity. Three approaches to preventing suicide emerged: talking with them about depression, talking about the impact of their suicide on others, and encouraging them to be active. The vast majority, 98%, were open to such conversations. An unexpected theme spontaneously arose: "What prevents men from acting on suicidal thoughts?" Conclusion: Suicide is rarely discussed in primary care encounters in the context of depression treatment. Our study suggests that older men are likely to be open to discussing suicide with their PCP. We have identified several pragmatic approaches to assist clinicians in reducing older men's distress and preventing suicide.

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