Reimbursement models to tackle market failures for antimicrobials: Approaches taken in France,Germany, Sweden,the United Kingdom,and the United States

IntroductionThe pipeline of new antibacterials remains limited. Reasons include low research investments, limited commercial prospects, and scientific challenges. To complement existing initiatives such as research grants, governments are exploring policy options for providing new market incentives to drug developers.Materials and methodsReimbursement interventions for antibacterials in France, Germany, Sweden, US, and UK were reviewed and analysed by the authors.ResultsIn France, Germany, and the US, implemented interventions centre on providing exceptions in cost-containment mechanisms to allow higher prices for certain antibacterials. In the US, also, certain antibacterials are granted additional years of protection from generic competition (exclusivity) and faster regulatory review. The UK is piloting a model that will negotiate contracts with manufacturers to pay a fixed annual fee for ongoing supply of as many units as needed. Sweden is piloting a model that will offer manufacturers of selected antibacterials contracts that would guarantee a minimum annual revenue. A similar model of guaranteed minimal annual revenues is under consideration in the US (PASTEUR Act).ConclusionsThe UK and Sweden are piloting entirely novel procurement and reimbursement models. Existing interventions in the US, France, and Germany represent important, but relatively minor interventions. More countries should explore the use of novel models and international coordination will be important for ‘pull’ incentives to be effective. If adopted, the PASTEUR legislation in the US would constitute a significant ‘pull’ incentive.     

DRG在深圳市某区临床重点专科评估中的应用

目的评价并遴选深圳市某区临床重点专科,为该区临床重点专科的发展以及我国临床重点专科的评估提供借鉴。方法将DRG相关指标与传统指标相结合作为该区临床重点专科评估指标体系,运用TOPSIS法计算该区11家医院41个临床专科2016—2018年的总排名。结果该区排名前5位的临床重点专科分别是I医院显微外科、J医院产科、K医院鼻科、K医院耳鼻咽喉科以及D医院骨科,排名后5位的专科分别是H医院风湿病科、D医院泌尿外科、C医院儿科、C医院眼耳鼻喉科以及F医院神经外科。结论该区应加快重点专科发展,形成区域专科优势;促进专科均衡发展,满足基本医疗需求;提高专科服务效率,优化医疗资源配置;依托医疗集团做强专科特色品牌,促进专科差异化发展;进一步提高病历首页质量管理水平。     

Examining community pharmacists’ intention to provide pharmacist-driven vaccination services: A structural equation modelling

BackgroundThe evidence of pharmacists' current involvement in vaccination services in low- and middle-income countries (LMICs) is uncertain. This study would be a first step to develop vaccination services by investigating community pharmacists’ intention to be involved in PDV services not just during COVID-19 pandemic but also during standard service provision in Turkey which can be taken as an example across LMICs.ObjectiveConsidering the efforts to empower community pharmacists in service provision, the goal of the present study was to develop a structural equation model to explain the “Pharmacist-Driven Vaccination Service Intention Model (PDV-SIM)” by using the theory of planned behavior (TPB).MethodsBased on the constructs of TPB, a measurement tool was developed. Sub-factors of PDV service intention was determined by conducting exploratory factor analysis (EFA). In the second step, confirmatory factor analysis (CFA) was conducted to prove the theoretical structure of the tool. Finally, a model explaining the relationship between observed variables, latent constructs from TPB was developed by SEM analysis.ResultsIn the proposed PDV-SIM, patient related attitude toward PDV services, attitude toward negative consequences of PDV services, and subjective norm about PDV services had an impact on the behavioral intention of community pharmacists. Nevertheless, professional development attitude toward PDV services and perceived behavioral control were not evaluated as determinants of the behavioral intention.ConclusionResults of this study revealed that TPB is appropriate for modelling PDV service intention of community pharmacists. This model can be utilized as a guide to potential pharmacy regulatory bodies and policy makers in their efforts to enable community pharmacists as vaccinators across LMICs.     

药物气相色谱分析衍生化方法推荐专家系统的设计与实现

介绍了药物气相色谱分析衍生化方法推荐专家系统。该系统可对分子量小于５００,且分子中含有－ＣＯＯＨ、－ＣＯＯ－、－ＯＨ、－Ｏ＾－、－ＮＨ２（包括Ｒ－２、＝ＣＯＮＨ２、－ＳＯ２ＮＨ２）、ＮＨ（包括Ｒ１ＮＨＲ２、－ＣＯＮＨＲ、－ＣＯＮＨＳＯ２－、－ＳＯ２ＮＨＲ、Ｒ１ＮＨＣＯＮＨＲ２）、Ｒ４Ｎ（＋＋、Ｃ＝、＝ＣＨＯ、－ＳＨ、＝ＳＯ３Ｈ、－ＳＯ３＾－等 有团的药物实现衍生化方法推荐,并能自动调用柱系统推荐子     

