The World Bank's perspective on global health

Over the next 25 years, as populations age and tobacco consumption increases, most developing regions will likely see noncommunicable diseases become the leading causes of disability and premature mortality. The already existing problems of malnutrition and infectious diseases will remain. In this context, the World Bank is examining its role and contribution to global health. From a small start approximately 25 years ago, the Bank has greatly expanded its role in international health, population, and nutrition to become the largest single external financier of health activities in low- and middle-income countries. Many other Bank-supported activities affect health, including poverty reduction, housing, water and sanitation, and the education of girls. The Bank is also increasingly active in health policy debates, publishing numerous studies annually. Most of these studies focus upon specific countries, but some address key issues of concern to many developing countries. This article explains why the Bank continues to expand its resources devoted to health and the rationale for the changing emphasis of its activities in the field.     

Impact of the World Trade Organization TRIPS agreement on the pharmaceutical industry in Thailand.

The 1994 World Trade Organization (WTO) Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) established minimum universal standards in all areas of intellectual property. It is intended to implement these standards globally through a WTO enforcement mechanism. The present article proposes a strategy for alleviating the potentially negative impact of TRIPS in Thailand in relation to the following: purchasers; prescribers and dispensers; producers; products; price control; patent-to-third-party; parallel imports; power of the customer; patentable new drugs; personnel; and prevention policies. The following TRIPS provisions are pertinent to the pharmaceutical industry in Thailand: the limited term of product and process patents; the conditions of protection; and the broad scope for compulsory licensing and enforcement procedures in the national patent system.     

世界卫生组织国家药品报告监测指标的制定和评价

1999年以来,世界卫生组织每4年开展一次全球药品部门调查,并计划改进监测指标后于2011年开展全球第4次调查,中国是全球13个试点监测国家之一。此项工作对推动我国基本药物政策的实施、做好改革的定期监测和评价工作具有深远意义,可为科学决策提供循证依据。本文主要介绍了世界卫生组织三个层次水平的监测指标、全球和欧盟国家的监测进展情况以及国家药品报告的具体做法等。     

Technology policy and planning in the Third World pharmaceutical sector: the Cuban and Caribbean community approaches

There has been growing international concern over many aspects of the use and flow of medicines in developing countries. This article briefly reviews factors which have contributed to problems in this area including marketing and promotional practices of the pharmaceutical companies, rising drug import costs, and the unsuitability or poor quality of available drugs. This analysis is primarily concerned with policies that have emerged from efforts to alleviate such problems, to increase control over multinational drug companies, and to bring about changes in the technology transaction processes and in the pharmaceutical sector. It focuses on two cases: the regional cooperation scheme of the Caribbean countries (CARICOM) and the national-level policy of Cuba. It is shown that the CARICOM strategy has significant limitations, primarily due to its voluntary nature and lack of enforcement mechanisms for member countries. On the other hand, the Cuban approach has brought about positive effects and progressive changes, made through political commitment to achieve social benefits, and in conjunction with integrated broad reforms of the entire health system within a socialist framework. Thus, the problems and promises of such strategies are viewed in a context which emphasizes the prevailing forces of the global political economy. The lessons from this study, applicable to other developing countries, not only reveal important measures for the pharmaceutical sector, but also stress the ultimate need for strong commitment to enforce policies at the national level and for major structural changes, in order to adequately meet the health and medical needs of the people.     

The World Bank, pharmaceutical policies, and health reforms in Latin America.

Health care systems spend a relatively high percentage of their resources on the purchase of medicines, and the poor spend a disproportionate amount of their income on pharmaceuticals. There is ample evidence in the literature that drugs are very poorly used. World Bank-led health reforms aim at improving equity, efficiency, quality, and users' satisfaction, and it will be difficult to achieve these goals without making medicines accessible and affordable. The purpose of this article is to examine the adequacy of World Bank pharmaceutical policies, as recommended in various Bank documents, for Latin America and to examine the implementation of the policy recommendations. The authors found that the World Bank identified and recommended a set of pharmaceutical policies that matched the needs of the region. But, as revealed through fieldwork and a review of the literature, the recommended pharmaceutical interventions were left out of the health reforms, and most of the loans that included pharmaceutical interventions allocated funds only to the purchase of drugs. The authors formulate four hypotheses that may explain the lack of congruence between the recommended policies and the strategies financed by World Bank health reform loans to the Latin American region.     

我国制药产业市场势力解析

本文根据产业组织学中的市场势力理论，从需求弹性、市场结构、纵向合谋以及制度层面等多个角度分析了我国制药产业市场势力的成因，继而根据静态和动态效率理论判断该产业市场势力对资源配置效率和产业动态发展的负面影响，并相应提出制药产业规制建议。     

国际单克隆抗体研究文献分析

目的通过比较分析1999—2008年单克隆抗体主要研究国家和机构的科研产出及单克隆抗体的研究领域、热点等,为科研工作者和科研管理者提供参考。方法利用文献计量学方法,对WebofScience（SCIE）收录的单克隆抗体论文的时间、国家、机构、期刊进行分析;同时结合共词分析、聚类分析和可视化分析方法,对单克隆抗体研究有关的论文开展主题分析。结果SCIE收录单克隆研究文献50357篇,美国在文献数量和质量上遥遥领先,中国与美国等发达国家差距较大;单克隆抗体研究属多学科交叉领域,CD40分子、EGFR等是当前研究的热点。结论中国应加大单克隆抗体资金投入,加强与顶级科研院所的交流合作,紧跟研究热点,提高自主创新能力。     

Analysis of a pharmaceutical risk sharing agreement based on the purchaser's total budget

Many public and private healthcare payers use formularies as a tool for controlling drug costs and quality. Although the price per dose is often negotiated as part of the formulary listing, payers may still face unlimited financial risk if demand is much greater than expected at the time of listing. The requirement for drug manufacturers to submit a budget impact analysis as part of the drug approval process suggests that payers are concerned not only with the cost effectiveness of a proposed drug but also with the potential increase in total expenditures that may result from new formulary listings. In this paper we define and analyze a model for financial risk sharing based on the total budget. Our analysis focuses on optimal decision making by manufacturers in the presence of a specific risk sharing agreement. We derive a manufacturer's optimal statement of budget impact and discuss several properties of the optimal solution.     

我国药品价格调整政策分析：1997—2011年

目的：为全面认识和分析药品价格管理政策提供技术支持。方法：回顾分析了1997年至2011年7月政府针对药品价格的28次调整规定中所涉及的药品种类,利用EXCEL和SPSS17.0统计分析了各类别对应的药品品种数目、调价频率位于前列的部分药品以及其调价幅度等指标。结果：调价药品品种主要集中于抗菌药物、心血管药物、抗肿瘤药物等临床常用和售价相对较高的药品;调价药品所涉及的剂型和规格也为临床常用剂型规格;调价方式主要以降价为主,也有少部分药物的价格略有提升;大多数药物的降价幅度较大,其中对于仿制药的降幅较单独定价药品要大;对于中成药的调价覆盖面广。结论：政府应加强对中药材价格的监管力度;药品价格政策的制定及实施应全面考虑相关利益团体的综合权益,以保证该项政策进入良性运转的轨道。     

药事服务与药事服务费的关系研究

新医改方案指出增设药事服务费,逐步取消药品加成政策.药事服务与药事服务费之间存在相辅相成的关系,药事服务费是弥补药事服务成本的合理途径,是促进药事服务水平提升的必然手段.     

The view of the pharmaceutical industry

Rhône-Poulenc Rorer has committed itself to the development of artemether because we believe the drug will be of considerable benefit to sufferers from severe falciparum malaria, and because it is a stable, effective and economical compound that can be given by intramuscular injection. The quality of the pharmaceutical product meets international regulatory standards. Artemether is unlikely to yield big profits, but we believe that major pharmaceutical companies have a responsibility to develop such much-needed products. To develop this project further, we will need the assistance of academic institutions, research organizations and international bodies.     

世界各国主要医疗保障模式比较分析

世界上共有 4种主要的医疗保障模式 :普遍医疗型、社会保险型、市场主导型和储蓄基金型。普遍医疗保障制度由国家承担医疗保障的绝大部分责任 ,以英国、瑞典、原苏联、东欧国家为代表。社会保险型指主要通过实施社会医疗保险制度实现对居民的医疗保障 ,以德国为代表 ,欧洲许多国家、日本、韩国、及台湾等均采用这种模式。市场主导型特指主要依靠私营保险的形式实现对居民的医疗保障 ,美国是该模式的典型代表。储蓄基金型以新加坡为代表 ,指主要通过强制性储蓄积累方式满足居民的医疗保障需求。下面分别以英国、德国、美国、新加坡为例 ,对 4…     

Perspectives on the pharmaceutical industry

This paper seeks to provide an economic perspective on the pharmaceutical industry, which has come under increasing criticism on a number of issues. In the main, that criticism amounts to a rather ineffective flailing at the supply side of the market for pharmaceutical products-much of it based on inaccurate perceptions-when a more productive policy would be to strengthen the hitherto weak and poorly informed demand side of the market.