Human leukocyte interferon-α in cream,for the treatment of genital warts in asian women a placebo-controlled,double-blind study

The purpose of this double-blind, placebo-controlled study was to determine and compare the clinical efficacy and tolerance of human leukocyte -interferon (incorporated 2 × 10⁶ IU/g) in hydrophilic cream to cure genital warts. Preselected Asian female patients (n=150) aged 18–40 years (mean 22.5), with the clinical and biopsy-confirmed diagnosis of genital warts (mean 2.64), predominantly flat vaginal condylomas, were randomly allocated to 3 parallel groups. Each patient was given a coded tube containing 80 g placebo/active preparation with a graduated applicator. Patients were instructed to inject 6 g of the either alloted placebo/active cream deep into the vagina thrice a day for 3 consecutive days (group A) or 4 consecutive days (group B) per week, and if not cured the same treatment was extended to 3 more weeks (maximum 4 weeks active treatment). To assess the clinical efficacy patients were examined on a week-to-week basis. A total clearance of warts (biopsy-confirmed) was evaluated as a complete cure. Patients cured during the treatment were spared further treatment and were requested to visit us after 16 weeks for relapse control. As for the remaining patients, empty tubes were collected, and similarly coded replacement tubes were given for further treatment (in total 588 tubes were used). By the end of the treatment 57.2% lesions (227/397) were eliminated in all the groups: 48% patients in group A, 90% patients in group B, and 10% patients in placebo groups taken as completely cured. Of the 150 patients 128 (85.3%) did not complain of any drug-related adverse symptoms. Transitory increase in body temperature (mean 38.4°C), accompanied by headache (14.6%) and generalized itching (6.6%) were the most frequently reported side effects; however, treatment was well tolerated by all the patients, and there were no dropouts. Our findings indicate that clinical efficacy is dose dependent, that is, the results of group B were significantly superior to that of group A (P < 0.05). Of the 49.3% cured patients (74/150) followed up for 6 months (monthly basis) seven had a relapse, and none had reinfection. It is concluded that clinical efficacy of leukocyte interferon-a to cure genital warts is dose dependent. These results further support the view that leukocyte interferon-a incorporated in hydrophilic cream can be considered a reliable, safe, and home-based treatment to cure vulvar and vaginal warts.Abbreviation HPV human papillomavirus     

三籽两型豆生长发育特性及栽培技术研究

目的 :探明两型豆的种子萌发、植株生长发育特性及主要栽培技术措施 ,为人工栽培提供依据。方法 :采用室内种子萌发、田间播种观察、光照处理及小区栽培方法。结果 :试验表明地上种子存在硬实现象 ,地下、地上种子播种都能正常出苗、开花、并都结出地上、地下正常发育的种子 ;在河北东部地区 5月初播种 ,九月初开花 ,10月下旬收获 ;两型豆的幼苗属于子叶不出土类型 ;地下种子的发育来自于子叶节部位着生的地下茎及分枝 ;两型豆是耐阴、怕高温的短日照植物 ,短日处理可大幅度提早开花、结实 ;栽培时注意种子处理、遮光、充足土壤水分供应及搭架等措施。结论 :初步明确了三籽两型豆地上、地下种子萌发、植株生长发育等特性和相关栽培技术措施。     

头孢类抗生素国内市场状况

目的为国内制药企业及相关科研单位的品种开发提供参考。方法根据所查阅的文献综述了近年来国内头孢类抗生素品种的发展状况、生产厂家、产量及医院用药情况。结果与结论提供了国内头孢类抗生素的开发品种及最新进展     

对高等中医药院校人才培养的几点看法

高等中医药院校担负着人才培养、科学研究、社会服务的三大职能.对高等中医药院校人才培养要求必须具有必要的西医学基础知识及临床诊疗技能;具有一定的社会人文科学知识和自然科学基础知识;不是单纯的培养中医治疗人才,而是培养为中医药行业服务的各类人才;培养目标与模式应是多样化、多元化.对人才培养应重视以人为本的思想,招生应采取按类招生模式,以充分调动学生的兴趣,发挥学生的个性;减轻学生负担,给其更多的自由空间、更多的课程选择机会;坚持主辅修,为学生开拓发展的空间.人才培养应强调动手能力、创新意识,使学生学会学习,应注重课内与课外相结合;教师的授课要多样化;应重视临床实践能力.     

维生素B_(12)市场透析

目的 :掌握维生素B12 的市场现状及发展趋势。方法 :对维生素B12 国内、外生产和销售情况进行分析。结果与结论 :我国维生素B12 市场潜力巨大 ,制药企业应密切关注市场变化 ,完善自身条件 ,以求进一步发展     

知识管理在我院药学部的应用

目的:探讨知识管理在医院药学部(药剂科)的应用。方法:总结近年来我院药学部关于知识管理的数种模式。结果:我院药学部知识管理已基本成型。结论:通过知识管理,增强了药学部的应变能力和创新能力。